The relationship between physical impairment and disability during stroke rehabilitation: effect of cognitive status

The objectives of this study were to assess the relationship between physical impairment and disability during stroke rehabilitation and to determine the effect of cognitive functions on physical impairment during rehabilitation. Prospectively collected data from stroke patients admitted for rehabilitation were compared at admission and at discharge by the Chedoke-McMaster Stroke Assessment (the Chedoke Assessment) impairment inventory and subscores of the Functional Independence Measure (FIM). The Chedoke Assessment was used to measure physical impairment in the lower extremities and the FIM was used to measure physical disability; motor and cognitive subscales of the FIM instrument were also evaluated. Although stroke-related impairment and motor FIM were significantly correlated with each other, cognitive measures on the FIM at discharge were not correlated with motor impairment, although cognitive disability was slightly improved. It is possible that dependency in physical activities of daily living and walking after stroke are mostly affected by degree of motor impairment.