Adapting Daily Activity Performance Through Strategy Training

Not Applicable

Completed

• Conditions: Strategy Training; Attention Control
• Interventions: Behavioral: Attention Control; Behavioral: Strategy Training

• Registration Number: NCT01934621
• Lead Sponsor: University of Pittsburgh

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. The proposed study examines a novel intervention, strategy training, that shows promise for helping individuals with stroke-related cognitive impairments reduce disability in daily tasks, which may lead to reductions in healthcare costs. We predict that strategy training will result in significantly greater independence 6 months after stroke compared to an attention control intervention, and that strategy training may reduce cognitive impairments.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2013-08-29
• Study First Submitted QC: 2013-08-29
• Study First Posted: 2013-09-04
• Study Start: 2013-11
• Primary Completion: 2018-05
• Study Completion: 2020-09
• Status Verified: 2020-11
• Last Update Submitted: 2020-11-03
• Last Update Posted: 2020-11-05

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 128

Inclusion Criteria

• primary diagnosis of acute stroke
• admission to acute inpatient rehabilitation
• impairment in higher order cognitive functions (EXIT-14 ≥ 3)

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Exclusion Criteria

• pre-stroke diagnosis of dementia in the medical record
• inability to follow two- step commands 80% of the time
• severe aphasia (BDAE ≤ 1)
• current major depressive, bipolar, or psychotic disorder
• drug or alcohol abuse within 3 months

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Attention Control	Attention Control	The attention control intervention will control for the non-specific effects of strategy training. The therapists will administer the standardized and dose-matched protocol, using scripted open-ended questions to facilitate participants' reflections on their rehabilitation activities and experiences. In lieu of the strategy training workbook materials, participants will complete a daily journal, and discuss their entries during attention control sessions.
Strategy Training	Strategy Training	Strategy training is a form of meta-cognitive instruction that trains individuals with stroke-related cognitive impairments to identify and prioritize problematic daily activities, identify the barriers impeding performance, generate and evaluate their own strategies to address barriers, and apply these skills through iterative practice. Participants use printed workbooks to learn and apply this method.

Primary Outcome Measures

Name	Time	Method
Change in Independence with Daily Activities	Baseline to Month 6	Moderate effect size of difference between groups in independence (measured with the Functional Independence Measure)

Secondary Outcome Measures

Name	Time	Method
Change in Executive Functions	Baseline to Month 6	Moderate effect size of difference between groups in independence (measured with selected indices of the Delis-Kaplan Executive Function System)

Trial Locations

Locations (1)

University of Pittsburgh; 🇺🇸 Pittsburgh, Pennsylvania, United States