Association between baseline cognitive function and motor improvement in subacute hemiplegic stroke patients after 4 weeks of rehabilitation

Abstract

Background & Objectives: Motor function and cognition are crucial for performing daily activities in patients with stroke. However, it remains unclear whether measures of motor function in patients with subacute hemiplegic stroke are related to baseline overall cognitive domains or to specific domains. The aim of this study is to determine which baseline cognitive domains are associated with improvements in motor function in patients with subacute hemiplegic stroke after 4 weeks of rehabilitation. Method: We retrospectively analyzed data of 129 hemiplegic patients with a first-ever stroke, who were admitted or transferred to the rehabilitation department within 3 months of stroke onset. We assessed patient demographics, baseline cognitive function using Mini-Mental Status Examination (MMSE), Wechsler Adult Intelligence Scale-IV, and Motor-Free Visual Perceptual Test-Revised (MVPT-R). Motor function was evaluated using the Berg Balance Scale, Timed Up and Go Test (TUG), 10 m gait time, and functional reach at baseline and after 4 weeks of rehabilitation. Pearson's correlation coefficient was used to analyze the correlation between improvements in motor and cognitive functions. Results: No significant correlation was observed between improvements in motor function and baseline MMSE, full-scale IQ, and MVPT total scores. However, subscale analysis of baseline MVPT demonstrated significant correlations between visual discrimination and all outcome effects. Additionally, visual closure and visual-spatial relationship exhibited significant correlation with TUG and 10 m gait velocity. Conclusions: This study highlighted the association between improvement in motor function, including balance and gait speed, and initial visual perception skills. Thus, evaluating and enhancing visual perception skills are essential for improving motor function in patients with subacute hemiplegic stroke.