Efficacy of time pressure management in stroke patients with slowed information processing: a randomized controlled trial

Abstract

Winkens I, Van Heugten CM, Wade DT, Habets EJ, Fasotti L. Efficacy of Time Pressure Management in stroke patients with slowed information processing: a randomized controlled trial.

Objective: To examine the effects of a Time Pressure Management (TPM) strategy taught to stroke patients with mental slowness, compared with the effects of care as usual.

Design: Randomized controlled trial with outcome assessments conducted at baseline, at the end of treatment (at 5-10wk), and at 3 months.

Setting: Eight Dutch rehabilitation centers.

Participants: Stroke patients (N=37; mean age +/- SD, 51.5+/-9.7y) in rehabilitation programs who had a mean Barthel score +/- SD at baseline of 19.6+/-1.1.

Intervention: Ten hours of treatment teaching patients a TPM strategy to compensate for mental slowness in real-life tasks.

Main outcome measures: Mental Slowness Observation Test and Mental Slowness Questionnaire.

Results: Patients were randomly assigned to the experimental treatment (n=20) and to care as usual (n=17). After 10 hours of treatment, both groups showed a significant decline in number of complaints on the Mental Slowness Questionnaire. This decline was still present at 3 months. At 3 months, the Mental Slowness Observation Test revealed significantly higher increases in speed of performance of the TPM group in comparison with the care-as-usual group (t=-2.7, P=.01).

Conclusions: Although the TPM group and the care-as-usual group both showed fewer complaints after a 3-month follow-up period, only the TPM group showed improved speed of performance on everyday tasks. Use of TPM treatment therefore is recommended when treating stroke patients with mental slowness.