Guided training relative to direct skill training for individuals with cognitive impairments after stroke: A pilot randomized trial

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Archives of Physical Medicine and Rehabilitation , Volume 98(4) , Pgs. 673-680.

NARIC Accession Number: J75820.  What's this?
ISSN: 0003-9993.
Author(s): Skidmore, Elizabeth R.; Butters, Meryl; Whyte, Ellen; Grattan, Emily; Shen, Jennifer; Terhorst, Lauren.
Publication Year: 2017.
Number of Pages: 8.
Abstract: Study compared the effects of direct skill training and guided training for promoting independence after stroke. Direct skill training maximizes the expertise of the rehabilitation practitioner, who directs the course of treatment. Guided training maximizes the expertise of the patient by training patients to actively engage in the direction and focus of their treatment. Forty-three participants in inpatient rehabilitation with acute stroke and cognitive impairments were randomized to receive direct skill training (10 sessions as adjunct to usual inpatient rehabilitation) or guided training (same dose). The Functional Independence Measure (FIM) assessed independence at baseline, rehabilitation discharge, and months 3, 6, and 12. Linear mixed models (random intercept, other effects fixed) revealed a significant intervention-by-time interaction, a significant main effect of time, and a significant effect of stroke severity. There was no main effect of intervention. Change in FIM scores was greater for the direct group at rehabilitation discharge (effect size of between-group differences) and greater for the guide group at months 3, 6, and 12. The difference between groups in mean 12-month change scores was 10.57 points. Results of this study showed that guided training, provided in addition to usual care, offered a small advantage in the recovery of independence, relative to direct skill training.
Descriptor Terms: COGNITIVE DISABILITIES, DAILY LIVING, PROGRAM EVALUATION, REHABILITATION, STROKE, TRAINING PROGRAMS.


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Citation: Skidmore, Elizabeth R., Butters, Meryl, Whyte, Ellen, Grattan, Emily, Shen, Jennifer, Terhorst, Lauren. (2017). Guided training relative to direct skill training for individuals with cognitive impairments after stroke: A pilot randomized trial.  Archives of Physical Medicine and Rehabilitation , 98(4), Pgs. 673-680. Retrieved 5/13/2017, from REHABDATA database.


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More information about this publication:
Archives of Physical Medicine and Rehabilitation.