Strategy Training During Inpatient Rehabilitation May Prevent Apathy Symptoms After Acute Stroke

Wiley - Tập 7 Số 6 - Trang 562-570 - 2015
Elizabeth R. Elizabeth R., Ellen M. Ellen M., Meryl A. Meryl A., Lauren Lauren, Charles F. Charles F.

Tóm tắt

AbstractBackgroundApathy, or lack of motivation for goal‐directed activities, contributes to reduced engagement in and benefit from rehabilitation, impeding recovery from stroke.ObjectiveTo examine the effects of strategy training, a behavioral intervention used to augment usual inpatient rehabilitation, on apathy symptoms over the first 6 months after stroke.DesignSecondary analysis of randomized controlled trial.SettingAcute inpatient rehabilitation.ParticipantsParticipants with acute stroke who exhibited cognitive impairments (Quick Executive Interview Scores ≥3) and were admitted for inpatient rehabilitation were randomized to receive strategy training (n = 15, 1 session per day, 5 days per week, in addition to usual inpatient rehabilitation) or reflective listening (n = 15, same dose).MethodsStrategy training sessions focused on participant‐selected goals and participant‐derived strategies to address these goals, using a global strategy training method (Goal‐Plan‐Do‐Check). Reflective listening sessions focused on participant reflections on their rehabilitation goals and experiences, facilitated by open‐ended questions and active listening skills (attending, following, and responding).Main Outcome MeasuresTrained raters blinded to group assignment administered the Apathy Evaluation Scale at study admission, 3 months, and 6 months. Data were analyzed with repeated‐measures fixed‐effects models.ResultsParticipants in both groups had similar subsyndromal levels of apathy symptoms at study admission (strategy training, mean = 25.79, standard deviation = 7.62; reflective listening, mean = 25.18, standard deviation = 4.40). A significant group × time interaction (F2,28 = 3.61, P = .040) indicated that changes in apathy symptom levels differed between groups over time. The magnitude of group differences in change scores was large (d = −0.99, t28 = −2.64, P = .013) at month 3 and moderate to large (d = −0.70, t28 = −1.86, P = .073) at month 6.ConclusionStrategy training shows promise as an adjunct to usual rehabilitation for maintaining low levels of poststroke apathy.

Tài liệu tham khảo

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Wiley

Tập 7 Số 6

562-570

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