Executive dysfunction and its association with balance function in stroke patients attendant at CRP

Abstract

Background: Executive dysfunction is a common but often under-recognized consequence of stroke that can impact various aspects of functional recovery, including mobility and balance. Impaired executive functions such as attention, planning, and cognitive flexibility may hinder a patient's ability to maintain postural control, increasing the risk of falls during rehabilitation. Despite its clinical relevance, the relationship between executive dysfunction and balance impairment in stroke survivors remains underexplored, particularly in the context of Bangladeshi rehabilitation settings. Objectives: The objectives of the study were to assess the level of executive dysfunction in stroke patients, to evaluate the balance function in the same population, and to investigate the association between executive dysfunction and balance function. Methodology: A cross-sectional study was conducted among 111 stroke patients attending the Neurology Unit at CRP. Participants were selected through convenience sampling based on inclusion and exclusion criteria. Executive function was assessed using the Trail Making Test (TMT-A and B), overall cognitive function was assessed by using the Mini-Mental State Examination (MMSE) scale, balance function was measured using the Berg Balance Scale (BBS), and risk of fall was measured by the Time Up and Go test (TUG test). Data were analyzed using SPSS software version 25. Results: The findings revealed that a significant proportion of the stroke patients exhibited mild to moderate executive dysfunction. This study found the prevalence of executive dysfunction was 42.3% (n=47), with severe cognitive impairment 22.5% (n=25), and mild cognitive impairment 19.8% (n=22). The BBS score indicated moderate balance impairment, with 73.9% walking with assistance and 26.1% Walking Independently. Statistical analysis showed a significant positive association between executive function and balance scores (p < 0.05), suggesting that poorer executive functioning was associated with greater balance deficits. Discussion: These findings highlight the importance of addressing cognitive, particularly executive, deficits alongside physical rehabilitation to improve balance and reduce fall risk in post-stroke patients. Keywords: Executive dysfunction, stroke, balance function.