Executive dysfunction and balance function post-stroke: A cross-sectional study

Abstract

ObjectivesThis study investigated the: (1) prevalence of executive dysfunction (ED); (2) demographic and clinical differences between participants with ED and without ED and; (3) independent association between executive function (EF) and balance post-stroke. DesignProspective observational cross-sectional study. SettingFour large acute hospitals. Participants: Convenience sample of people with first stroke. Main outcome: Balance function. Secondary outcomes: EF, stroke severity, depression and global cognition. MethodsDescriptive statistics were used to report the prevalence of ED post-stroke. Comparisons of demographic and clinical characteristics were made between participants with ED and participants without ED using independent t-tests. Hierarchical multiple linear regression analysis determined the association between EF and balance post-stroke. ResultsParticipant (n=100) age ranged from 31 to 98 years, time since stroke ranged from 4 to 180 days and the participants reported formal education ranging from 7 to 21 years. Participants with ED had more severe strokes (BADS) [median (IQR) vs median (IQR), p-value] [(44 (16) vs (51 (7), p<0.01], poorer global cognition [24 (6) vs 29 (2), p<0.01] and poorer balance [29 (40) vs 46.5 (17), p<0.01] in comparison with participants without ED. Age (β=−0.24, p<0.05), years in education, (β=−0.21, p<0.05), stroke severity (β=0.71, p<0.01), time since stroke, (β=−0.17, p<0.01) and EF (β=0.19, p<0.05) were independently associated with balance post-stroke. The total variance in balance explained by the model was 72%. ConclusionsED is independently associated with balance post-stroke. Physiotherapists should consider this when developing rehabilitation strategies to improve balance post-stroke.