Stroke-specific executive function assessment: a literature review of performance-based tools

Area of Science:

• Neurorehabilitation
• Occupational Therapy
• Psychometrics

Background:

• Executive function assessment is crucial for post-stroke rehabilitation but is underutilized by occupational therapists in Canada.
• Performance-based assessments mirroring real-world activities are vital for identifying stroke survivors' challenges in home and community reintegration.

Purpose of the Study:

• To conduct a literature review to identify performance-based executive function measures.
• To determine the stroke-specific psychometric properties of these identified measures.
• To increase clinician awareness and facilitate the selection of appropriate executive function assessment tools.

Main Methods:

• A systematic literature review identified 17 performance-based tools and 41 stroke-specific studies.
• Tools were critically appraised based on executive function components, functioning level, assessment environment, psychometric properties, and clinical utility.
• Findings were compiled into a Stroke-Specific Executive Function Toolkit.

Main Results:

• The Executive Function Performance Test, Multiple Errands Test, and Assessment of Motor and Process Skills showed the strongest reliability and validity.
• The Assessment of Motor and Process Skills is the only tool adequately evaluated for detecting change over time.
• The Kettle Test offers high clinical utility with a short administration time (<20 minutes) and minimal equipment requirements.

Conclusions:

• The Stroke-Specific Executive Function Toolkit offers valuable information for clinicians.
• The toolkit aids in selecting appropriate executive function assessment tools for stroke care.
• Improved assessment selection can enhance rehabilitation outcomes for stroke survivors.