Adapting Daily Activity Performance Through Strategy Training (ADAPTS)

University of Pittsburgh

Status: Completed

Conditions: Attention Control; Strategy Training

Treatments: Behavioral: Strategy Training; Behavioral: Attention Control

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT01934621

PRO13070029

R01HD074693 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

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.

Enrollment: 128 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

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

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

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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128 participants in 2 patient groups, including a placebo group

Strategy Training

Experimental group

Description:

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.

Treatment:

Behavioral: Strategy Training

Attention Control

Placebo Comparator group

Description:

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.

Treatment:

Behavioral: Attention Control