Cognitive and affective predictors of rehabilitation participation after stroke.
OBJECTIVE
To examine associations between cognitive and affective impairments and rehabilitation participation during stroke rehabilitation.


METHODS
Secondary analyses of stroke patients who received acetylcholinesterase inhibitors during inpatient rehabilitation.


METHODS
University-affiliated inpatient rehabilitation facilities.


METHODS
Patients (N=44) admitted to inpatient stroke rehabilitation with impairment in attention, memory, or executive functions.


METHODS
Secondary analysis of patients receiving inpatient stroke rehabilitation care plus random assignment to one of two acetylcholinesterase inhibitors or no drug at rehabilitation admission.


METHODS
Correlations between measures of cognitive (Digit Span, Hopkins Verbal Learning Test, Executive Interview) and affective impairments (Hamilton Rating Scale for Depression, Apathy Evaluation Scale) and participation (Pittsburgh Rehabilitation and Participation Scale) were examined. Significant correlates of participation were examined in a linear multiple regression model.


RESULTS
Executive functions and depressive symptoms were significant correlates of participation. After controlling for baseline disability, executive functions predicted participation, but depressive symptoms did not (F(4,32)=9.35; R(2)=.54, P<.001).


CONCLUSIONS
These findings are an important first step toward understanding potentially modifiable clinical factors that contribute to rehabilitation participation and overall functional status after rehabilitation. A better understanding of cognitive impairment and rehabilitation participation may be used to develop strategies for improving functional outcomes after stroke.
Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, USA.
Elizabeth R
ER
Skidmore
Ellen M
EM
Whyte
Margo B
MB
Holm
James T
JT
Becker
Meryl A
MA
Butters
Mary Amanda
MA
Dew
Michael C
MC
Munin
Eric J
EJ
Lenze
D000368:Aged; D000369:Aged, 80 and over; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology* / Q000628:therapy; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000209:etiology / Q000469:parasitology* / Q000628:therapy; D010349:Patient Compliance; D020521:Stroke / Q000188:drug therapy / Q000523:psychology*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
D002800:Cholinesterase Inhibitors