Case Studies: Promoting Strategy Use in Functional Activities

Weill Cornell Medicine (WCM)

Status: Completed

Conditions: Cognitive Impairment; Acquired Brain Injury; Executive Dysfunction

Treatments: Other: Multicontext (MC) approach

Study type: Interventional

Funder types: Other

Identifiers

NCT04363645

1308014257

Details and patient eligibility

About

The purpose of the study is to provide evidence of feasibility, acceptability, patient satisfaction, and patient perceived benefit of the Multicontext (MC) approach. The project consists of eight case studies of persons with acquired brain injury undergoing acute inpatient rehabilitation who have difficulties in completing multiple step activities due to deficits in executive function and/or visual perception. The MC approach provides a structured occupational therapy framework that provides guidelines for enhancing strategy use and self monitoring skills for person's with acquired brain injury.

Enrollment: 8 patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age between 18 and 80 years
• English-speaking
• Confirmed diagnosis of acquired brain injury (ABI) based on radiological assessment
• Able to comprehend multistep directions and participate in conversation as assessed by the Functional Independence Measure (FIM; required score of 4 or above on Comprehension and Expression items)
• Impaired performance (<2 SD below demographically-corrected normative data) on at least one screening measure of executive functioning
• Able to attend to a cognitive task for at least 10 minutes
• Cognitively independent in basic self-care activities
• Able to read standard size newsprint
• Ability to demonstrate functional use of at least one hand.

Exclusion criteria

• Global aphasia or moderate - severe comprehension deficits (as indicated by a FIM comprehension score of less than 4)
• Global cognitive impairment or dementia as indicated by a score of 20 or less on the Montreal cognitive assessment
• History of treatment for substance abuse or hospitalizations for psychiatric disorder, within the past year
• non-English speaking

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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8 participants in 1 patient group

Multicontext approach (Intervention) Arm

Experimental group

Description:

Participants received 30-minute sessions of strategy and self-monitoring practice within the context of everyday activities. These sessions were delivered either daily or twice a day. The total number of sessions varied depending on the participant's length of stay in acute rehabilitation.

Treatment:

Other: Multicontext (MC) approach