Abstract
Objective:
To examine the feasibility of a strategy training clinical trial in a small group of adults with stroke-related cognitive impairments in inpatient rehabilitation, and to explore the impact of strategy training on disability.
Design:
Non-randomized two-group intervention pilot study.
Setting:
Two inpatient rehabilitation units within an academic health centre.
Participants:
Individuals with a primary diagnosis of acute stroke, who were admitted to inpatient rehabilitation and demonstrated cognitive impairments were included. Individuals with severe aphasia; dementia; major depressive disorder, bipolar, or psychotic disorder; recent drug or alcohol abuse; and anticipated length of stay less than five days were excluded.
Intervention:
Participants received strategy training or an attention control session in addition to usual rehabilitation care. Sessions in both groups were 30–40 minutes daily, five days per week, for the duration of inpatient rehabilitation.
Main outcome measures:
We assessed feasibility through participants’ recruitment and retention; research intervention session number and duration; participants’ comprehension and engagement; intervention fidelity; and participants’ satisfaction. We assessed disability at study admission, inpatient rehabilitation discharge, 3 and 6 months using the Functional Independence Measure.
Results:
Participants in both groups (5 per group) received the assigned intervention (>92% planned sessions; >94% fidelity) and completed follow-up testing. Strategy training participants in this small sample demonstrated significantly less disability at six months (M (SE) = 117 (3)) than attention control participants (M(SE) = 96 (14); t8 = 7.87, P = 0.02).
Conclusions:
It is feasible and acceptable to administer both intervention protocols as an adjunct to acute inpatient rehabilitation, and strategy training shows promise for reducing disability.
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