The Effect of Rehabilitation without Specific Cognitive Rehabilitation on the Improvement of Cognitive Functions in Stroke Patients: Evaluation with Risk Factors

Year 2023, Volume: 5 Issue: 2, 277 - 83, 15.05.2023

İlker Fatih Sarı , Evren Er , İlker İlhanlı , Fazıl Kulaklı , Nurçe Çilesizoğlu Yavuz

https://doi.org/10.37990/medr.1200571

Abstract

Aim: This study aimed to evaluate if rehabilitation without specific cognitive rehabilitation improved cognitive functions in patients who had suffered a stroke more than 1 year ago, and to correlate this finding with risk factors.
Material and Methods: Thirty stroke patients were included in the study. A rehabilitation program was administered to the patients for a total of 30 sessions, 5 days a week. In addition, demographic data of the patients were collected, as well as several risk factors that may impair their cognitive function. The pre-and post-treatment cognitive function of the patients was evaluated using mini-mental state examination (MMSE) and functional independence measure (FIM)-cognitive. With the FIM cognitive evaluation, cognitive functions such as comprehension, expression, social interaction, problem solving, and memory were evaluated. With MMSE, from cognitive functions; orientation, registration, attention and calculation, recall, language, and praxis were evaluated. Pre- and post-treatment motor function was measured by the Brunnstrom motor recovery stage (BMRS). Pre- and post-treatment walking ability was assessed with Functional Ambulation Categories (FAC). Along with the general comparison of cognitive function pre- and post-treatment, additional pre- and post-treatment comparisons were made according to risk factors.
Results: According to MMSE and FIM-cognitive scores, improvement in cognitive function was detected following treatment (p<0.001, p=0.001, respectively). There was no statistical improvement in FAC and BMRS scores. According to MMSE, cognitive functions were more impaired before treatment in women, those with <5 years of education, and those with aphasia (p=0.025, p=0.004, p=0.002, respectively). According to FIM-cognitive, cognitive functions were lower in patients with aphasia, and those with left-sided brain damage (p=0.002, p=0.045, respectively). There was no difference in the magnitude of improvement between the risk factors.
Conclusion: This study showed that the rehabilitation program applied without a specific cognitive rehabilitation program in patients with chronic stroke can improve cognitive functions, although it does not cause a significant improvement compared to BMRS and FAC. Therefore, we believe that rehabilitation without specific cognitive rehabilitation will improve patients' daily activities and increase their participation in treatment.

Keywords

Stroke, cognitive impairment, rehabilitation

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