The association between specific cognitive domains function and gait performance or postural control in post-stroke...

Stroke survivors frequently experience cognitive dysfunction, impaired postural control, and gait impairments, significantly impacting physical abilities and hinders their ability to live independently. Although cognitive impairment exacerbates motor deficits, existing research primarily examines global cognition or executive function, with limited focus on domain-specific cognitive association. This study aims to investigate the distinct relationships between specific cognitive domains and both gait performance and postural control in stroke survivors.

Thirty-three acute and subacute stroke participants (mean age 63.94 ± 10.3 years, 60.6% male, mean post-stroke duration 2.97 ± 2.86 months) underwent standardized assessments: Executive function (Shape Trail Test, STT), attention (Symbol Digit Modalities Test, SDMT), Visuospatial ability and memory (Rey-Osterrieth Complex Figure Test, ROCFT), gait (10-Meter Walk Test, 10MWT, Timed Up and Go Test, TUG), and postural control (NeuroCom Balance System parameters: Movement Velocity (MVL), Max Excursions (MXE), and Directional Control (DCL)). Domain-specific associations between cognitive functions and gait performance or postural control were analyzed using multiple linear regression, with adjustment for age, sex, time since onset, stroke type, and hemiparetic side.

The results revealed that better executive function significantly predicted faster MVL and greater MXE during postural control (p < 0.01). In contrast, superior visual memory was associated with slower MVL (p = 0.027). However, no cognitive domains significantly predicted performance on the 10MWT or TUG.

Impairments in specific cognitive domains differentially correlate with gait and postural control, underscoring the need for integrated cognitive-motor rehabilitation in acute and subacute stroke.