Telerehabilitation for Attention and Memory in Stroke (TEAMS): Development and Initial Evaluation of an Internet-Based Training Program
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 7
- 试验地点
- 1
- 主要终点
- Change in working memory function between baseline and 6 weeks post training onset
研究概览
简要总结
The investigators propose to develop a Telerehabilitation approach to working memory training for patients experiencing working memory deficits post stroke. The investigators have currently developed a game-like computerized working memory training program that can be accessed via the internet for research purposes. The investigators propose to refine the website to focus more on clinically based training, and to evaluate the feasibility and initial effectiveness of this approach in a pilot study with participants after stroke.
详细描述
Vascular disease and stroke often affect working memory, which is the ability to hold information in mind in order to deal with tasks, such as reading, having a conversation, problem-solving and decision-making. Working memory deficits can lead to problems with everyday activities, affecting independence and quality of life. Thus, interventions to improve working memory are important for optimal health outcomes in individuals after stroke.
Currently, approaches to provide interventions for working memory deficits are limited to intensive face-to-face rehabilitation sessions requiring trained therapists over many weeks. Even one-on-one computerized training requires significant health care resources, however, including supervision of daily sessions by a trained therapist, set-up of the program on the computer, teaching the patient how to use the program, regular encouragement and feedback to maintain motivation, monitoring of progress, and trouble-shooting when there are difficulties. Thus, access to these interventions is usually restricted to patients currently in hospital in urban areas, and limited or not available to those in the community once discharged, or when treated in hospital in more rural settings. Thus, new approaches to increase accessibility of this intervention approach to patients are needed.
The investigators developed one method of working memory training which uses a computerized, game-like approach, which is ideal for providing intensive, repetitive practice, with feedback and monitoring of progress. While the maximally effective dose is not yet identified, adaptive training practice normally is provided for 5 days/week for 5-10 weeks. With this intensity, computerized working memory training has been shown to improve cognitive abilities in a range of groups (e.g., healthy younger and older adults, those with Attention deficit hyperactivity disorder (ADHD), stroke, schizophrenia) and these benefits can generalize to other cognitive abilities and be maintained, at least in the short term.
The investigators propose to develop and evaluate an internet-based intervention approach, using the computerized working memory method that has been shown to be effective in improving working memory in several patient groups, including stroke. The investigators will develop and refine a website that the investigators can use to provide an already available computerized game-like software program for working memory training, and conduct an initial evaluation of this approach for feasibility and effectiveness in a pilot study involving clinical sites in Nova Scotia.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •at least 3 months post first stroke documented clinically or by imaging
- •subjective concerns or objective assessment data regarding deficits in attention and working memory ability
- •normal or corrected-to-normal vision
- •have access to a computer at home
排除标准
- •severe aphasia or dementia
- •other neurological diagnosis such as epilepsy, multiple sclerosis, Parkinson's disease
- •current diagnosis of a severe psychiatric disorder such as major depressive disorder or psychosis
结局指标
主要结局
Change in working memory function between baseline and 6 weeks post training onset
时间窗: 6 weeks post training onset
Baseline working memory function
时间窗: Baseline
Using operation and symmetry span task, as well as as Sternberg memory scanning tasks Operation span task: A dual-task in which participants complete mathematical reasoning (e.g. solving a mathematical equation) while using short-term verbal memory to remember words. Symmetry span task: A dual task in which participants discriminate about the symmetry of visual stimuli while using short-term spatial memory to remember the locations of stimuli. Sternberg memory scanning tasks: A task that involved remembering various number of cards as memory test
次要结局
- Baseline anxiety/depression(Baseline)
- Change in in memory function 6 weeks post training onset(6 weeks post training onset)
- Baseline executive functioning(Baseline)
- Baseline premorbid intelligence quotient (IQ)(Baseline)
- Change in executive functioning 6 weeks post training onset(6 weeks post training onset)
- Change in aphasia assessment 6 weeks post training onset(6 weeks post training onset)
- Baseline memory function(Baseline)
- Baseline cognitive function(Baseline)
- Baseline aphasia assessment(Baseline)
- Change in attention function 6 weeks post training onset(6 weeks post training onset)
- Baseline behaviour and motivation(Baseline)
- Baseline attention function(Baseline)
- Change in behaviour and motivation 6 weeks post training onset(6 weeks post training onset)