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Measures of executive functioning as predictors of functional ability and social integration in a rehabilitation
R A Hanks1, L J Rapport, S R Millis
1Department of Psychology, Wayne State University, Detroit, MI, USA.
Objective:
To examine the utility of executive function tests in predicting rehabilitation outcome.
Design:
A prospective, descriptive study of the value of neuropsychologic and motor functioning measures in the prediction of functional outcome 6 months after acute rehabilitation.
Setting:
A Midwestern, urban, university-affiliated rehabilitation hospital.
Patients:
Ninety consecutive admissions to traumatic brain injury, orthopedic, and spinal cord injury units. Age of the participants ranged from 17 to 73.
Main Outcome Measures:
Community Integration Questionnaire (CIQ), Disability Rating Scale (DRS), SF-36 Health Survey.
Results:
Canonical correlation analyses indicated that measures of executive functioning and verbal memory were strongly related to measures of functional outcome 6 months after rehabilitation, as measured by the DRS and the CIQ. In contrast, perceived health status as measured by the SF-36 was highly related to estimated premorbid IQ and modestly related to visuospatial impairment.
Conclusions:
Executive functioning, verbal memory, and estimated premorbid intelligence predict functional dependence after discharge from rehabilitation beyond information regarding basic sensory and motor skills. Moreover, there is a dissociation between measures of functional outcome, such that objective and behaviorally oriented measures of disability (CIQ and DRS) are strongly related to each other; however, they are not related to perceptions of general health status (SF-36).