Measures of executive functioning as predictors of functional ability and social integration in a rehabilitation sample

Objective: To examine the utility of executive function tests in predicting rehabilitation outcome. Design: A prospective, descriptive study of the value of neuropsychologic a nd motor functioning measures in the prediction of functional outcome 6 mon ths after acute rehabilitation. Setting: A Midwestern, urban, university-affiliate rehabilitation hospital. Patients: Ninety consecutive admissions to traumatic brain injury, orthoped ic, and spinal cord injury units. Age of the participants ranged from 17 to 73. Main Outcome Measures: Community Integration Questionnaire (CIQ), Disabilit y Rating Scale (DRS), SF-36 Health Survey. Results: Canonical correlation analyses indicated that measures of executiv e functioning and verbal memory were strongly related to measures of functi onal outcome 6 months after rehabilitation, as measured by the DRS and the CIQ. In contrast, perceived health status as measured by the SF-36 was high ly related to estimated premorbid IQ and:modestly related to visuospatial i mpairment. Conclusions: Executive functioning, verbal memory,:and estimated premorbid intelligence predict functional dependence after discharge from rehabilitat ion beyond information regarding basic sensory and motor skills. Moreover, there is a dissociation between measures of functional outcome, such that o bjective and behaviorally oriented measures of disability (CIQ and DRS) are strongly related to each other; however, they are not related to perceptio ns of general health status (SF-36). (C) 1994 by the American Congress of R ehabilitation Medicine and the American Academy of Physical Medicine and Re habilitation.