Article

Purpose This pilot partially randomised controlled trial compared the feasibility
and preliminary efficacy of two promising interventions for persons with
executive dysfunction post-stroke: (1) occupation-based strategy training using
an adapted version of the Cognitive Orientation to daily Occupational Performance
(CO-OP) approach; and (2) Computer-based EF training (COMPUTER training). Method
Participants received 16 h of either CO-OP or COMPUTER training. We assessed
feasibility and acceptability of each intervention, and change in intervention
outcomes at baseline, post-intervention and one-month follow-up. Performance and
satisfaction with performance in self-selected everyday life goals were measured
by the participant and the significant other-rated Canadian Occupational
Performance Measure (COPM). Other intervention outcomes included changes in EF
impairment, participation in daily life and self-efficacy. Results Six
participants received CO-OP and five received COMPUTER training: one in each
group discontinued the intervention for medical reasons unrelated to the
intervention. The remaining nine participants completed all 16 sessions.
Participants expressed high levels of satisfaction with both interventions. Both
treatment groups showed large improvements in self and significant other-rated
performance and satisfaction with performance on their goals immediately
post-intervention and at follow-up (CO-OP: effect sizes (ES) = 1.6-3.5; COMPUTER:
ES = 0.9-4.0), with statistically significant within-group differences in CO-OP
(p < 0.05). The COMPUTER group also showed large improvements in some areas of EF
impairment targeted by the computerised tasks (ES = 0.9-1.6); the CO-OP group
demonstrated large improvements in self-efficacy for performing everyday
activities (ES = 1.5). Conclusions Our findings provide preliminary evidence
supporting the feasibility of using both CO-OP and COMPUTER training with
patients with executive dysfunction post-stroke. Implications for Rehabilitation
Computerised executive function training and occupation-based strategy training
are feasible to deliver and acceptable to persons with executive dysfunction
post-stroke. Preliminary evidence suggests that both interventions have a
positive impact on real-world outcomes; and, that CO-OP might have a greater
impact on improving self-efficacy for performing everyday activities.

Langue : ANGLAIS