Association Between Montreal Cognitive Assessment Scores and Measures of Functional Mobility in Lower Extremity Amputees After Inpatient Rehabilitation

Abstract

Objective: To determine whether scores on a cognitive measure are associated with walking endurance and functional mobility of individuals with transfemoral or transtibial amputations at discharge from inpatient prosthetic rehabilitation.

Design: Retrospective cohort study.

Setting: Rehabilitation hospital.

Participants: Consecutive admissions (N=176; mean age ± SD, 64.27±13.23y) with transfemoral or transtibial amputation that had data at admission and discharge from an inpatient prosthetic rehabilitation program.

Interventions: Not applicable.

Main outcome measures: Cognitive status was assessed using the Montreal Cognitive Assessment (MoCA). The L Test and the 2-minute walk test (2MWT) were used to estimate functional mobility and walking endurance.

Results: The mean ± SD MoCA score was 24.05±4.09 (range, 6-30), and 56.3% of patients had scores <26. MoCA scores had a small positive correlation with the 2MWT (r=.29, P<.01), and a small negative correlation to the L Test (r=-.24, P<.01). In multivariable linear regression, compared with people with the highest MoCA score quartile, there was no difference on the 2MWT, but people in the lowest 2 quartiles took longer to complete the L Test.

Conclusions: Cognitive impairment was very prevalent. The association between MoCA and functional mobility was statistically significant. These results highlight the potential for differences on complex motor tasks for individuals with cognitive impairment but does not indicate a need to exclude them from rehabilitation on the basis of cognitive impairment alone.

Keywords: Amputation; Cognition; Rehabilitation.