The Effect of Rehabilitation without Specific Cognitive Rehabilitation on the Improvement of Cognitive Functions in Stroke Patients: Evaluation with Risk Factors

Abstract

Aim: This study aimed to evaluate if rehabilitation without specific cognitive rehabilitation improved cognitive functions in patients who had suffered a stroke more than 1 year ago, and to correlate this finding with risk factors. Material and Methods: Thirty stroke patients were included in the study. A rehabilitation program was administered to the patients for a total of 30 sessions, 5 days a week. In addition, demographic data of the patients were collected, as well as several risk factors that may impair their cognitive function. The pre-and post-treatment cognitive function of the patients was evaluated using mini-mental state examination (MMSE) and functional independence measure (FIM)-cognitive. With the FIM cognitive evaluation, cognitive functions such as comprehension, expression, social interaction, problem solving, and memory were evaluated. With MMSE, from cognitive functions; orientation, registration, attention and calculation, recall, language, and praxis were evaluated. Pre- and post-treatment motor function was measured by the Brunnstrom motor recovery stage (BMRS). Pre- and post-treatment walking ability was assessed with Functional Ambulation Categories (FAC). Along with the general comparison of cognitive function pre- and post-treatment, additional pre- and post-treatment comparisons were made according to risk factors. Results: According to MMSE and FIM-cognitive scores, improvement in cognitive function was detected following treatment (p<0.001, p=0.001, respectively). There was no statistical improvement in FAC and BMRS scores. According to MMSE, cognitive functions were more impaired before treatment in women, those with <5 years of education, and those with aphasia (p=0.025, p=0.004, p=0.002, respectively). According to FIM-cognitive, cognitive functions were lower in patients with aphasia, and those with left-sided brain damage (p=0.002, p=0.045, respectively). There was no difference in the magnitude of improvement between the risk factors. Conclusion: This study showed that the rehabilitation program applied without a specific cognitive rehabilitation program in patients with chronic stroke can improve cognitive functions, although it does not cause a significant improvement compared to BMRS and FAC. Therefore, we believe that rehabilitation without specific cognitive rehabilitation will improve patients' daily activities and increase their participation in treatment.