Background Stroke leads to both motor and cognitive impairments that can substantially limit daily activities and independence. Although these impairments are often treated separately in rehabilitation, growing evidence suggests they are interconnected. Understanding how cognitive and motor impairments relate to one another is essential for developing more effective, integrated rehabilitation strategies.

Objective This longitudinal study addressed three key questions: (1) Do motor and cognitive impairments co-occur after stroke? (2) Does cognitive ability influence motor recovery? (3) Are cognitive and motor recovery trajectories associated?

Methods We followed 148 individuals in the subacute phase of stroke, assessing them at 1 and 3 months post-stroke. Cognitive function was measured using the Montreal Cognitive Assessment (MoCA) and the clock drawing test. Motor impairment was assessed using the Fugl-Meyer Assessment (FMA) and grip strength. Activity was evaluated using the Action Research Arm Test (ARAT), 10-Meter Walk Test (10MW), and Timed Up and Go (TUG).

Results At one month post-stroke, cognitive and motor impairment and activity levels were not correlated, although strong within-domain correlations were observed. Baseline cognitive ability did not predict motor impairment recovery. However, improvements in cognitive ability from 1 to 3 months were moderately correlated with gains in motor activity measures (r = 0.22–0.29, p < 0.05).

Conclusions Although cognitive and motor impairments may arise independently after stroke, their recovery processes appear partially linked. These findings underscore the importance of addressing both domains in rehabilitation and advancing understanding of shared mechanisms that support recovery across functional systems.

The authors have declared no competing interest.

This research was supported by the Israeli Science Foundation (Grant 1244/22 to LS) and the Lillian and David E. Feldman Research fund.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The study was conducted at the Adi Negev Nahalat Eran rehabilitation center (Israel) in collaboration with The Lillian and David E. Feldman Research Center for Rehabilitation Sciences and was approved by the Regional Ethical Review Board at Adi Negev, Israel (Approval Number ADINEGEV-2023_106)

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Data produced in the present study is available upon reasonable request to the authors.