Ontology highlight
ABSTRACT: Objective
To examine the effects of direct skill training and guided training for promoting independence after stroke.Design
Single-blind randomized pilot study.Setting
Inpatient rehabilitation facility.Participants
Participants in inpatient rehabilitation with acute stroke and cognitive impairments (N=43).Interventions
Participants were randomized to receive direct skill training (n=22, 10 sessions as adjunct to usual inpatient rehabilitation) or guided training (n=21, same dose).Main outcome measure
The FIM assessed independence at baseline, rehabilitation discharge, and months 3, 6, and 12.Results
Linear mixed models (random intercept, other effects fixed) revealed a significant intervention by time interaction (F4,150=5.11, P<.001), a significant main effect of time (F4,150=49.25, P<.001), and a significant effect of stroke severity (F1,150=34.46, P<.001). There was no main effect of intervention (F1,150=.07, P=.79). Change in FIM scores was greater for the direct group at rehabilitation discharge (effect size of between-group differences, d=.28) and greater for the guide group at months 3 (d=.16), 6 (d=.39), and 12 (d=.53). The difference between groups in mean 12-month change scores was 10.57 points.Conclusions
Guided training, provided in addition to usual care, offered a small advantage in the recovery of independence, relative to direct skill training. Future studies examining guided training in combination with other potentially potent intervention elements may further advise best practices in rehabilitation for individuals with cognitive impairments after acute stroke.
SUBMITTER: Skidmore ER
PROVIDER: S-EPMC5368028 | biostudies-literature | 2017 Apr
REPOSITORIES: biostudies-literature
Skidmore Elizabeth R ER Butters Meryl M Whyte Ellen E Grattan Emily E Shen Jennifer J Terhorst Lauren L
Archives of physical medicine and rehabilitation 20161026 4
<h4>Objective</h4>To examine the effects of direct skill training and guided training for promoting independence after stroke.<h4>Design</h4>Single-blind randomized pilot study.<h4>Setting</h4>Inpatient rehabilitation facility.<h4>Participants</h4>Participants in inpatient rehabilitation with acute stroke and cognitive impairments (N=43).<h4>Interventions</h4>Participants were randomized to receive direct skill training (n=22, 10 sessions as adjunct to usual inpatient rehabilitation) or guided t ...[more]