Akademik Veri Yönetim Sistemi
Turk Beyin Damar Hastaliklar Dergisi, cilt.11, sa.1, ss.19-24, 2005 (Scopus)
Aim: To compare the rehabilitation outcomes of the hemiplegic patients with normal cognitive function with the hemiplegic patients who have impaired cognitive status and to evaluate the effect of initial functional and cognitive level on post-rehabilitational functional improvement. Material and Methods: Sixty patients older than 60 years, experiencing first stroke attack and with a post-stroke duration shorter than 6 months were included in the study. Mini Mental State Examination (MMSE) was used to evaluate initial cognitive status and patients were diveded into two groups according to their MMSE results. Thirty-eight patients were cognitively normal (Group 1), cognitive impairment has been found in twenty-two patients (Group 2). At the beginning and at the end of the treatment, Barthel Index and Brunnstrom's stages of recovery were used for functional status evaluation and motor evaluation, respectively. Results: In thirty-eight patients with normal cognitive status, significant improvements were found with Barthel Index (p< 0.001), Brunnstrom upper extremity staging (p< 0.01) and Brunnstrom lower extremity staging (p< 0.001). In patients with impaired cognitive function, significant improvements were found with Barthel Index (p< 0.01) and Brunnstrom's lower extremity staging (p< 0.05); but no improvement was detected with upper extremity staging (p< 0.05). In comparison of the groups, significant improvements were found with Barthel Index (p< 0.001), Brunnstrom's upper extremity (p< 0.05) and lower extremity staging (p< 0.05) in favor of cognitively normal patients. When the effect of cognitive status arid functional level on rehabilitation outcomes was evaluated, a positive correlation with cognitive status (r = 0.45; p< 0.01) and a strong positive correlation with functional level (r = 0.91; p< 0.001) were detected. Conclusion: Although the results of this study showed that initial functional status is the most predictive factor, we also demonstrated that cognitive status has an important effect on improvement. For this reason, we suggest that cognitive evaluation is essential at the initial period of the rehabilitation program and might be used routinely.