The StrokeCog Study: Cognitive Rehabilitation Intervention in Stroke (StrokeCog-R)
Stroke, Stroke Sequelae, Cognitive Impairment
About this trial
This is an interventional treatment trial for Stroke
Eligibility Criteria
Inclusion Criteria: WHO-defined stroke, to include ICD-10 codes 160 (subarachnoid haemorrhage), 161 (intracerebral haemorrhage), 163 (cerebral infarction) including sub-categories, and 164 (stroke not specified as haemorrhage or infarction); First-ever and recurrent stroke; Age 18 and over (no upper age limit); Community dwelling (i.e., normal place of residence is not in a long-term care facility) Is a resident in the Republic of Ireland Capable of providing informed consent Exclusion Criteria: Transient ischaemic attack; Aphasia; Poor English language ability; Nursing home resident; Dementia or severe cognitive impairment; Neurodegenerative disorder; Current psychiatric disorder (as defined by DSM-V or ICD-II criteria); Terminal illness.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Cognitive rehabilitation intervention arm
Usual care
Five-week group-based and largely interactive format, with groups of four patients. Short presentations are delivered by the clinical neuropsychologist relating to psychoeducation and adjustment to stroke-related deficits in executive function, attention, and memory, respectively, and strategies addressing the activities and participation levels of functioning. Each session lasts approximately 2.5 hours, with a break in the middle. Tailored home activities are included for completion between group sessions to encourage self-efficacy and generalisation of skills and strategies. A member of the research team contacts all participants by telephone twice a week to assess engagement and reported self-efficacy in managing cognitive difficulties. In addition, a weekly text message is sent to all participants. In the proposed pilot RCT, for those receiving the intervention, the text message will contain tips on implementing compensatory strategies.
Those in the control group will be allocated to usual care from their multidisciplinary rehabilitation team in both acute and rehabilitation settings. Usual rehabilitation care is likely to vary across hospital settings (acute vs. rehabilitation). Information about type, dose, and amount of rehabilitation therapy will be captured from patients' medical charts in both the intervention and control arm of the study. A member of the research team (RA) contacts all participants by telephone twice a week to assess engagement and reported self-efficacy in managing cognitive difficulties. In addition, a weekly text message is sent to all participants. For those in the wait-list control condition, the text message will contain a positive affirmation.