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 and motor functioning measures in the prediction of functional outcome 6 months after acute rehabilitation. Setting: A Midwestern, urban, university-affiliate rehabilitation hospital. Patients: Ninety consecutive admissions to traumatic brain injury, orthopedic, and spinal cord injury units. Age of the participants ranged from 17 to 73. Main Outcome Measures: Community Integration Questionnaire (CIQ), Disability Rating Scale (DRS), SF-36 Health Survey. Results: Canonical correlation analyses indicated that measures of executive functioning and verbal memory were strongly related to measures of functional 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 highly related to estimated premorbid IQ and:modestly related to visuospatial impairment. Conclusions: Executive functioning, verbal memory,:and estimated premorbid intelligence predict functional dependence after discharge from rehabilitation beyond information regarding basic sensory and motor skills. Moreover, there is a dissociation between measures of functional outcome, such that objective and behaviorally oriented measures of disability (CIQ and DRS) are strongly related to each other; however, they are not related to perceptions of general health status (SF-36). (C) 1994 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.