The effect of five activities daily living on improving cognitive function in ischemic stroke patients

Frana Andrianur; Dwi Prihatin Era; Arifin Hidayat; Ismansyah Ismansyah; Diah Setiani

doi:10.4081/hls.2023.11730

Authors

Frana Andrianur
franaandrianur@gmail.com
Department of Nursing, Poltekkes Kemenkes Kalimantan Timur, Samarinda, Indonesia. https://orcid.org/0000-0002-2250-4635
Dwi Prihatin Era Department of Nursing, Poltekkes Kemenkes Kalimantan Timur, Samarinda, Indonesia.
Arifin Hidayat Department of Nursing, Poltekkes Kemenkes Kalimantan Timur, Samarinda, Indonesia.
Ismansyah Ismansyah Department of Nursing, Poltekkes Kemenkes Kalimantan Timur, Samarinda, Indonesia.
Diah Setiani Department of Nursing, Poltekkes Kemenkes Kalimantan Timur, Samarinda, Indonesia.

This study aimed to assess the effects of five activities of daily living (ADL) interventions on improving cognitive function in patients with ischemic stroke. The study employed a quasi-experimental design with 16 ischemic stroke patients (n=8 per group) in an inpatient ward at a regional hospital in Samarinda, Indonesia. Inclusion criteria were: i) confirmed ischemic stroke via medical records, ii) effective communication, iii) current inpatient status, and iv) hemiparesis. Data collection used an ADL activity instrument sheet, while cognitive function was assessed with the MoCA-Ina screening (maximum score: 30 points). Data analysis included the Wilcoxon test and independent T-Test, with significance set at p<0.05. After the intervention, the intervention group's cognitive function significantly improved (from mean 20.25 ± 2.60 to 25.13 ± 1.81), while the control group changed from mean 17.13 ± 2.10 to 20.50 ± 2.00. The intervention group showed a significant cognitive improvement compared to the control group (p < 0.05). In conclusion, ADL interventions enhance cognitive function in ischemic stroke patients, aiding recovery and serving as an effective hospital nursing intervention.

American Stroke Association. Hemiparesis [Internet]. American Stroke Association. 2019. Available from: https://www.stroke.org/en/about-stroke/effects-of-stroke/physical-effects-of-stroke/physical-impact/hemiparesis#:~:text=Hemiparesis is weakness or the,Loss of balance

Arfianti L, Rochman F, Hidayati HB, Subadi I. The addition of mirror therapy improved upper limb motor recovery and level of independence after stroke: a randomized controlled trial. Brazilian J Occup Ther 2022;30. DOI: https://doi.org/10.1590/2526-8910.ctoao245932182

WHO. Health Topics: Stroke, Cerebrovascular Accident. World Health Organization. 2019.

Huttami VT, Hidajah AC. The Utilization Of Golden Period Of Ischemic Stroke In Patients In Productive Ages. Indones J Public Heal 2020;15:258–65. DOI: https://doi.org/10.20473/ijph.v15i3.2020.258-265

Rajahthurai SD, Farrukh MJ, Makmor-Bakry M, Tan HJ, Fatokun O, Mohd Saffian S, et al. Use of Complementary and Alternative Medicine and Adherence to Medication Therapy Among Stroke Patients: A Meta-analysis and Systematic Review. Front Pharmacol 2022;13. DOI: https://doi.org/10.3389/fphar.2022.870641

Nurani RRS, Martini S, Marzela F. Risk Factors of Cognitive Impairment Post Ischemic Stroke. KEMAS J Kesehat Masy 2019;15:295–302. DOI: https://doi.org/10.15294/kemas.v15i2.16845

Black, J. M., & Hawks JH. Keperawatan Medikal Bedah: Manajemen Klinis untuk hasil yang diharapkan. – Buku 3. Edisi 8. Singapore: Elsevier; 2014.

CDC. Stroke Facts [Internet]. Centers for Disease Control and Prevention. 2023 [cited 2023 Feb 20]. Available from: https://www.cdc.gov/stroke/facts.htm

Feigin VL, Stark BA, Johnson CO, et al. Global, regional, and national burden of stroke and its risk factors, 1990-2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol 2021;20:1–26. DOI: https://doi.org/10.1016/S1474-4422(21)00252-0

Hamdan M, Wisnujono R, Haryono Y, et al. Correlation between hyperglycemia stress and short-term memory function in thrombotic stroke patients. Indian J Forensic Med Toxicol 2020;14:1777–81.

Heltty H, Zahalim Z. Resilience after stroke and its correlation with functional independence. J Ners 2023;18:57–63. DOI: https://doi.org/10.20473/jn.v18i1.41229

Stroke Association. Problems with memory and thinking (cognitive problems). Stroke Association. 2023.

Sullivan AB, Miller D. Who is Taking Care of the Caregiver? J Patient Exp 2015;2:7–12. DOI: https://doi.org/10.1177/237437431500200103

Bherer L. Cognitive plasticity in older adults: Effects of cognitive training and physical exercise. Ann N Y Acad Sci 2015;1337:1–6. DOI: https://doi.org/10.1111/nyas.12682

Prakoso K, Vitriana, Ong A. Correlation between Cognitive Functions and Activity of Daily Living among Post-Stroke Patients. Althea Med J 2016;3:329–33. DOI: https://doi.org/10.15850/amj.v3n3.874

Uwa-Agbonikhena IF, Gryb VA, Gerasymchuk VR. Associations Between the Upper Extremity Function and Cognition in Post-Stroke Patients. Wiad Lek 2021;74:1917–20. DOI: https://doi.org/10.36740/WLek202108124

Panentu D, Irfan M. Uji Validitas Dan Reliabilitas Butir Pemeriksaan Dengan Moteral Cognitive Assessment Versi Indonesia ( MoCA- INA ) Pada Insan Pasca Stroke Fase Recovery. J Fisioter 2013;13:55–67.

O’Donnell M, Hankey GJ, Rangarajan S, et al. Variations in knowledge, awareness and treatment of hypertension and stroke risk by country income level. Heart 2021;107:282–9. DOI: https://doi.org/10.1136/heartjnl-2019-316515

Hanas M, Lestari E, Asni EK. Gambaran Fungsi Kognitif pada Pasien Pasca Stroke di Poliklinik RSUD Arifin Achmad Provinsi Riau. J Online Mhs Fak Kedokt 2016;3:1–12.

Israfil I, Yusuf A, Efendi F. Effect of Cognitive Behavioral Therapy on The Behavior of Patients with Cardiovascular Disease: A Systematic Review. Gac Med Caracas 2023;131:S478–88. DOI: https://doi.org/10.47307/GMC.2023.131.s3.22

Ting WK chun, Fadul FA rahaman, Fecteau S, Ethier C. Neurostimulation for Stroke Rehabilitation 2021;15:1–11. DOI: https://doi.org/10.3389/fnins.2021.649459

Whitiana GD, Cahyani A. Level of Activity Daily Living in Post Stroke Patients. Althea Med J 2017;4:261–6. DOI: https://doi.org/10.15850/amj.v4n2.1068

Ryan S, Brady O. Cognitive stimulation and activities of daily living for individuals with mild-to-moderate dementia: A scoping review. Br J Occup Ther 2023;86:540-559. DOI: https://doi.org/10.1177/03080226231156517

An HS, Kim DJ. Effects of activities of daily living-based dual-task training on upper extremity function, cognitive function, and quality of life in stroke patients. Osong Public Health Res Perspect 2021;12:304-313. DOI: https://doi.org/10.24171/j.phrp.2021.0177

Prasetyo BT, Kurniawan RG, Rilianto B, et al. Clinical prediction score for prolonged length of hospital stay in aneurysmal subarachnoid hemorrhage. BMC Neurol 2023;23:1–10. DOI: https://doi.org/10.1186/s12883-023-03279-3

Alison A, Hunter SM. Optimising rehabilitation potential after stroke: a 24‐Hour interdisciplinary approach. Br J Neurosci Nurs 2015;10:242–6. DOI: https://doi.org/10.12968/bjnn.2014.10.6.268

Kennedy NC. The role of neuroplasticity in stroke nursing. Br J Neurosci Nurs 2021;17:S20–5. DOI: https://doi.org/10.12968/bjnn.2021.17.Sup2.S20

Pollock A, Farmer SE, Brady MC, et al. Cochrane overview: Interventions for improving upper limb function after stroke. Stroke 2015;46:e57–8. DOI: https://doi.org/10.1161/STROKEAHA.114.008295

Pollock A, Farmer SE, Brady MC, et al. Interventions for improving upper limb function after stroke. Cochrane Database Syst Rev 2014;2014:CD010820. DOI: https://doi.org/10.1002/14651858.CD010820.pub2

Bakhti KKA, Mottet D, Schweighofer N, et al. Proximal arm non-use when reaching after a stroke. Neurosci Lett 2017;657:91–6. DOI: https://doi.org/10.1016/j.neulet.2017.07.055

Hu Y, Zhong W, Cen Y, et al. Prediction of epidemiological characteristics of vascular cognitive impairment using SIR mathematical model and effect of brain rehabilitation and health measurement system on cognitive function of patients. Results Phys 2021;25:104331. DOI: https://doi.org/10.1016/j.rinp.2021.104331

Maher C. Activities of Daily Living After Stroke: How to Regain Your Independence. Flint Rehab 2022; Available from: https://www.flintrehab.com/activities-of-daily-living-after-stroke/

NINDS. Post-Stroke Rehabilitation Fact Sheet. National Institute of Neurological Disorders and Stroke. 2022.

Bhatnagar K, Bever CT, Tian J, et al. Comparing Home Upper Extremity Activity With Clinical Evaluations of Arm Function in Chronic Stroke. Arch Rehabil Res Clin Transl 2020;2:100048. DOI: https://doi.org/10.1016/j.arrct.2020.100048

Yamanie N, Lamuri A, Felistia Y, et al. Importance of social support for Indonesian stroke patients with depression. F1000Research. 2022;11. DOI: https://doi.org/10.12688/f1000research.126504.1

Purton J, Sim J, Hunter SM. The experience of upper-limb dysfunction after stroke: a phenomenological study. Disabil Rehabil 2021;43:3377–86. DOI: https://doi.org/10.1080/09638288.2020.1743775

Genzor S, Prasko J, Mizera J, et al. Sex transition from female to male as a risk factor for sleep-disordered breathing. Sleep Med 2023;102:180–5. DOI: https://doi.org/10.1016/j.sleep.2023.01.006

Ding R, Zhang H. Efficacy of very early mobilization in patients with acute stroke: a systematic review and meta-analysis. Ann Palliat Med 2021;10:11776–84. DOI: https://doi.org/10.21037/apm-21-2997

Pruski A. Stroke Recovery Timeline. The Johns Hopkins Hospital. 2021.

Dehem S, Gilliaux M, Stoquart G, et al. Effectiveness of upper-limb robotic-assisted therapy in the early rehabilitation phase after stroke: A single-blind, randomised, controlled trial. Ann Phys Rehabil Med 2019;62:313–20. DOI: https://doi.org/10.1016/j.rehab.2019.04.002

Song CS, Lee ON, Woo HS. Cognitive strategy on upper extremity function for stroke: A randomized controlled trials. Restor Neurol Neurosci 2019;37:61–70. DOI: https://doi.org/10.3233/RNN-180853

Widiyawati W, Yusuf A, Devy SR. Developing a vocational social rehabilitation model to increase the independence of the instrumental activity of daily living (ADL) among people with severe mental illness. J Public Health Res 2021;10:2263. DOI: https://doi.org/10.4081/jphr.2021.2263

Alonso MB, Stienstra J, Dijkstra R. Brush and learn: Transforming tooth brushing behavior through interactive materiality, a design exploration. TEI 2014 - 8th Int Conf Tangible, Embed Embodied Interact Proc. 2014;113–20. DOI: https://doi.org/10.1145/2540930.2540981

Lee PH, Yeh TT, Yen HY, et al. Impacts of stroke and cognitive impairment on activities of daily living in the Taiwan longitudinal study on aging. Sci Rep 2021;11:1–9. DOI: https://doi.org/10.1038/s41598-021-91838-4

Andrianur F. Dukungan Keluarga Sebagai Caregiver Pada Aktivitas Hidup Sehari- Hari (Adl) Pasien Stroke: Literatur Riview. In: Seminar Nasional & Call For Papers “ Inovasi Pelayanan Penyakit Tidak Menular .” Samarinda: Politeknik Kesehatan Kementerian Kesehatan Kalimantan Timur; 2019. p. 66–71.

Andrianur F, Era DP. Level of Patient Dependence in Stroke Patients in Fulfilling Daily Activities ( ADL ). In: Post Covid-19 Pandemic The Future of Health Care (Opportunities and Challenges). Surabaya: Poltekkes Kemenkes Surabaya; 2022. p. 36–42.

Diener HC, Hankey GJ. Primary and Secondary Prevention of Ischemic Stroke and Cerebral Hemorrhage: JACC Focus Seminar. J Am Coll Cardiol 2020;75:1804–18. DOI: https://doi.org/10.1016/j.jacc.2019.12.072

Andrianur, F., Era, D. P., Hidayat, A., Ismansyah, I., & Setiani, D. (2023). The effect of five activities daily living on improving cognitive function in ischemic stroke patients. Healthcare in Low-Resource Settings, 11(2). https://doi.org/10.4081/hls.2023.11730