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It is common for individuals after stroke to have a cognitive perceptual impairment called unilateral spatial neglect (neglect). Individuals with neglect have difficulty paying attention to one side of their body or one side of the environment and therefore experience difficulty performing daily activities. There are a lack of effective treatments for neglect and new interventions are needed to help reduce disability for these individuals. Metacognitive strategy training (strategy training) is an intervention that has the potential to reduce neglect-related disability and improve individuals' attention and awareness of their neglect. This study seeks to examine the effects of strategy training on neglect, self-awareness, and disability, specifically for individuals who are living in the community after their stroke.
Unilateral spatial neglect (neglect) post stroke is characterized by a lack of attention to one side of the body or one side of the environment. Individuals with neglect experience significant disability and are often unaware of their neglect symptoms which can make it even more difficult to treat. There are a lack of effective treatments for neglect and new interventions are needed to help reduce disability for these individuals. Metacognitive strategy training (strategy training) is an intervention that has the potential to reduce neglect-related disability and improve individuals' attention and awareness of their neglect. Strategy training teaches individuals to develop personalized goals, self-assess their performance of daily activities, and develop and evaluate strategies designed to overcome barriers and improve their performance of daily activities. While strategy training shows promise for individuals with neglect, no studies have tailored the intervention for this group of individuals or examined the effects of strategy training for individuals with neglect specifically with individuals living in the community. This study examines whether strategy training facilitates reductions in neglect and disability and improves self-awareness.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Strategy Training | Experimental | The strategy training intervention teaches individuals to develop personalized goals, self-assess their performance of daily activities, and develop and evaluate strategies designed to overcome barriers and improve their performance of daily activities. Participants use a workbook to support their application of the strategy training. |
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| Attention Control | Active Comparator | The attention control intervention controls for the non-specific effects of strategy training. The study team will administer the standardized and dose-matched protocol, using scripted open-ended questions to facilitate participants' reflections on their rehabilitation activities and experiences. Participants complete a daily journal, merely reviewing their rehabilitation activities. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Strategy Training | Behavioral | This intervention will use an adapted form of strategy training for people with neglect. |
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| Measure | Description | Time Frame |
|---|---|---|
| Change in attention/neglect | Change in attention/neglect measured with the Catherine Bergego Scale. Total scores on the Catherine Bergego Scale therapist-rated assessment range from 0-30 (higher=greater neglect). The a priori criterion for change was a medium effect size of change (Cohen's d≥0.5) | Baseline to Post-intervention (up to 60 days) |
| Measure | Description | Time Frame |
|---|---|---|
| Client Satisfaction with Strategy Training | Client satisfaction is measured using the Client Satisfaction Questionnaire-8. The a priori criterion for satisfaction was: ≥90% of participants report mean satisfaction score ≥3 on the Client Satisfaction Questionnaire-8 items. Item scores on the Client Satisfaction Questionnaire-8 range from 0-4. Higher scores on the Client Satisfaction Questionnaire-8=greater satisfaction. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Emily Grattan, PhD, OTRlL | Contact | 412-648-0619 | esg39@pitt.edu |
| Name | Affiliation | Role |
|---|---|---|
| Emily Grattan, PhD, OTR/L | University of Pittsburgh | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Pittsburgh | Recruiting | Pittsburgh | Pennsylvania | 15260 | United States |
At present, there is no plan to share data.
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| ID | Term |
|---|---|
| D020521 | Stroke |
| D010468 | Perceptual Disorders |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| Attention Control | Behavioral | This intervention will use a reflective listening protocol. |
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| Post-intervention (up to 60 days) |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |