Subgroups defined by the Montreal cognitive assessment differ in functional gain during acute inpatient stroke rehabilitation

And what EXACTLY  are you doing so ALL GROUPS get functional gains to 100% recovery?  Yes, that will be difficult, but leaders tackle and solve difficult problems. Are you a leader or a mouse? Leave no survivor behind. I absolutely hate recovery predictions because they mean useful research was not done and they don't help one whit in getting survivors recovered.  Until stroke leadership understands that survivors will be screwed.

Subgroups defined by the Montreal cognitive assessment differ in functional gain during acute inpatient stroke rehabilitation

Archives of Physical Medicine and Rehabilitation , Volume 101(2) , Pgs. 220-226.

NARIC Accession Number: J83113.  What's this?
ISSN: 0003-9993.
Author(s): Jaywant, Abhishek; Toglia, Joan; Gunning, Faith M.; O'Dell, Michael W..
Publication Year: 2020.
Number of Pages: 7.

Abstract: 

Study validated subgroups of cognitive impairment on the Montreal Cognitive Assessment (MoCA)-defined as normal (score of 25-30), mildly impaired (score of 20-24), and moderately impaired (score less than 19)-by determining whether they differ in rehabilitation gain during inpatient stroke rehabilitation. Linear regression models were conducted and predictors included MoCA subgroups and relevant baseline demographic and clinical covariates. Separate models included the cognitive subscale of the Functional Independence Measure (FIM) instrument as a predictor. Participants were 334 patients with mild-moderate strokes who were administered the MoCA on admission to the inpatient rehabilitation facility of an urban, academic medical center. Outcome variables included the mean relative FIM gain (mRFG), which quantifies the amount of functional gain achieved as a percentage of the total functional gain possible, and mean relative functional efficiency (mRFE), which adjusts for length of stay) on the FIM total. MoCA subgroups significantly predicted mRFG and mRFE after accounting for age, sex, education, stroke severity, and recurrent vs first stroke. The normal group exhibited greater mRFG and mRFE than the mildly impaired group, while the moderately impaired group had significantly worse mRFG and mRFE than the mildly impaired group. The moderately impaired group had a significantly smaller proportion of individuals who made a clinically meaningful change on the total-FIM than the mildly impaired and normal groups. MoCA subgroups better accounted for mRFG and mRFE than a standard-of-care cognitive assessment (cognitive-FIM). Use of MoCA-defined subgroups can assist providers in predicting(There is that useless term again.)  functional gain in survivors of stroke being treated in inpatient rehabilitation.
Descriptor Terms: CLIENT CHARACTERISTICS, COGNITIVE DISABILITIES, DEMOGRAPHICS, FUNCTIONAL EVALUATION, MEASUREMENTS, OUTCOMES, PERFORMANCE STANDARDS, REHABILITATION, STROKE


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Citation: Jaywant, Abhishek, Toglia, Joan, Gunning, Faith M., O'Dell, Michael W.. (2020). Subgroups defined by the Montreal cognitive assessment differ in functional gain during acute inpatient stroke rehabilitation.  Archives of Physical Medicine and Rehabilitation , 101(2), Pgs. 220-226. Retrieved 4/17/2020, from REHABDATA database.