<i>‘There's a real plan here, and I am responsible for that plan’:</i>participant experiences with a novel cognitive-based treatment approach for adults living with chronic stroke

McEwen, Sara; Polatajko, Helene J.; Davis, Jane A.; Huijbregts, Maria; Ryan, Jennifer D.

doi:10.3109/09638280903180189

Cited by 34 publications

(22 citation statements)

References 42 publications

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“…Participants also reported an altered perspective of life that helped them deal with their problems [17]. These themes have been echoed in other analyses of cognitive rehabilitation programs [18–20]. However, qualitative examinations of cognitive rehabilitation interventions for those with type 2 diabetes have not been done.…”

Section: Introductionmentioning

confidence: 99%

Participant Perspectives of Cognitive Rehabilitation for Type 2 Diabetes: Expectations and Impact

Cuevas

Stuifbergen

Ward

2018

Journal of Aging Research

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Purpose To describe the experiences of people with type 2 diabetes who have completed a comprehensive cognitive rehabilitation intervention. Method Nineteen participants with type 2 diabetes enrolled in an 8-week intervention consisting of 4 educational classes to learn strategies to improve cognitive function and an online training program at home to practice cognitively stimulating activities. Two focus groups were conducted as part of a study designed to assess the feasibility of the comprehensive cognitive rehabilitation intervention. Results Three main themes were identified in the qualitative data: (1) expectations of cognitive change; (2) use of cognitive strategies; and (3) effect on diabetes self-management. Participants shared valuable insight into how their experiences with the intervention changed and how they viewed diabetes. Conclusions While the participants did not initially tie their cognitive complaints to diabetes, they were able to show how and why they might use cognitive strategies to improve diabetes self-management activities. By adapting those strategies for diabetes, quality of life can improve as well as potentially glycemic control.

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Section: Introductionmentioning

confidence: 99%

Participant Perspectives of Cognitive Rehabilitation for Type 2 Diabetes: Expectations and Impact

Cuevas

Stuifbergen

Ward

2018

Journal of Aging Research

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“…11,12,19 Two single case experimental series showed not only improved activity performance and retention of learning following CO-OP intervention, 11 but also improvement of untrained activities, suggesting the occurrence of transfer to new skills. 12 Because it is relatively well established that stroke outcomes are improved if rehabilitation occurs in the first few months following the event, 8,20,21 and because past CO-OP participants recommended the strategies be taught much earlier in the rehabilitation process, 22 we sought to investigate the efficacy of the approach in sub-acute stroke. Therefore, the primary objective of this exploratory trial was to estimate, in people less than 3 months post stroke, the effect of CO-OP compared to usual occupational therapy on immediate and longer-term activity performance and participation.…”

Section: Introductionmentioning

confidence: 99%

Combined Cognitive-Strategy and Task-Specific Training Improve Transfer to Untrained Activities in Subacute Stroke

McEwen

Polatajko

Baum

et al. 2014

Neurorehabil Neural Repair

102

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Purpose The purpose of this study was to estimate the effect of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach compared to usual outpatient rehabilitation on activity and participation in people less than 3 months post stroke. Methods An exploratory, single blind, randomized controlled trial with a usual care control arm was conducted. Participants referred to 2 stroke rehabilitation outpatient programs were randomized to receive either Usual Care or CO-OP. The primary outcome was actual performance of trained and untrained self-selected activities, measured using the Performance Quality Rating Scale (PQRS). Additional outcomes included the Canadian Occupational Performance Measure (COPM), the Stroke Impact Scale Participation Domain, the Community Participation Index, and the Self Efficacy Gauge. Results Thirty-five (35) eligible participants were randomized; 26 completed the intervention. Post-intervention, PQRS change scores demonstrated CO-OP had a medium effect over Usual Care on trained self-selected activities (d=0.5) and a large effect on untrained (d=1.2). At a 3 month follow-up, PQRS change scores indicated a large effect of CO-OP on both trained (d=1.6) and untrained activities (d=1.1). CO-OP had a small effect on COPM and a medium effect on the Community Participation Index perceived control and the Self-Efficacy Gauge. Conclusion CO-OP was associated with a large treatment effect on follow up performances of self-selected activities, and demonstrated transfer to untrained activities. A larger trial is warranted.

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“…Meta-cognitive strategy training shows promise as a class of interventions that may help individuals with cognitive impairments actively engage in, and even “steer” their rehabilitation programs (Kennedy et al, 2008; McEwen, Polatajko, Davis, Huijbregts, & Ryan, 2010). This training teaches individuals a meta-cognitive strategy that can be used to increase awareness of impaired skills or processes (through self-assessment and self-monitoring), develop goals and plans to address areas of disability, and improve their ability to perform desired activities (thus reducing disability).…”

mentioning

confidence: 99%

“…This training teaches individuals a meta-cognitive strategy that can be used to increase awareness of impaired skills or processes (through self-assessment and self-monitoring), develop goals and plans to address areas of disability, and improve their ability to perform desired activities (thus reducing disability). Previous studies have reported improved awareness of cognitive impairments, improved ability to verbally articulate and implement the meta-cognitive strategy, reductions in performance errors and inappropriate behaviors during laboratory tasks, and improved performance of skilled behaviors among individuals with chronic traumatic brain injury and stroke (Cicerone, 2002; Dawson et al, 2009; McEwen, Polatajko, Huijbregts, & Ryan, 2010; Von Cramon, Matthes-Von Cramon, & Mai, 1991; Webster & Scott, 1983). Recent evidence from 3 case studies suggests that these cognitive strategies may be effective in helping individuals with cognitive impairments after traumatic brain injury reduce disability in self-selected activities in their home and community (Dawson et al, 2009).…”

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confidence: 99%

The feasibility of meta-cognitive strategy training in acute inpatient stroke rehabilitation: Case report

Skidmore

Holm

Whyte

et al. 2011

Neuropsychological Rehabilitation

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Meta-cognitive strategy training may be used to augment inpatient rehabilitation to promote active engagement and subsequent benefit for individuals with cognitive impairments after stroke. We examined the feasibility of administering a form of meta-cognitive strategy training, Cognitive Orientation to daily Occupational Performance, during inpatient rehabilitation. We trained an individual with cognitive impairments after right hemisphere stroke to identify performance problems, set self-selected goals, develop plans to address goals, and evaluate performance improvements. To assess feasibility, we examined the number of meta-cognitive training sessions attended, the number of self-selected goals, and changes in goal-related performance. We also examined changes in rehabilitation engagement and disability. The participant used the metacognitive strategy to set 8 goals addressing physically-oriented, instrumental, and work-related activities. Mean improvement in Canadian Occupational Performance Measure Performance Scale scores was 6.1. Pittsburgh Rehabilitation Participation Scale scores (measuring rehabilitation engagement) improved from 3.2 at admission to 4.9 at discharge. Functional Independence Measure scores (measuring disability) improved from 68 at admission, to 97 at discharge. Performance Assessment of Self-care Skills scores improved from 1.1 at admission to 2.9 at discharge. The results indicate that meta-cognitive strategy training was feasible during inpatient rehabilitation and warrants further evaluation to determine its effectiveness.

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‘There's a real plan here, and I am responsible for that plan’:participant experiences with a novel cognitive-based treatment approach for adults living with chronic stroke

Abstract: The findings suggest the cognitive strategies were well learned and effectively used. CO-OP was able to provide participants with increased decision-making autonomy, but may require modifications to better support their transition to higher levels of independence.

Cited by 34 publications

References 42 publications

Participant Perspectives of Cognitive Rehabilitation for Type 2 Diabetes: Expectations and Impact

Participant Perspectives of Cognitive Rehabilitation for Type 2 Diabetes: Expectations and Impact

Combined Cognitive-Strategy and Task-Specific Training Improve Transfer to Untrained Activities in Subacute Stroke

The feasibility of meta-cognitive strategy training in acute inpatient stroke rehabilitation: Case report

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