Unraveling the Link Between Cognition and Motor Impairment and Activity After Stroke: A Longitudinal Study

BackgroundStroke leads to both motor and cognitive impairments that can substantially limit daily activities and independence. Although these impairments are often treated separately in rehabilitation, growing evidence suggests they are interconnected. Understanding how cognitive and motor impairments relate to one another is essential for developing more effective, integrated rehabilitation strategies. ObjectiveThis longitudinal study addressed three key questions: (1) Do motor and cognitive impairments co-occur after stroke? (2) Does cognitive ability influence motor recovery? (3) Are cognitive and motor recovery trajectories associated? MethodsWe followed 148 individuals in the subacute phase of stroke, assessing them at 1 and 3 months post-stroke. Cognitive function was measured using the Montreal Cognitive Assessment (MoCA) and the clock drawing test. Motor impairment was assessed using the Fugl-Meyer Assessment (FMA) and grip strength. Activity was evaluated using the Action Research Arm Test (ARAT), 10-Meter Walk Test (10MW), and Timed Up and Go (TUG). ResultsAt one month post-stroke, cognitive and motor impairment and activity levels were not correlated, although strong within-domain correlations were observed. Baseline cognitive ability did not predict motor impairment recovery. However, improvements in cognitive ability from 1 to 3 months were moderately correlated with gains in motor activity measures (r = 0.22-0.29, p < 0.05). ConclusionsAlthough cognitive and motor impairments may arise independently after stroke, their recovery processes appear partially linked. These findings underscore the importance of addressing both domains in rehabilitation and advancing understanding of shared mechanisms that support recovery across functional systems.