Cognitive Correlates of a Large Time Differential between Timed Up and Go and Gait Speed during Inpatient Stroke Rehabilitation

IF 0.9 4区医学 Q4 REHABILITATION Physiotherapy Canada Pub Date : 2023-04-06 DOI:10.3138/ptc-2022-0089

H. Kim, Abishek Jaywant, J. Toglia, Amy Meyer, M. Campo, M. O'dell

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引用次数: 0

Abstract

Cognitive impairment is highly prevalent after stroke but can be difficult to identify acutely. We aimed to study if a large difference between two common, routine physical therapy assessments (Timed Up and Go [TUG] test and 10-Meter Walk Test [10MWT]) could identify patients with subtle cognitive difficulties post-stroke. An observational study was conducted in 141 individuals admitted to acute inpatient rehabilitation after stroke. We computed the percent difference between TUG and 10MWT performance. Cognitive outcome measures were the Trail Making Test A and B (TMT-A and -B) and the Functional Independence Measure (FIM)-Cognition subscale. Linear and logistic regression analyses were conducted to evaluate if the difference between TUG and 10MWT was associated with cognitive functioning. After adjusting for covariates, there was no significant linear association between TUG-10MWT discrepancy and cognition; however, stroke patients with the largest difference between TUG and 10MWT (highest quartile of scores) exhibited significantly worse attention on the TMT-A (adjusted odds ratio = 2.46, p = 0.04). A large difference between TUG and 10MWT may reflect deficits in complex sustained attention in individuals with stroke. Physical therapy staff may use this difference score to identify patients with potential cognitive deficits and refer them for comprehensive neuropsychological evaluation.

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脑卒中住院康复期间，起身和行走时间差异和步态速度的认知相关性

认知障碍在中风后非常普遍，但很难急性识别。我们的目的是研究两种常见的常规物理治疗评估(Timed Up and Go [TUG]测试和10米步行测试[10MWT])之间的巨大差异是否可以识别中风后轻度认知困难的患者。一项观察性研究对141名中风后入院的急性住院康复患者进行了研究。我们计算了TUG和10MWT性能之间的百分比差异。认知结果的测量方法为轨迹测试A和轨迹测试B (TMT-A和-B)和功能独立性测量(FIM)-认知子量表。采用线性和逻辑回归分析来评估TUG和10MWT之间的差异是否与认知功能有关。调整协变量后，TUG-10MWT差异与认知无显著的线性相关;然而，TUG与10MWT(最高四分位数得分)差异最大的脑卒中患者在TMT-A上的注意力明显较差(校正优势比= 2.46,p = 0.04)。TUG和10MWT之间的巨大差异可能反映了中风患者复杂持续注意的缺陷。物理治疗人员可以使用该差异评分来识别潜在认知缺陷的患者，并将其转介给综合神经心理学评估。

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来源期刊

Physiotherapy Canada REHABILITATION-

CiteScore

1.90

自引率

20.00%

发文量

审稿时长

>12 weeks

期刊介绍： Physiotherapy Canada is the official, scholarly, refereed journal of the Canadian Physiotherapy Association (CPA), giving direction to excellence in clinical science and reasoning, knowledge translation, therapeutic skills and patient-centred care. Founded in 1923, Physiotherapy Canada meets the diverse needs of national and international readers and serves as a key repository of inquiries, evidence and advances in the practice of physiotherapy. Physiotherapy Canada publishes the results of qualitative and quantitative research including systematic reviews, meta analyses, meta syntheses, public/health policy research, clinical practice guidelines, and case reports. Key messages, clinical commentaries, brief reports and book reviews support knowledge translation to clinical practice. In addition to delivering authoritative, original scientific articles and reports of significant clinical studies, Physiotherapy Canada’s editorials and abstracts are presented in both English and French, expanding the journal’s reach nationally and internationally. Key messages form an integral part of each research article, providing a succinct summary for readers of all levels. This approach also allows readers to quickly get a feel for ‘what is already known’ and ‘what this study adds to’ the subject. Clinician’s commentaries for key articles assist in bridging research and practice by discussing the article’s impact at the clinical level. The journal also features special themed series which bring readers up to date research supporting evidence-informed practice. The Canadian Physiotherapy Association (CPA) is the national professional association representing almost 15,000 members distributed throughout all provinces and territories. CPA’s mission is to provide leadership and direction to the physiotherapy profession, foster excellence in practice, education and research, and promote high standards of health in Canada.

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