Executive functions: Relationships with activities of daily living, social problem-solving, and participation

Stroke affects not only motor abilities but also cognitive and social functioning, resulting in complex life changes. This study investigated the relationship between executive functions and activities of daily living (ADL), social problem-solving, and participation among stroke survivors. A total of 110 individuals with stroke and 28 healthy controls participated. The control group completed the Executive Function Performance Test (EFPT), and stroke participants were grouped based on EFPT scores. Pearson's correlation and linear regression analyses examined the relationships and predictive effects, while group differences were assessed using the Mann-Whitney U test. Stroke survivors with executive dysfunction showed significantly poorer ADL performance and social problem-solving skills than those without impairment, although no significant difference was observed in participation. Executive functions were significantly correlated with both basic and instrumental ADL and problem-solving styles. Executive functions accounted for 27% of the variance in ADL, 16% in instrumental ADL, and 37% in social problem-solving. The findings highlight the adverse impact of executive dysfunction on daily functioning and cognitive skills post-stroke. However, no significant association was found with participation. These results underscore the importance of targeted rehabilitation strategies to address executive function impairments in stroke recovery.