Article

Cognitive impairments occur frequently after stroke and contribute to
significant disability. Strategy training shows promise but has not been examined
in the acute phase of recovery. OBJECTIVE: We conducted a single-blind randomized
pilot study estimating the effect of strategy training, relative to reflective
listening (attention control), for reducing disability and executive cognitive
impairments. METHODS: Thirty participants with acute stroke who were enrolled in
inpatient rehabilitation and had cognitive impairments were randomized to receive
strategy training (n = 15, 10 sessions as adjunct to usual inpatient
rehabilitation) or reflective listening (n = 15, same dose). The Functional
Independence Measure assessed disability at baseline, rehabilitation discharge,
3, and 6 months. The Color Word Interference Test of the Delis-Kaplan Executive
Function System assessed selected executive cognitive impairments (inhibition,
flexibility) at baseline, 3, and 6 months. RESULTS: Changes in Functional
Independence Measure scores for the 2 groups over 6 months showed significant
effects of group (F1,27 = 9.25, P = .005), time (F3,74 = 96.00, P < .001), and
group * time interactions (F3,74 = 4.37, P < .007) after controlling for baseline
differences in stroke severity (F1,27 = 6.74, P = .015). Color Word Interference
Inhibition scores showed significant effects of group
(F1,26 = 6.50, P = .017)
and time (F2,34 = 4.74, P = .015), but the group * time interaction was not
significant (F2,34 = 2.55, P = .093). Color Word Interference Cognitive
Flexibility scores showed significant effects of group (F1,26 = 23.41, P < .001),
time (F2,34 = 12.77, P < .001), and group * time interactions (F2,34 = 7.83, P <
.002). Interaction effects suggested greater improvements were associated with
strategy training. CONCLUSIONS: Strategy training shows promise for addressing
disability in the first 6 months after stroke. Lessons from this pilot study may
inform future clinical trials.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS