Guided Versus Directed Training in Acute Stroke Rehabilitation
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Guided Training
- Sponsor
- University of Pittsburgh
- Enrollment
- 77
- Locations
- 1
- Primary Endpoint
- Differences in Independence With Activities of Daily Living (Functional Independence Measure) Between Groups Over Time
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
Individuals with cognitive impairments after stroke sustain significant disability in their daily tasks, and account for a significant proportion of stroke-related healthcare costs. This loss of independence is costly because individuals with stroke-related cognitive impairments require more rehabilitation and more resources to support their living, whether in institutional or community settings. The proposed study examines the effects of directed and guided training on the recovery of independence with daily activities in adults with stroke-related cognitive impairments in acute rehabilitation. The investigators predict that patients in both groups will demonstrate significant improvement in independence with daily activities in the first 12 months after rehabilitation admission, but that patients who receive guided training will demonstrate significantly more improvements than patients who received directed training.
Investigators
Elizabeth R. Skidmore, PhD, OTR/L
Assistant Professor
University of Pittsburgh
Eligibility Criteria
Inclusion Criteria
- •primary diagnosis of acute stroke
- •admission to acute inpatient rehabilitation
- •impairment in cognitive functions (as indicated by 14-item Executive Interview ≥ 3)
Exclusion Criteria
- •diagnosis of dementia in the medical record
- •inability to follow two-step commands 80% of the time
- •severe aphasia (score of 0 or 1 on the Boston Diagnostic Aphasia Examination 3rd Edition Severity Rating Scale)
- •current untreated major depressive, bipolar, or psychotic disorder (PRIME-MD)
- •drug or alcohol abuse within 3 months (Mini-International Neuropsychiatric Interview)
Outcomes
Primary Outcomes
Differences in Independence With Activities of Daily Living (Functional Independence Measure) Between Groups Over Time
Time Frame: Baseline, rehab discharge, month 3, month 6, month 12
Differences between groups in mean independence scores (computed from Functional Independence Measure total scores) over time. The Functional Independence Measure contains 18 items with a total score ranging from 18-126 is obtained (18=complete dependence/total assistance with basic self-care and mobility activities; 126=complete independence with basic self-care and mobility activities). Total scores were calculated for each participant at baseline, discharge, month 3, month 6, and month 12, and mean total scores for each group were calculated at each time point. Differences in mean scores were examined between groups over time with mixed model analyses.