Profiles of executive functioning following traumatic brain injury and stroke using the assessment of participation and executive functions: combined cross-sectional and longitudinal designs

Abstract

Objectives: The Assessment of Participation and Executive Functions (A-PEX) evaluates executive functioning through daily participation in complex daily activities. This study examines its ability to discriminate between executive functioning profiles post-traumatic brain injury and post-stroke and its sensitivity to changes. Design: Cross-sectional with a longitudinal component. Patients: Adults with post-traumatic brain injury (n = 28) and post-stroke (n = 26) in a rehabilitation facility. Methods: Patients were administered the A-PEX, Multiple Errands Test-Hospital version and Color Trail Test at 2 time-points 1 month apart. The Montreal Cognitive Assessment was administered at the first time-point, and Executive Functions Performance Test’s Internet-based Bill Payment subtest at the second. The analysis used Mann–Whitney and Wilcoxon signed-rank tests. Results: The stroke group’s A-PEX scores were higher than the traumatic brain injury group’s at the first time-point (p < 0.05). No differences were found in the other assessments. Within-group differences in both groups were significant in the A-PEX (–3.7 < r < – 2.3, p < 0.05) and Multiple Errands Test-Hospital version (–3.4 < r < –3.3, p < 0.01). Conclusion: The A-PEX may provide valuable information about the uniqueness of executive functioning profiles and patients’ progress.