Testing the effectiveness of group-based memory rehabilitation in chronic stroke patients

Abstract

Memory complaints are common after stroke, yet there have been very few studies of the outcome of memory rehabilitation in these patients. The present study evaluated the effectiveness of a new manualised, group-based memory training programme. Forty outpatients with a single-stroke history and ongoing memory complaints were enrolled. The six-week course involved education and strategy training and was evaluated using a wait-list crossover design, with three assessments conducted 12 weeks apart. Outcome measures included: tests of anterograde memory (Rey Auditory Verbal Learning Test: RAVLT; Complex Figure Test) and prospective memory (Royal Prince Alfred Prospective Memory Test); the Comprehensive Assessment of Prospective Memory (CAPM) questionnaire and self-report of number of strategies used. Significant training-related gains were found on RAVLT learning and delayed recall and on CAPM informant report. Lower baseline scores predicted greater gains for several outcome measures. Patients with higher IQ or level of education showed more gains in number of strategies used. Shorter time since onset was related to gains in prospective memory, but no other stroke-related variables influenced outcome. Our study provides evidence that a relatively brief, group-based training intervention can improve memory functioning in chronic stroke patients and clarified some of the baseline factors that influence outcome.

Evidence-Based Cognitive Rehabilitation: Systematic Review of the Literature From 2009 Through 2014

“…With respect to memory, like the studies on individual cognitive rehabilitation, the evidence on group interventions also suggests that internal memory strategies are more effective in people with either TBI or stroke who have mild to moderate impairment of memory. 44 Improvement in goal management was demonstrated not only on performance of a complex functional task, but also on fMRI following group treatment incorporating regulation of attention through mindfulness training and metacognitive strategies. 70,108,109 These new findings provided the basis for a Practice Option for group treatment for aspects executive function impairment following TBI.…”

“…The CRTF reviewed 7 Class I studies, 37-43 7 Class II studies [44][45][46][47][48][49][50] and 6 Class III studies [50][51][52][53][54][55][56] addressing remediation of memory. Many of these studies focused on specific types of memory impairments rather than global memory functioning.…”

“…Two Class II studies evaluated group-based memory training techniques to improve recall of information for the purpose of performing everyday tasks, compared with no intervention, after a TBI 49 or single stroke. 44 O'Neill and colleagues 49 used a group training intervention focused on internal memory strategy training and found improvement on everyday memory measures, with greater effect for mild and moderately impaired participants. Miller and colleagues 44 studied the use of a group memory training program patients during the chronic stage of recovery after a single stroke.…”

“…44 O'Neill and colleagues 49 used a group training intervention focused on internal memory strategy training and found improvement on everyday memory measures, with greater effect for mild and moderately impaired participants. Miller and colleagues 44 studied the use of a group memory training program patients during the chronic stage of recovery after a single stroke. The intervention included education about memory and the use of both internal/mental strategies and external compensatory aides.…”

The Assessment and Prediction of Prospective Memory after Stroke

“…One study (Kim, Craik, Luo, & Ween, 2009) found no difference in event-based PM performance but significantly poorer time-based PM for individuals with stroke (n = 12) when compared to controls (n = 12). An intervention study (Miller & Radford, 2014) reported that individuals with stroke (n = 27) performed lower than normative means on the Royal Prince Alfred PM Test at baseline. Another intervention study (Mitrovic, Matthews, Ohlsson, Holland, & McKinlay, 2006) similarly reported that onethird of their stroke sample (n = 15) showed PM impairment at baseline according to the normative data of the Cambridge Prospective Memory Test (CAMPROMPT).…”