The aim: Was to determine the relations between the the upper extremity function and cognition in post-stroke patients. Materials and methods: Totally there were 86 patients examined in the 1-year period after first-ever anterior circulation ischemic stroke. Examination of the upper extremity function was performed with the Fugl-Meyer assessment (FMA). Cognitive function was assessed with the Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), Trail-making Test A and B (TMT) and the Clock Drawing Test (CDT). Results: Motor dysfunction mostly manifested in low “Wrist” and “Hand” subtests scores (5 and 7 , respectively) and therefore resulted in decreased “Total motor function” score of 40 . The most significant relations were found out between the FMA “Hand”, “Total motor function” subtests and CI indices. MoCA score correlated with FMA “Wrist” (r=0.34; p=0.021), “Hand” (r=0.52; p=0.001) and “Total motor function” (r=0.48; p=0.003) scores. “Hand” score also correlated with the FAB (r=0.43; p=0.012), CDT (r=0.22; p=0.016), TMT-A (r=-0.31; p=0.023) and TMT-B (-0.48; p=0.009) scores. There was no significant correlation between the sensory FMA subtests. Conclusion: Our findings suggest that upper extremity motor impairment, especially hand and wrist dysfunction, are associated with cognitive impairment and executive functions disorder in particular.

60 patients after a hemispheric ischemic stroke (IS) were examined. Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), Trail Making Test A and B (TMT), and the Clock Drawing Test (CDT) were used for the cognitive status assessment. A decrease in the MMSE, FAB and MoCA score compared to the control group (CG) (p<0.05) was observed, with probable differences mainly in the domains of attention (p<0.05) and executive functions (p<0.05). An increase in the time of task execution by 45.5% was detected for TMT A (p <0.05) and 61.9% for TMT B (p <0.01), and violation of CDT performance compared to the CG (p<0.05). Thus, the study of cognitive status using TMT and CDT may be recommended for timely detection of the initial executive functions impairment.

Motor dysfunction makes the greatest contribution to the patient’s functional independence and has a significant impact on the quality of life (QOL) of post-stroke patients. The objective of the research was to evaluate the impact of different physical therapy approaches and choline alphoscerate on the functional independence and quality of life in patients in 1 year after ischemic stroke. Materials and methods. There were 104 patients examined in 1-year period after first anterior circulation ischemic stroke. Neurological status, functional independence and QOL were assessed according to the National Institute of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Functional Independence Measurement (FIM) and Stroke Specific Quality of Life Scale (SS-QOL). Patients in Group 1 received secondary stroke prevention therapy and performed the exercises complex for general muscle function improvement for 2 months; patients in Group 2 also performed the exercise complex for hand motility improvement for 2 months; patients in Group 3 received choline alphoscerate 400 mg twice a day for 2 months in addition to the abovementioned physical therapy. Results. 2 months of physical therapy in Group 1 resulted in increase of “Transfer” and subtotal motor scores. A significant increase in the “Self-care”, “Transfer” and therefore subtotal motor and total scores was observed in the patients in Group 2 and Group 3; the motor subtotal and total scores in Group 3 were 11.4% and 11.6 % higher than the same indices in Group 1, respectively. The most significant improvement of QOL parameters was observed in patients in Group 3, whose total score increased by 36.8% from the baseline (p<0.05), and exceeded the same index of Group 1 by 17.1% (p<0.05). Conclusions. Adding of hand exercise into the physical therapy complex for post-stroke patients contributes to better upper extremity motor performance and therefore functional independence. Stimulation of cholinergic neurotransmission with the choline alphoscerate may also increase the efficacy of physical therapy and contribute to patients’ general mobility, upper extremity function and QOL.

Motor dysfunction and cognitive impairment (CI) are the most prevalent and disabling among the stroke consequences. CI decreases the effectivity of motor rehabilitation, but motor dysfunction itself may also influence the manifestations and progression of CI. So development and study of novel physical therapy tactics, which are aiming to target both of these syndromes, becomes a subject of great interest nowadays. The aim of study was to evaluate the impact of different physical therapy approaches on the upper extremity function, cognition and functional independence in patients in 1 year after ischemic stroke. Materials and methods. Totally there were 72 patients examined in the 1-year period after first-ever anterior circulation ischemic stroke. Neurological status, upper extremity function and functional independence were assessed with the National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer assessment (FMA), modified Rankin Scale (mRS) and the Functional Independence Measurement (FIM). Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), Trail-making Test A and B tests (TMT). Patients in Group 1 received secondary stroke prevention therapy and performed the exercises complex for general muscle function improvement for 2 months; patients in Group 2 also performed the exercise complex for paretic hand function improvement for 2 months. Results. After 2 months of physical therapy a significant increase of the FIM “Self-care”, “Transfer” and therefore subtotal motor and total scores was observed in patients in Group 2; in Group 1 significant improvement was observed only in “Transfer” and subtotal motor scores. Adding of the hand exercise to the physical therapy complex (Group 2) appeared to be more beneficial for the upper extremity motor function. Patients in Group 2 after 2 months showed increase of the FMA “Wrist” score by 40 % (p<0.05), “Hand” score by 42.8 % (p<0.01) and “Total motor function” by 30.1 % (p<0.05), and the “Total motor function” score in Group 2 was 10.9 % higher in comparison with the Group 1 (p<0.05). In cognitive status significant differences compared to baseline level were observed only in Group 2; MoCA score increased by 14.3 % (p<0.05) and TMT-B performance time decreased by 14.8 % (p<0.05). Baseline MoCA score correlated with FMA “Wrist” (r=0.32; p=0.028), “Hand” (r=0.49; p=0.001) and “Total motor function” (r=0.46; p=0.004) scores. TMT-B score showed significant correlation with the FMA “Wrist” (r=-0.032; p=0.025), “Hand” (-0.45; p=0.009), “Speed/coordination” (r=-0.023; p=0.036) and “Total motor function” (r=-0.42; p=0.023). Conclusion. Adding of exercise for hand function improvement into the physical therapy complex for post-stroke patients contributes to better upper extremity motor performance and therefore is more favourable for patients’ functional independence. Upper extremity motor impairment, especially hand and wrist dysfunction, are associated with worse cognitive performance. Hand function and fine motor skills improvement could be beneficial for the patients’ cognition. Further research is needed in regard to the prognostic significance of these findings and their impact on the treatment and rehabilitation strategies.

60 patients after a hemispheric ischemic stroke (IS) were examined. Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), Trail Making Test A and B (TMT), and the Clock Drawing Test (CDT) were used for the cognitive status assessment. A decrease in the MMSE, FAB and MoCA score compared to the control group (CG) (p<0.05) was observed, with probable differences mainly in the domains of attention (p<0.05) and executive functions (p<0.05). An increase in the time of task execution by 45.5% was detected for TMT A (p <0.05) and 61.9% for TMT B (p <0.01), and violation of CDT performance compared to the CG (p<0.05). Thus, the study of cognitive status using TMT and CDT may be recommended for timely detection of the initial executive functions impairment.