Cognitive-physical-functional correlates in chronic brain injury: a pilot study

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Abstract
Introduction: Functional challenges persist even years following brain injury. Integrating multiple domains as part of therapy may improve global outcomes. The purpose of this study is to investigate the relationships among cognitive, physical and functional domains in adults with chronic brain injury. Material and methods: Seventeen community-dwelling brain injury survivors (Stroke n = 8, TBI n = 9) aged 20–60 years, long-term post-brain injury participated in the study. Cognition, including attention, memory, and executive functioning, were examined by select measures of Woodcock-Johnson tests; physical abilities were determined based on muscle strength, gait and balance; functionality was measured based on self-reported questionnaires: community-integration, activities of daily living (ADLs), and satisfaction with life. Results: The relationships between cognitive, physical and functional domains were evaluated using Spearman's nonparametric correlational analyses. The physical domains of balance and mobility correlated positively with the cognitive domains of visual-auditory learning (r = 0.90, p = 0.037), as well as with the functional domain scores for Satisfaction with Life (r = 0.671, p = 0.048). Similarly, the productivity subscale of the Community Integration measure was significantly associated with the cognitive domain of concept formation (r = 0.676, p = 0.032). Higher scores on the productivity subscale were moderately related to higher memory scores (r = 0.588) and fluency (r = 0.531). Conclusions: The relationships between physical, cognitive, and functional domains could be exploited in long-term periods of recovery following a brain injury. Engagement of one domain to help improve another domain could enhance rehabilitation outcomes. More research is needed to explore the feasibility and benefits of integrative therapies.

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