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Executive functioning and daily living of individuals with chronic stroke : measurement and implications

Deficits in executive functioning (EF) are often still present at the chronic
stage after stroke, which may negatively impact independent living. The
objectives of this study were (a) to characterize the EF and independence in
daily living of community-dwelling individuals with chronic stroke by using
pen-and-paper and performance-based EF assessments, (b) to explore correlations
between scores detected by different EF assessments and (c) to assess the
correlations between EF and independence in basic activities of daily living
(BADL) and instrumental activities of daily living (IADL). This cross-sectional
study included 50 (30 men and 20 women) community-dwelling individuals [mean (SD)
age 59.8 (9.3)] with chronic stroke. Participants were overall independent in
basic activities of daily living, without significant cognitive impairment.
Participants underwent EF assessment using two pen-and-paper tools: Trail Making
Test, Zoo Map subtest from the Behavioral Assessment of Dysexecutive Syndrome and
two performance-based tools; EF Route-Finding Task and bill-paying subtest from
the Executive Functions Performance Test. BADL, IADL, depressive symptoms, gait
speed and upper extremity motor impairment were also assessed. Participants
demonstrated mild to moderate EF deficits with moderate significant correlations
between the scores of various EF assessments. Participants varied in their
independence in IADL, and EF was significantly correlated to independence in BADL
and IADL (-0.31<r<0.48; -0.37<r<-0.42; P<0.05, respectively, depending on the
assessment). EF deficits with varying severity are still present at the chronic
stage after stroke among independent community-dwelling individuals. These
findings can guide the choice of an appropriate assessment tool for the specific
needs of individuals with chronic stroke.

Langue : ANGLAIS

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