Sara Hayes1, Claire Donnellan2, Emma Stokes3. 1. Department of Clinical Therapies, University of Limerick, Limerick, Ireland. Electronic address: sara.hayes@ul.ie. 2. School of Medicine, Royal College of Surgeons in Ireland, Medical University in Bahrain, Al Sayh, Bahrain. Electronic address: cdonnellan@rcsi-mub.com. 3. Discipline of Physiotherapy, Trinity Centre for Health Sciences, St. James's Hospital, Dublin 8, Ireland. Electronic address: estokes@tcd.ie.
Abstract
OBJECTIVES: This study investigated the: (1) prevalence of executive dysfunction (ED); (2) demographic and clinical differences between participants with ED and without ED and; (3) independent association between executive function (EF) and balance post-stroke. DESIGN: Prospective observational cross-sectional study. SETTING: Four large acute hospitals. PARTICIPANTS: Convenience sample of people with first stroke. MAIN OUTCOME: Balance function. SECONDARY OUTCOMES: EF, stroke severity, depression and global cognition. METHODS: Descriptive statistics were used to report the prevalence of ED post-stroke. Comparisons of demographic and clinical characteristics were made between participants with ED and participants without ED using independent t-tests. Hierarchical multiple linear regression analysis determined the association between EF and balance post-stroke. RESULTS: Participant (n=100) age ranged from 31 to 98 years, time since stroke ranged from 4 to 180 days and the participants reported formal education ranging from 7 to 21 years. Participants with ED had more severe strokes (BADS) [median (IQR) vs. median (IQR), p-value] [(44 (16) vs. (51 (7), p<0.01], poorer global cognition [24 (6) vs. 29 (2), p<0.01] and poorer balance [29 (40) vs. 46.5 (17), p<0.01] in comparison with participants without ED. Age (β=-0.24, p<0.05), years in education, (β=-0.21, p<0.05), stroke severity (β=0.71, p<0.01), time since stroke, (β=-0.17, p<0.01) and EF (β=0.19, p<0.05) were independently associated with balance post-stroke. The total variance in balance explained by the model was 72%. CONCLUSIONS: ED is independently associated with balance post-stroke. Physiotherapists should consider this when developing rehabilitation strategies to improve balance post-stroke.
OBJECTIVES: This study investigated the: (1) prevalence of executive dysfunction (ED); (2) demographic and clinical differences between participants with ED and without ED and; (3) independent association between executive function (EF) and balance post-stroke. DESIGN: Prospective observational cross-sectional study. SETTING: Four large acute hospitals. PARTICIPANTS: Convenience sample of people with first stroke. MAIN OUTCOME: Balance function. SECONDARY OUTCOMES: EF, stroke severity, depression and global cognition. METHODS: Descriptive statistics were used to report the prevalence of ED post-stroke. Comparisons of demographic and clinical characteristics were made between participants with ED and participants without ED using independent t-tests. Hierarchical multiple linear regression analysis determined the association between EF and balance post-stroke. RESULTS:Participant (n=100) age ranged from 31 to 98 years, time since stroke ranged from 4 to 180 days and the participants reported formal education ranging from 7 to 21 years. Participants with ED had more severe strokes (BADS) [median (IQR) vs. median (IQR), p-value] [(44 (16) vs. (51 (7), p<0.01], poorer global cognition [24 (6) vs. 29 (2), p<0.01] and poorer balance [29 (40) vs. 46.5 (17), p<0.01] in comparison with participants without ED. Age (β=-0.24, p<0.05), years in education, (β=-0.21, p<0.05), stroke severity (β=0.71, p<0.01), time since stroke, (β=-0.17, p<0.01) and EF (β=0.19, p<0.05) were independently associated with balance post-stroke. The total variance in balance explained by the model was 72%. CONCLUSIONS: ED is independently associated with balance post-stroke. Physiotherapists should consider this when developing rehabilitation strategies to improve balance post-stroke.