Managing executive dysfunction following acquired brain injury and stroke using an ecologically valid rehabilitation approach: a study protocol for a randomized, controlled trial

A protocol!!! Fire off the fireworks, your doctor needs to see what a protocol looks like, ask for one for every phase of your recovery. 100% recovery and nothing less. Give your doctor a heart attack when s/he realizes you are serious about full recovery. And expect him/her to know how to get there.
http://www.trialsjournal.com/content/pdf/1745-6215-14-306.pdf

Abstract

Background

We have been investigating an ecologically valid strategy-training approach to enable adults

with executive dysfunction to attain everyday life goals. Here, we report the protocol of a

randomized controlled trial of the effects of this training compared to conventional therapy in

a sample of community-dwelling adults with acquired brain injury and/or stroke.

Methods/design

We will recruit 100 community-dwelling survivors at least six months post-acquired brain

injury or stroke who report executive dysfunction during a telephone interview, confirmed in

pre-training testing. Following pre-training testing, participants will be randomized to the

ecologically valid strategy training or conventional therapy and receive two one-hour

sessions for eight weeks (maximum of 15 hours of therapy). Post-testing will occur

immediately following the training and three months later. The primary outcome is self-

reported change in performance on everyday life activities measured using the Canadian

Occupational Performance Measure, a standardized, semi-structured interview. Secondary

outcomes are objective measurement of performance change from video tapes of treatment

session, Performance Quality Rating Scale; executive dysfunction symptoms, Behavioural

Rating Inventory of Executive Function – Adult; participation in everyday life, Mayo-

Portland Adaptability Inventory Participation Index; and ability to solve novel problems,

Instrumental Activities of Daily Living Profile.

Discussion

This study is of a novel approach to promoting improvements in attainment of everyday life

goals through managing executive dysfunction using an ecologically valid strategy training

approach, the Cognitive Orientation to daily Occupational Performance

. This study compares the efficacy of this approach with that of conventional therapy. The approach has the potential to be a valuable treatment for people with chronic acquired brain injury and/or stroke.

Trial registration

Clinical Trials.gov, Trial Identification Number: NCT01414348