Effect of the cognitive strategy training protocol on task mastery and cognitive performance during the instrumental activity of daily living in stroke patients

Abstract

Background: Stroke leads to decrease in physical, emotional, social function, and activities in daily living. Cognitive functions, either basic or higher-level, are fundamental factors in performing tasks and functional activities in daily life. Therefore, cognitive training to enhance functions in stroke patients is necessary. This study developed a cognitive strategy training protocol using the Perceive, Recall, Plan & Perform (PRPP) System of Intervention and the Multicontext Approach to improve cognitive function during performance in instrumental activities of daily living (IADL) tasks. Objectives: This study aimed to examine the task mastery of stroke patients during the performance of IADL tasks and to examine the effects of the cognitive strategy training protocol on cognitive performance in stroke patients. Materials and methods: The study was a quasi-experimental, one-group, pretestposttest research design. Eight stroke patients with cognitive impairment aged between 18-70 years old participated in the study. The intervention called “cognitive strategy training protocol” included 12 sessions, 3 times a week across 4 consecutive weeks. Each session took approximately 60 minutes. An outcome measure was the PRPP System of Task Analysis-Thai version. Descriptive data obtained from Stage One of the PRPP System-Thai version were analyzed to determine for task mastery, and pre-and post-scores of Stage Two of the PRPP System-Thai version were computed using the Wilcoxon signed-rank test. Results: After the cognitive strategy training protocol, all participants had higher percentage scores obtained from Stage One of the PRPP System-Thai version for at least 1 activity. Five out of eight participants showed higher percentage scores in both activities. Comparing the pre- and post-test scores from Stage Two of the PRPP System-Thai version using the Wilcoxon signed-rank test revealed no significant difference in all activities (p>0.05). However, the descriptive results of the posttest percentage scores of Stage Two of the PRPP System-Thai version showed that 4 out of 8 participants had higher scores for at least 1 activity and 2 participants showed higher scores in both activities. Conclusion: The cognitive strategy training protocol was likely to be possible to improve task mastery and cognitive performance during the IADLs tasks in the participants despite no statistically significant difference.