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Randomized Controlled Trial
. 2021 Jul 28;18(15):7988.
doi: 10.3390/ijerph18157988.

Effectiveness of the Functional and Cognitive Occupational Therapy (FaCoT) Intervention for Improving Daily Functioning and Participation of Individuals with Mild Stroke: A Randomized Controlled Trial

Tal Adamit  1   2 , Jeffrey Shames  2 , Debbie Rand  1
Affiliations
Randomized Controlled Trial

Effectiveness of the Functional and Cognitive Occupational Therapy (FaCoT) Intervention for Improving Daily Functioning and Participation of Individuals with Mild Stroke: A Randomized Controlled Trial

Tal Adamit et al. Int J Environ Res Public Health. .

Abstract

Background: Mild stroke can cause subtle cognitive-behavioral symptoms, which although might be hidden, can restrict community reintegration and participation. Cognitive rehabilitation programs exist for stroke but not specifically for mild stroke and the research evidence varies. The Functional and Cognitive Occupational Therapy (FaCoT) intervention was developed specifically for this population.

Objective: To examine the effectiveness of FaCoT intervention for improving daily functioning and participation compared with standard care.

Method: A single blind randomized controlled trial with assessments pre (T1), post (T2) and 3-month follow-up (T3). Individuals in the FaCoT group received 10 weekly sessions practicing cognitive and behavioral strategies. The Canadian Occupational Performance Measure (COPM) was the primary outcome measure, IADL-questionnaire, Reintegration to Normal Living questionnaire (RNL) were secondary measures.

Results: In total, 66 community-dwelling individuals with mild stroke were randomly allocated to FaCoT (n = 33, mean (SD) age 64.6 (8.2), 33% women), or control group (n = 33, mean (SD) age 64.4 (10.8), 45% women). Time X Group interaction effects were found for the COPM performance (F(1.4,90.3) = 11.75, p < 0.000) and satisfaction (F(1.5,96.8) = 15.70, p < 0.000), with large effect size values. Significant between-group effects were found for RNL (F = 10.02, p < 0.002, ɳP2 = 0.13). Most participants in FaCoT achieved a clinically important difference in COPM between T1-T2, T1-T3, and in RNL between T1 to T3 compared with the control group.

Conclusions: FaCoT intervention is effective to improve daily functioning, participation and satisfaction of individuals with mild stroke compared with standard care, therefore FaCoT should be implemented in community rehabilitation settings.

Keywords: PROMs; cognitive–functional interventions; participation; stroke rehabilitation.

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Conflict of interest statement

The authors declare no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Figure 1
Figure 1
CONSORT flow diagram (Note: at T2 and T3, all 33 cases in each group were analyzed using intention-to-treat analysis).
See this image and copyright information in PMC

References

    1. Adams H.P., Leclerc J.R., Bluhmki E., Clarke W., Hansen M.D., Hacke W. Measuring outcomes as a function of baseline severity of ischemic stroke. Cerebrovasc. Dis. 2004;18:124–129. doi: 10.1159/000079260. - DOI - PubMed
    1. Carlsson G.E., Möller A., Blomstrand C. Consequences of mild stroke in persons. Cerebrovasc. Dis. 2003;16:383–388. doi: 10.1159/000072561. - DOI - PubMed
    1. Duncan P.W., Samsa G.P., Weinberger M., Goldstein L.B., Bonito A., Witter D.M., Enarson C., Matchar D. Health status of individuals with mild stroke. Stroke. 1997;28:740–745. doi: 10.1161/01.STR.28.4.740. - DOI - PubMed
    1. Terrill A.L., Schwartz J.K., Belagaje S.R. Best Practices for The Interdisciplinary Rehabilitation Team: A Review of Mental Health Issues in Mild Stroke Survivors. Stroke Res. Treat. 2018;2018:1–8. doi: 10.1155/2018/6187328. - DOI - PMC - PubMed
    1. Della Vecchia C., Préau M., Carpentier C., Viprey M., Haesebaert J., Termoz A., Dima A.L., Schott A.-M. Illness beliefs and emotional responses in mildly disabled stroke survivors: A qualitative study. PLoS ONE. 2019;14:e0223681. doi: 10.1371/journal.pone.0223681. - DOI - PMC - PubMed

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