Cognitive Oriented Strategy Training Augmented Rehabilitation (COSTAR) Treatment Approach for Stroke
Overview
- Phase
- Phase 1
- Intervention
- Not specified
- Conditions
- Stroke
- Sponsor
- Washington University School of Medicine
- Enrollment
- 47
- Locations
- 1
- Primary Endpoint
- Canadian Occupational Performance Measure (COPM)
- Status
- Completed
- Last Updated
- 7 years ago
Overview
Brief Summary
Stroke is the most serious disabling condition in the United States and the developed world. Novel stroke rehabilitation approaches, such as task-specific training, have shown promise in improving an individual's recovery in the rehabilitation setting; however, evidence suggests that these improvements are not generalized or transferred to the home, community, or work settings. Thus, these interventions usually do not impact overall health and participation outcomes. This research study seeks to improve task-specific training as a stroke rehabilitation approach by integrating it with evidence-based cognitive-oriented strategies which have shown great promise as a way to address the limitations of task-specific training. The new treatment protocol is called Cognitive-Oriented Strategy Training Augmented Rehabilitation, or COSTAR. The hypothesis of this study is that COSTAR will result in more efficient functional skill acquisition, better long-term retention of skills learned, and generalization and transfer of skills learned to home, community, and work settings.
Investigators
Eligibility Criteria
Inclusion Criteria
- •age 18 or older;
- •have completed all physician recommended rehabilitation and currently not receiving rehabilitation services;
- •at least one-month post-stroke;
- •have self-reported unmet functional goals; and
- •NIH Stroke Scale (NIHSS) total score of 2-12.
Exclusion Criteria
- •have sustained a hemorrhagic stroke;
- •NIH Stroke Scale (NIHSS) aphasia rating of 1 or more (impaired speech);
- •MoCA cognitive screen score of less than 21 (impaired general cognitive ability);
- •neurological diagnoses other than stroke;
- •major psychiatric illness (bipolar disorder, OCD, panic disorder, PTSD, and/or borderline personality disorder);
- •no major depressive symptoms (PHQ-9 \< 20);
- •a score of 6 or less on the CIHI aphasia screen combined items 64 and 66;
- •terminal illness;
- •blindness; and
- •non-English speaking.
Outcomes
Primary Outcomes
Canadian Occupational Performance Measure (COPM)
Time Frame: Change from baseline to post-intervention (12 weeks)
Performance Quality Rating Scale (PQRS)
Time Frame: Change from baseline to post-intervention (12 weeks)
Secondary Outcomes
- Self-Efficacy Gauge (SEG)(Change from baseline to post-intervention (12 weeks))
- Activity Card Sort (ACS)(Change from baseline to post-intervention (12 weeks))
- Reintegration to Normal Living Index (RNLI)(Change from baseline to post-intervention (12 weeks))
- Stroke Impact Scale (SIS)(Change from baseline to post-intervention (12 weeks))
- Patient Reported Outcomes Measurement System (PROMIS-57)(Change from baseline to post-intervention (12 weeks))
- Patient Health Questionnaire (PHQ-9)(Change from baseline to post-intervention (12 weeks))