Международный журнал физической медицины и реабилитации
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Impact of Cognitive Impairments on Functional Ambulation in Stroke Patients

Isha S Akulwar

Background: Regaining the ability to walk independently is the most important functional goal in rehabilitation of stroke patients. Cognitive impairments are increasingly recognized as affecting functional outcome in stroke. The purpose of this study was to determine the association between cognition and functional ambulation level in chronic stroke patients.

Methods:

Design: Cross-sectional, observational

Setting: Tertiary care centre, Mumbai, India

Participants: 60 ambulatory post-acute stroke patients

Main outcome measures:

• Cognition was assessed using Montreal Cognitive Assessment (MoCA) scale

• Functional ambulation level was determined using Modified Hoffer functional ambulation classification (FAC).

Results: The prevalence of cognitive impairments was 46%. According to FAC, 28.3% of the patients were community walkers. MoCA score discriminated between unlimited household and most limited community walkers (p<0.03) and also between least limited community and community walkers (p<0.04).

Conclusion: Community ambulation is significantly limited in chronic stroke patients. Cognitive impairments are prevalent and persistent even after the acute phase. Cognition is an important factor in the attainment of community ambulation in chronic stroke patients. Along with physical impairments, cognitive impairments need to be specifically addressed for successful rehabilitation outcome in stroke.