None listed
Conditions
Brief summary
dentifying and addressing cognitive impairments post-stroke is a significant component of stroke rehabilitation. However, few cognitive assessments measure real-world performance. One assessment that addresses cognition in the ‘here and now’ is Perceive Recall Plan Perform (PRPP). PRPP is an assessment and intervention system used by Occupational Therapists (OTs) to identify errors of cognitive strategy application and structure individualised intervention. PRPP is a unique tool: it measures cognitive strategy application in any task, in any setting, and can be used with any client, regardless of diagnosis or age. PRPP is standardised, reliable, valid and criterion-referenced assessment (Chapparo & Ranka, 2012), meaning that it can be used to measure how much of a task that an individual needs to do in their own situation, rather than using generic criteria to measure success. It consists of a two stage assessment framework: stage one uses task analysis to record motor steps and errors. Stage two is used to attribute errors in applying cognitive strategies which occurred during the task. PRPP is widely used for assessment and intervention in brain injury (Nott, Chapparo, & Heard, 2009), however there is little documented evidence of PRPP in stroke rehabilitation. This study will be conducted with stroke survivors in an Early Supported Discharge (ESD) setting, titled Rehabilitation in the Home (RITH). Three different assessments will be conducted by OTs: PRPP on two different tasks, the Functional Independence Measure (FIM) to measure burden of care and Lawton’s Instrumental Activities of Daily Living (LIADL) to measure domestic task independence. PRPP stage one and stage two scores will be related with these measures and examined for any trends. All data will be collected within the first five OT home visits as a component of standard care and full data sets from ten patients are required for analysis. This exploratory study aims to examine the use of PRPP in stroke as a tool to identify errors in using cognitive strategy application, measure task mastery and detail trends in the assessment results. The objectives are to: Determine if it is feasible to use PRPP with stroke patients receiving ESD, examine the usefulness of each aspect of PRPP in stroke rehabilitation; and explore the association between PRPP and FIM and LIADL. It is anticipated that this study will examine the feasibility of using PRPP in stroke ESD, provide evidence for the use of PRPP in stroke to assess cognitive strategy application and explore PRPP as a real-world measure of information processing in stroke rehabilitation.
Interventions
Ten stroke survivors will be assessed on 3 outcomes measures in their initial Occupational Therapy home visit sessions as part of an early supported discharge service.
They will be assessed with the Perceive Recall Plan Perform System of Task Analysis (PRPP). This is an observational assessment of occupational performance and cognitive strategy application. It is non-invasive and is standardised, reliable and valid. They will also be assesed on the Functional Independence Measure to measure bu
Ten stroke survivors will be assessed on 3 outcomes measures in their initial Occupational Therapy home visit sessions as part of an early supported discharge service. They will be assessed with the Perceive Recall Plan Perform System of Task Analysis (PRPP). This is an observational assessment of occupational performance and cognitive strategy application. It is non-invasive and is standardised, reliable and valid. They will also be assesed on the Functional Independence Measure to measure burden of care and the Lawtons Scale to measure independence in instrumental activities of daily living. These assessments will all occur in their home and will take an average of an hour to complete. This is part of standard care and is in face to face delivery. PRPP will be conducted on two different tasks, and the other scales are once-off. These assessments will be completed within the first 5 OT home visits, ie: early in the episode of care with the service. PRPP is an observational assessment. Participants will negotiate tasks to be assessed with their an OT at an appropriate level of challenge. They will be advised that notes will be taken and that they will receive their results once the assessment has been scored. Tasks may include using a computer, preparing a meal or shaving.
Sponsors
Royal Perth Hospital
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Diagnosis of stroke, less than six months post stroke, 18 years and older, able to communicate in basic English, identified post-stroke cognitive impairment and able to give consent. People with aphasia are also potential participants. Recruitment must have been completed within the first four OT home visits, with the assessments being completed by the fifth visit. Participants will continue with standard care with the ESD service during and after data collection.
Exclusion criteria
Diagnosis of a premorbid intellectual impairment, readmission to hospital prior to the assessments being completed and not receiving OT with the ESD service.
Outcome results
None listed