gms | German Medical Science

The main purpose of this study was to investigate how and if cognitive function influence gait capacity in first time ever stroke patients in the early rehabilitation at the acute stroke unit. The association between gait capacity and cognitive function was analysed to reveal if any correlation existed.

Patients with first time ever stroke, 32 women and 43 men (n=75), were consecutively included in the study. Mean age was 74 years, (range 38 - 98) and mean time at the stroke unit was 19 days, (range 2 - 47). Outcome measures were 6-minute walk test (6MWT) in addition an observation of the ability to follow instructions of physical activities and observation of the performance of the same activity was evaluated by the examiner. The ability to follow instructions of physical activities, e.g. lift your arms, was noted as; being able or not (yes / no). The performance of the same activity was evaluated as; no, slight, moderate, severe problem to go through with the activity. In addition Motor Assessment Scale (MAS) part score 5 (walking), Barthel ADL index (BI), part score 9 (walking) and 10 (walking stairs) was registered.

Correlations of the performed tests and observations were analysed in an SPSS11 statistical package with Spearman correlation coefficients.

35% (26 patients) could not walk at baseline. Cognitive function was reduced in 55% patients (n =41), light reduction 20 % (n = 15), moderate 23% (n = 17) and severe 12% (n = 9).

Cognitive function and 6MWT correlated poorly (r = -0.28). As did cognitive function and MAS 5 (r-0.33), ADL 9 (r-0.34) and BI 10 (r = -0.28).

The poor association between cognitive function and gait capacity in these acute stroke patients indicate that cognitive function, only to a smaller degree can explain reduced walking capacity and that factors like motor function at this stage is more influential.