Adapting Daily Activity Performance Through Strategy Training

Closing the Gap: Early Intervention for Cognitive Disability After Stroke

Individuals with cognitive impairments after stroke sustain significant disability in their daily tasks, and account for a significant proportion of stroke-related healthcare costs. The proposed study examines a novel intervention, strategy training, that shows promise for helping individuals with stroke-related cognitive impairments reduce disability in daily tasks, which may lead to reductions in healthcare costs. We predict that strategy training will result in significantly greater independence 6 months after stroke compared to an attention control intervention, and that strategy training may reduce cognitive impairments.

Inclusion Criteria:

• primary diagnosis of acute stroke
• admission to acute inpatient rehabilitation
• impairment in higher order cognitive functions (EXIT-14 ≥ 3)

Exclusion Criteria:

• pre-stroke diagnosis of dementia in the medical record
• inability to follow two- step commands 80% of the time
• severe aphasia (BDAE ≤ 1)
• current major depressive, bipolar, or psychotic disorder
• drug or alcohol abuse within 3 months