Chronotype Shifts and Cognitive Performance in Stroke Survivors: Exploring the Impact of Occupational Therapy Treatment Timing on Rehabilitation Outcomes.

Importance: Stroke survivors commonly report persistent sleep disruptions during rehabilitation and postrecovery. Despite little research that explores the impact of stroke on a patient's chronotype, no studies have explored the differences in cognitive performance between treatment timing fitted an...

Descripción completa

Detalles Bibliográficos
Publicado en:American Journal of Occupational Therapy Vol. 79; no. 5; pp. 1 - 9
Autores principales: Hersch, Ayelet, Serfaty, Corinne, Portnoy, Sigal
Formato: research tables/charts Journal Article
Publicado: American Occupational Therapy Association Sep/Oct2025
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=187784705&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 187784705
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        02729490
        44I
      jtl: American Journal of Occupational Therapy
      issn: 02729490
      maglogo: N
    pubinfo:
      dt: Sep/Oct2025
      vid: 79
      iid: 5
      pid: 6680
      pub: American Occupational Therapy Association
      place: North Bethesda, Maryland
    artinfo:
      ui:
        187784705
        187784705
        187784705
        10.5014/ajot.2025.051036
        187784705
      ppf: 1
      ppct: 8
      formats:
        fmt:
          – @attributes:
              type: T
          – @attributes:
              type: P
      tig:
        atl: Chronotype Shifts and Cognitive Performance in Stroke Survivors: Exploring the Impact of Occupational Therapy Treatment Timing on Rehabilitation Outcomes.
      aug:
        au:
          Hersch, Ayelet
          Serfaty, Corinne
          Portnoy, Sigal
        affil: Ayelet Hersch, OT, is Master's Student, Occupational Therapy Department, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
      sug:
        subj:
          Chronotype
          Cognition
          Task Performance and Analysis
          Sleep Quality
          Stroke Patients
          Occupational Therapy
          Stroke Rehabilitation
          Treatment Outcomes
          Time Factors
          Human
          Male
          Female
          Middle Age
          Adult
          Aged
          Prospective Studies
          Sociodemographic Factors
          Surveys
          Questionnaires
          Actigraphy
          Motion Capture
          Brain Stem
          Cerebellum
          Ischemia
          Rehabilitation Centers
          Israel
          Convenience Sample
          Data Analysis Software
          Mann-Whitney U Test
          Wilcoxon Signed Rank Test
          Spearman's Rank Correlation Coefficient
          Psychological Tests
          Descriptive Statistics
          Funding Source
          Middle Aged: 45-64 years
          Adult: 19-44 years
          Aged: 65+ years
          Male
          Female
      ab: Importance: Stroke survivors commonly report persistent sleep disruptions during rehabilitation and postrecovery. Despite little research that explores the impact of stroke on a patient's chronotype, no studies have explored the differences in cognitive performance between treatment timing fitted and nonfitted to the patient's chronotype. Objective: To characterize the sleep chronotype in patients in the subacute poststroke period, to explore cognitive task performance differences during fitted and nonfitted hours, and to examine the relationships between sleep quality and cognitive performance. Design: Cohort design. Setting: Health care institution. Participants: Twenty men and women (M age = 60.2, SD = 8.6) post–first stroke. Outcomes and Measures: The following measures were collected twice, during fitted and nonfitted chronotypic times: demographic surveys, the Munich Chronotype Questionnaire, the Montreal Cognitive Assessment (MoCA), the Rivermead Behavioral Memory Test, Second Edition (RBMT–2), a fatigue questionnaire, and of actigraphy for 4 to 5 days. Results: Stroke survivors exhibited an earlier sleep chronotype postinjury compared with preinjury. Enhanced memory (higher RBMT–2 scores) occurred during fitted hours. No significant differences emerged in executive functions, attention tasks, and MoCA scores between fitted and nonfitted hours. The Wake After Sleep Onset index correlated with the MoCA and RBMT–2 scores during fitted hours (MoCA: r =.53, p =.021; RBMT–2: r =.51, p =.027). Number of awakenings correlated with the MoCA letter task during nonfitted hours (r =.45; p =.044). Conclusions and Relevance: Occupational therapy practitioners should be aware of the relationship between chronotype and cognitive performance, with a focus on the importance of personalized rehabilitation strategies in stroke care. Plain-Language Summary: The timing of cognitive assessments poststroke can influence their reliability, particularly when considering a patient's chronotype (sleep cycle). For instance, if a morning person is evaluated later in the day (nonfitted to their chronotype), the results may indicate greater cognitive decline compared with scores they might achieve in the morning. In our study, we assessed cognitive performance twice: once fitted to the patient's chronotype and once not. Our findings revealed that memory function significantly improved during evaluations conducted at personalized times. This suggests that occupational therapy practitioners who evaluate patients during nonoptimal times may prescribe a more extensive rehabilitation plan than necessary. The study findings revealed that memory function for stroke survivors significantly improved during cognitive assessments conducted at personalized times, highlighting the importance of personalized occupational therapy rehabilitation strategies.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N