Courtney Frengopoulos1, Michael W Payne2, Ricardo Viana2, Susan W Hunter3. 1. Faculty of Health & Rehabilitation Sciences, University of Western Ontario, London, Ontario, Canada. Electronic address: cfrengop@uwo.ca. 2. Department of Physical Medicine and Rehabilitation, Parkwood Institute, London, Ontario, Canada; Department of Physical Medicine and Rehabilitation, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada. 3. Department of Physical Medicine and Rehabilitation, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada; School of Physical Therapy, University of Western Ontario, London, Ontario, Canada.
Abstract
OBJECTIVE: To investigate the association between cognitive functioning, as measured by the Montreal Cognitive Assessment (MoCA), and functional outcomes upon discharge from prosthetic rehabilitation. DESIGN: Retrospective chart audit. SETTING: Rehabilitation hospital. PARTICIPANTS: Consecutive admissions (N=130; mean age, 66.21±11.19y) with lower extremity amputation of dysvascular etiology. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Cognitive status was assessed using the MoCA. The L Test of Functional Mobility (L Test) and the 2-minute walk test were used to estimate functional mobility and walking endurance. RESULTS: In multivariable linear regression analysis, those who scored 2 on the visuospatial/executive functioning (out of 5) and language (out of 3) domains had statistically shorter distances walked on the 2-minute walk test than did those who scored the highest on these MoCA domains. These values were not clinically relevant. Time to complete the L Test for those who scored the lowest on the MoCA domains of visuospatial/executive functioning and delayed recall and 3 on the attention domain (out of 6) was significantly longer than that for those who scored the highest. CONCLUSIONS: Individuals with lower extremity amputation have an increased risk of cognitive impairment related to amputation etiology. Lower levels of functioning on MoCA domains of visuospatial/executive functioning, delayed recall, and attention were shown to negatively relate to the rehabilitation outcome of functional mobility, as measured by the L Test.
OBJECTIVE: To investigate the association between cognitive functioning, as measured by the Montreal Cognitive Assessment (MoCA), and functional outcomes upon discharge from prosthetic rehabilitation. DESIGN: Retrospective chart audit. SETTING: Rehabilitation hospital. PARTICIPANTS: Consecutive admissions (N=130; mean age, 66.21±11.19y) with lower extremity amputation of dysvascular etiology. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Cognitive status was assessed using the MoCA. The L Test of Functional Mobility (L Test) and the 2-minute walk test were used to estimate functional mobility and walking endurance. RESULTS: In multivariable linear regression analysis, those who scored 2 on the visuospatial/executive functioning (out of 5) and language (out of 3) domains had statistically shorter distances walked on the 2-minute walk test than did those who scored the highest on these MoCA domains. These values were not clinically relevant. Time to complete the L Test for those who scored the lowest on the MoCA domains of visuospatial/executive functioning and delayed recall and 3 on the attention domain (out of 6) was significantly longer than that for those who scored the highest. CONCLUSIONS: Individuals with lower extremity amputation have an increased risk of cognitive impairment related to amputation etiology. Lower levels of functioning on MoCA domains of visuospatial/executive functioning, delayed recall, and attention were shown to negatively relate to the rehabilitation outcome of functional mobility, as measured by the L Test.
Authors: Stijn Denissen; Alexander De Cock; Tom Meurrens; Luc Vleugels; Ann Van Remoortel; Benoit Gebara; Miguel D'Haeseleer; Marie B D'Hooghe; Jeroen Van Schependom; Guy Nagels Journal: J Cent Nerv Syst Dis Date: 2019-11-06