The cognitive augmented mobility program (CAMP): feasibility and preliminary efficacy

Abstract

The objective of this project was to examine the feasibility and preliminary outcomes of an evidence-based cognitive augmented mobility program (CAMP) for persons with stroke. Relevance• Current mobility treatment approaches for survivors of stroke are not usually associated with improved community participation, transfer of skills learned in therapy to new skills, nor skill maintenance 1,2 • A potential solution may be to combine the best practices for improving walking and mobility in persons with stroke with cognitive strategy training to improve problem solving, confidence, maintenance and transfer of skills to the community • Best evidence suggests therapists should incorporate task-specific training, aerobics, and strengthening to improve mobility in gait in persons with stroke • Related research suggests that incorporating cognitive problem-solving strategy training may lead to better skill maintenance and transfer 3,4 Methods Analysis: Due to the small sample size, non-parametric statistics were used. Medians and ranges were calculated, and to estimate efficacy, differences between assessment points were analyzed using Wilcoxon test and non-parametric effect size r was calculated and were are coded as small (.1), medium (.3) or large (.5) effects. 3 Additionally, for measures for which an estimate of a minimally important change was available, the proportion of participants who achieved that level was calculated and reported.Two groups of 4 participants post stroke, post usual care, with mobility goals, able to walk at least 3 metres, and able to follow directions. Analysis & Results Discussion & Conclusion• The positive results included a large effect on self-selected goal performance at one-month follow-up and transfer of learning to balance and mobility skills • Findings suggest CAMP is feasible, and, that there is a potential complementary effect in combining best evidence for mobility and fitness for persons with stroke with cognitive strategy training that warrants further investigation • These results may be a precursor to future discussions exploring methods to include active problem-solving & shared-decision making throughout care