Impaired Performance on a Cognitively-Based Instrumental Activities of Daily Living Task, the 10-Item Weekly Calendar Planning Activity, in Individuals With Stroke Undergoing Acute Inpatient Rehabilitation.
Impaired Performance on a Cognitively-Based Instrumental Activities of Daily Living Task, the 10-Item Weekly Calendar Planning Activity, in Individuals With Stroke Undergoing Acute Inpatient Rehabilitation.
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DOI：
10.3389/fneur.2021.704775
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发表时间：
2021
影响因子：
3.4
通讯作者：
Toglia J
中科院分区：
文献类型：
--
作者：
Jaywant A;Arora C;Lussier A;Toglia J
基于表现的、功能相关的和标准化的日常生活认知工具活动测量(C-IADL)可以补充认知障碍的神经心理学测试，并为康复计划提供有价值的临床信息。现有措施已在门诊环境中得到验证。在这里，我们试图评估一种C-IADL测量的10个项目的简写形式，每周日历计划活动(WCPA-10)，在接受急性康复的住院中风患者中。具体目标是确定WCPA-10是否能够区分接受急性住院康复治疗的中风患者和健康对照组。我们还探讨了WCPA-10是否会在被筛选为认知完整的中风患者中确定C-IADL的局限性。77名接受康复治疗的中风住院患者和77名健康对照组参与者完成了WCPA-10，其中包括在每周的时间表中输入一份模拟的、虚构的约会清单，同时跟踪和遵守多项任务规则，并忽略内置的障碍和分心。与对照组相比，中风患者的准确率明显下降，犯的错误更多，使用的认知策略更少，遵循的规则更少，完成任务所需的时间更长，效率更低。83%的中风患者的准确性低于他们的年龄预测，%的患者使用的策略比他们的年龄预测少。在28名在蒙特利尔认知评估中被筛选为具有“正常”认知功能的参与者中，大多数人在WCPA-10上存在缺陷。我们的研究结果为接受住院康复治疗的中风患者使用简明的C-IADL评估WCPA-10提供了初步支持。他们表明，中风患者在中风康复的这个阶段在C-IADL的准确性、效率和策略使用方面存在缺陷。结果强调了使用基于表现的功能认知评估的必要性，即使是那些在认知筛查工具上表现良好的人。
Performance-based, functionally relevant, and standardized measures of cognitive-instrumental activities of daily living (C-IADL) can complement neuropsychological tests of cognitive impairment and provide valuable clinical information to inform rehabilitation planning. Existing measures have been validated in the outpatient setting. Here, we sought to evaluate a 10-item, short-form of a C-IADL measure, Weekly Calendar Planning Activity (WCPA-10), in inpatients with stroke undergoing acute rehabilitation. The specific goal was to determine if the WCPA-10 could differentiate between stroke patients undergoing acute inpatient rehabilitation and healthy control individuals. We also explored whether the WCPA-10 would identify C-IADL limitations in stroke patients screened as having intact cognition. Seventy-seven stroke inpatients undergoing rehabilitation and 77 healthy control participants completed the WCPA-10, which involves entering a list of simulated, fictional appointments into a weekly schedule while keeping track of and adhering to multiple task rules and ignoring built-in obstacles and distractions. Compared to the control group, stroke patients had significantly worse accuracy, made more errors, used fewer cognitive strategies, followed fewer rules, took more time to complete the task, and were less efficient. 83% of stroke patients were less accurate than predicted by their age, and 64% used less strategies than their age prediction. Among 28 participants who screened as having “normal” cognitive function on the Montreal Cognitive Assessment, the majority had deficits on the WCPA-10. Our results provide initial support for use of a brief C-IADL assessment, WCPA-10, for individuals with stroke undergoing inpatient rehabilitation. They indicate that stroke patients have deficits in C-IADL accuracy, efficiency, and strategy use at this stage of stroke recovery. Results highlight the need to use performance based, functional cognitive assessments, even for those who perform well on cognitive screening tools.
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DOI：
10.1080/13803395.2011.553587
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