Affiliations: [a] Rehabilitation Department, Amal Rehabilitation Center, Tehran, Iran | [b] Department of Neurology, Carmen and Louis Warschaw Chair in Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, USA | [c] Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran | [d] Department of Occupational Therapy, Iran University of Medical Sciences, Tehran, Iran
Correspondence:
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Address for correspondence: Mohamad Kamali, PhD. PT., Associate Professor, Dean of Rehabilitation Research Centre, School of Rehabilitation Sciences, Iran University of Medical sciences, Nezam st., Shah Nazari st., Madar sq. Mirdamad st., Tehran, Iran. Fax: +98 21 22 220946; E-mail: [email protected]
Abstract: Objectives:We investigated the hypothesis that ADL tests dependent on cortical functions could be used to assess outcome in stroke patients. Materials and method:27 right-handed stroke patients were evaluated on National Institute of Health Stroke Scale (NIHSS), Barthel Index (BI), Instrumental Activities of Daily Living (IADL) Scale and thinking process items of Loewenstein Occupational Therapy Cognitive Assessment (LOTCA). Results:Correlations between thinking process subtests of LOTCA and different items of NIHSS such as consciousness, arm movement, aphasia, ataxia and inattention was significant. Spearman correlation of thinking process and BI tasks showed no relationship, although Structured Riska of thinking process evaluation was correlated to both self-care and mobility areas of the BI. Thinking process was strongly related to IADL total score (p = 0.004). The total NIHSS correlated significantly with BI and IADL total scores. Conclusion:Higher-order functions, such as categorization, sorting and reasoning, are related to IADL performance which depends on complicated cognitive abilities. In contrast, the BI depends heavily on motoric function, and does not correlate with higher-order functions. Further confirmation is needed, but our data suggest that commonly used IADL tests could serve to as valid, reliable tests of cognitive impairment and recovery in stroke victims.
