Pilot randomized controlled trial of self-regulation in promoting function in acute poststroke patients

Abstract

Objective: To test the efficacy of self-regulation (SR) for promoting task performance and motor and cognitive functions.

Design: Pilot randomized controlled trial.

Setting: Rehabilitation unit.

Participants: Inpatients with acute poststroke (N=44) after a cerebral infarction aged ≥60 years.

Interventions: Patients were randomly assigned to the SR (n=24) or functional rehabilitation (control; n=20) intervention. The SR intervention consisted of 1 week of therapist-supervised practices of daily tasks using SR of one's own performance (five 1-h sessions). Patients in the control intervention practiced the same daily tasks with a therapist's demonstration and guidance.

Main outcome measures: Performance of tasks, including household and monetary transaction tasks; FIM; Fugl-Meyer Assessment (FMA); and Color Trails Test (CTT).

Results: The SR group showed significant improvement in all tasks (median difference, 1-2; effect size [r]=.74-.89) versus none (median difference, 0-0.5) in the control group. Results of the FIM (P<.001, r=.87 in the motor subscale; P<.001, r=.49 in the cognitive subscale), FMA (P<.001, r=.84 for upper extremity motor function and r=.63 for lower extremity motor function), and CTT (P=.002, r=.72) of the SR group improved. The SR group outperformed their control counterparts in 4 of the 5 tasks (median difference, 1; r=.30-.52) and in the FIM motor subscale (P=.002, r=.47), but not in the cognitive subscale and motor and cognitive functions.

Conclusions: SR appears useful for improving task performance that demands both motor and cognitive abilities by promoting information processing and active learning.

Keywords: Occupational therapy; Randomized controlled trial as topic; Recovery of function; Rehabilitation.