Article

OBJECTIVE: To examine the feasibility of a strategy training clinical trial in a
small group of adults with stroke-related cognitive impairments in inpatient
rehabilitation, and to explore the impact of strategy training on disability.
DESIGN: Non-randomized two-group intervention pilot study. SETTING: Two inpatient
rehabilitation units within an academic health centre. PARTICIPANTS: Individuals
with a primary diagnosis of acute stroke, who were admitted to inpatient
rehabilitation and demonstrated cognitive impairments were included. Individuals
with severe aphasia; dementia; major depressive disorder, bipolar, or psychotic
disorder; recent drug or alcohol abuse; and anticipated length of stay less than
five days were excluded. INTERVENTION: Participants received strategy training or
an attention control session in addition to usual rehabilitation care. Sessions
in both groups were 30-40 minutes daily, five days per week, for the duration of
inpatient rehabilitation. MAIN OUTCOME MEASURES: We assessed feasibility through
participants' recruitment and retention; research intervention session number and
duration; participants' comprehension and engagement; intervention fidelity; and
participants' satisfaction. We assessed disability at study admission, inpatient
rehabilitation discharge, 3 and 6 months using the Functional Independence
Measure. RESULTS: Participants in both groups (5 per group) received the assigned
intervention (>92% planned sessions; >94% fidelity) and completed follow-up
testing. Strategy training participants in this small sample demonstrated
significantly less disability at six months (M (SE) = 117 (3)) than attention
control participants (M(SE) = 96 (14); t 8 = 7.87, P = 0.02). CONCLUSIONS: It is
feasible and acceptable to administer both intervention protocols as an adjunct
to acute inpatient rehabilitation, and strategy training shows promise for
reducing disability.

Langue : ANGLAIS