Stroke, Neglect, Hemispatial
Conditions
Brief summary
It is common for individuals after stroke to have a cognitive perceptual impairment called unilateral spatial neglect (neglect). Individuals with neglect have difficulty paying attention to one side of their body or one side of the environment and therefore experience difficulty performing daily activities. There are a lack of effective treatments for neglect and new interventions are needed to help reduce disability for these individuals. Metacognitive strategy training (strategy training) is an intervention that has the potential to reduce neglect-related disability and improve individuals' awareness of their neglect. This study seeks to examine the effects of strategy training on self-awareness, disability, and neglect.
Detailed description
Unilateral spatial neglect (neglect) post stroke is characterized by a lack of attention to one side of the body or one side of the environment. Individuals with neglect experience significant disability and are often unaware of their neglect symptoms which can make it even more difficult to treat. There are a lack of effective treatments for neglect and new interventions are needed to help reduce disability for these individuals. Metacognitive strategy training (strategy training) is an intervention that has the potential to reduce neglect-related disability and improve individuals' awareness of their neglect. Strategy training teaches individuals to develop personalized goals, self-assess their performance of daily activities, and develop and evaluate strategies designed to overcome barriers and improve their performance of daily activities. While strategy training shows promise for individuals with neglect, no studies have tailored the intervention for this group of individuals or examined the effects of strategy training for individuals with neglect. This study examines whether strategy training facilitates reductions in disability and neglect and improves self-awareness after acute stroke.
Interventions
BEHAVIORALStrategy Training
This intervention will use an adapted form of strategy training for people with neglect.
BEHAVIORALAttention Control
This intervention will use a reflective listening protocol.
Sponsors
American Occupational Therapy Foundation
University of Pittsburgh
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* primary diagnosis of stroke * admission to inpatient rehabilitation facility * ≥18 years old * presence of neglect as determined by score of \<18 on the Virtual Reality Lateralized Attention Test (VRLAT) or score below established cutoff for neglect on one of the six subtests of the Behavioral Inattention Test (BIT)
Exclusion criteria
* Boston Diagnostic Aphasia Examination (BDAE) Severity Scale score of 0 (severe global aphasia) * diagnosis of dementia indicated in medical record * diagnosis of active major depressive disorder/bipolar/psychotic disorder indicated in medical record * anticipated length of stay \<10 days
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in online self-awareness | Baseline to Post-intervention (up to 3 weeks) | Change in online self-awareness measured with the Catherine Bergego Scale. The Catherine Bergego Scale includes a therapist-rated assessment and client-rated (self) assessment. Total scores on the Catherine Bergego Scale therapist-rated assessment and client-rated (self) assessment each range from 0-30 (higher=greater neglect). The difference in client-rated total Catherine Bergego Scale scores and assessor-rated total Catherine Bergego Scale scores will be used as a measure of online self-awareness (smaller difference=better awareness). The a priori criterion for change was a medium effect size of change (Cohen's d≥0.5) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Client Satisfaction with Strategy Training | Post-intervention (up to 3 weeks) | Client satisfaction is measured using the Client Satisfaction Questionniare-8. The a priori criterion for satisfaction was: ≥90% of participants report mean satisfaction score ≥3 on the Client Satisfaction Questionnaire-8 items. Item scores on the Client Satisfaction Questionnaire-8 range from 0-4. Higher scores on the Client Satisfaction Questionnaire-8=greater satisfaction. |
Countries
United States
Contacts
Primary ContactEmily Grattan, PhD
Outcome results
None listed