Strategy Training for People With Aphasia After Stroke
30. august 2021 oppdatert av: Elizabeth R. Skidmore, PhD, OTR/L, University of Pittsburgh
One-third to one-half of acute strokes result in newly acquired cognitive impairments.
Approximately 30 to 40% of people in the acute phase of stroke also sustain communication impairments.
Stroke-related cognitive impairments are associated with significant functional disability, as indicated by the inability to regain independence in daily activities.
The overall aim of this study is to examine the feasibility of an adapted form of strategy training for people with communication impairments who are admitted to inpatient rehabilitation.
These analyses will address a critical gap in current rehabilitation research, namely the exclusion of people with communication impairments in acute stroke rehabilitation clinical trials, and provide pilot data to inform the design of future inclusive clinical trials seeking to reduce disability after stroke.
Studieoversikt
Status
Avsluttet
Forhold
Intervensjon / Behandling
Detaljert beskrivelse
This pilot study will use a descriptive case series design with repeated measures to assess the feasibility of an adapted form of strategy training for people with communication impairments after acute stroke.
The investigators will recruit people with aphasia due to stroke admitted to the inpatient rehabilitation units and administer the adapted form of strategy training one session per day 5 days per week for 10-15 sessions.
The investigators will assess the feasibility of the intervention based on feedback from participants and therapists.
These data will serve as pilot data to inform the design of a future clinical trials for people with cognitive impairments after stroke, including people with communication impairments.
These efforts will allow the investigators to test new models to support optimal interventions for individuals with stroke-related cognitive impairments, including people with communication impairments who are among those most vulnerable for long-term disability.
Studietype
Intervensjonell
Registrering (Faktiske)
16
Fase
- Ikke aktuelt
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Studiesteder
-
-
Pennsylvania
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Pittsburgh, Pennsylvania, Forente stater, 15260
- University of Pittsburgh
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Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
18 år og eldre (Voksen, Eldre voksen)
Tar imot friske frivillige
Nei
Kjønn som er kvalifisert for studier
Alle
Beskrivelse
Inclusion Criteria:
- primary diagnosis of acute stroke
- admission to acute rehabilitation
- mild to moderate aphasia but able to understand and express communication with verbal, written, and/or augmentative communication (score of 1 or 2 on the National Institutes of Health Stroke Scale item 9, or score 1 to 5 on the Boston Diagnostic Aphasia Examination Severity Scale)
Exclusion Criteria:
- pre-stroke diagnosis of dementia
- severe global aphasia (Boston Diagnostic Aphasia Examination Severity Scale score of 0)
- dysarthria as the only communication impairment (score of 1 or 2 two on the National Institutes of Health Stroke Scale item 10, but score of 0 on item 9)
- current major depressive disorder (unless treated and in partial remission), bipolar disorder, or any other psychotic disorder (indicated by PRIME-MD)severe global aphasia (Boston Diagnostic Aphasia Examination Severity Scale score of 0)
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: N/A
- Intervensjonsmodell: Enkeltgruppeoppdrag
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
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Eksperimentell: Strategy Training
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.
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This study will use an adapted form of strategy training for people with communication impairments.
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Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Mean Patient-therapist Communication Score
Tidsramme: Baseline to Post-Intervention (up to 3 weeks)
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Measure of Participation in Conversation (MPC) Interaction score greater than or equal to 2. The scale assesses the degree of participation executed by the participant with communication impairment during supported conversation.
Scores range from 0=no participation/comprehension to 4=full participation/comprehension.
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Baseline to Post-Intervention (up to 3 weeks)
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Change in Independence With Daily Activities
Tidsramme: Baseline to 6 months
|
Change in independence measured with the Functional Independence Measure.
The FIM assesses 18 tasks in 6 functional domains (self-care, sphincter control, transfers, locomotion, communication and social cognition) using a scale of 1 (dependent) to 7 (independent).
Scores range from 18 to 126.
Higher values represent better outcomes.
The a priori criterion for change was a medium effect size of change (Cohen's d≥0.5).
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Baseline to 6 months
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Change in Cognition
Tidsramme: Baseline to 6 months
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Change in cognition measured with the Cognitive Linguistic Quick Test Executive Function Score.
The severity score measures executive functions using 4 tasks (symbol trails, generative naming, mazes, and design generation).
The score ranges from 40 (within normal limits) to 0 (severe impairment).
Higher values represent better outcomes.
The a priori criterion for change was a medium effect size of change (Cohen's d≥0.5).
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Baseline to 6 months
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Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Sponsor
Samarbeidspartnere
Etterforskere
- Hovedetterforsker: Elizabeth R. Skidmore, PhD, OTR/L, University of Pittsburgh
Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart (Faktiske)
23. juli 2018
Primær fullføring (Faktiske)
1. august 2020
Studiet fullført (Faktiske)
1. august 2020
Datoer for studieregistrering
Først innsendt
22. juni 2018
Først innsendt som oppfylte QC-kriteriene
10. juli 2018
Først lagt ut (Faktiske)
20. juli 2018
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
24. september 2021
Siste oppdatering sendt inn som oppfylte QC-kriteriene
30. august 2021
Sist bekreftet
1. august 2021
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- PRO18050075
- R01HD074693 (U.S. NIH-stipend/kontrakt)
Legemiddel- og utstyrsinformasjon, studiedokumenter
Studerer et amerikansk FDA-regulert medikamentprodukt
Nei
Studerer et amerikansk FDA-regulert enhetsprodukt
Nei
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