Correlation between executive and motor function in patients after a stroke

Abstract

Executive functions refer to a number of cognitive processes that use and modify information from cortical sensory systems in the anterior and posterior regions of the brain, so they could alter and produce behavior and movement. These integrative functions, including motor and behavioral components are necessary for effective aimed actions that represent base for performing activities of daily living. The most important components of executive functions are selection of the goal, planning, inhibition of irrelevant responses and impulse, monitoring and control activities, as well as the evaluation of the action outcome. Attention control, working memory and temporal organized behavior, also stand out as a special executive functions. Cognitive impairment after a stroke may be complex, particularly for the involvement of the cerebral hemisphere or the frontal lobes, and depending on the lesion, executive function could be more or less effective. The function of the walking is the most compromised motor function. The subject of this study was to examine the correlation between executive functions, attention and walk disorders after a stroke and how that relation influences the recovery process and achievement of functional independence in patients. Within the aim of the research, the relation between the levels of organization activities, attention and walk disorders in patients after a stroke had been analyzed. The examined sample consisted of 50 patients after a stroke, included in the rehabilitation process and 50 patients randomly chosen, matched by age and general characteristics, which in its medical history and neurological examination, had no symptoms of acute or chronic neurological disease. For the evaluation of executive functions, attention, cognitive state, the Tests for the evaluation of motor functions including the evaluation of all gait parameters and the Test for the evaluation of functional abilities have been used in the paper. The received results show that the patients after stroke have a statistically important lower achievement at the Test for evaluation of attention (p>.001), a statistically important lower achievement at the Test of executive functions (p>.001), that 72% of examinees have a minor cognitive disorder, while 6% of the examinees have a major cognitive disorder after a stroke. The obtained results also show a statistically important lower efficiency in all examined motor functions, in the gait frequency (p>.01), gait speed (p>.001), the length of pace (p>.001), the motor leg index (p>.001), obstacle management and balance keeping (p>.001). The results confirm the existence of a statistically important difference in all examined variables between the two groups of examinees (p>.001). A statistically important difference in results of the right-sided and left-sided hemiparesis of the examined patients after the stroke had been noticed at executive functions (p>.05), while at motor functions the difference is of no statistical importance. Within the group of after-stroke patients there is a statistically important link between the level of cognitive damage and the examined parameters of walk (p>.05). Furthermore, within the group of after-stroke patients there is a statistically important link between the level of cognitive damage and functional ability (p>.05).