Deans' stroke musings: The effect of cognitive rehabilitation with a multicontextual treatment approach in stroke: a randomized controlled trial

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, April 7, 2026

The effect of cognitive rehabilitation with a multicontextual treatment approach in stroke: a randomized controlled trial

What is your COMPETENT? DOCTORS' EXACT COGNTIVE TRAINING PROTOCOL? Doesn't have one, does s/he? So, you DON'T have a functioning stroke doctor, do you? Too bad, they are still getting paid for incompetence. Billable hours are everything; who fucking cares about recovery? Certainly not the president or board of directors!

The effect of cognitive rehabilitation with a multicontextual treatment approach in stroke: a randomized controlled trial

Özden Erkan Oğul1*, Esma Özkan2, Gonca Bumin3, Yakup Krespi4 Author Information: 1Özden Erkan Oğul, PT, PhD, Assist. Prof., Department of Ergotherapy, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Türkiye. ORCID: 0000-0002-7226-510X 2Esma Özkan, PT, PhD, Assoc. Prof., University of Health Sciences, Gülhane Faculty of Health Sciences, Department of Occupational Therapy, Ankara, Türkiye. ORCID: 0000-0001-6857-4084 3Gonca Bumin, PT, PhD, Prof, Department of Occupational Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Türkiye. ORCID: 0000-0002-8241-2206 4Yakup Krespi, MD, Assoc. Prof., Department of Neurology, Faculty of Health Sciences, Istanbul Istinye University, Istanbul, Türkiye. ORCID: 0000-0001-5246-5908 Correspondence: [*] Address for correspondence: Özden Erkan Oğul, ORCID: 0000-0002-7226- 510X, Kavacık Mah. Ekinciler Cad. No.19 Kavacık Kavşağı-Beykoz 34810, Istanbul, Turkey. Tel.: +90 212 460 e-mail: oogul@medipol.edu.tr ARTICLE IN PRESS

ABSTRACT

Background: The multicontextual approach is a specific intervention that shapes cognitive functioning through interactions among individuals, activities, and the environment, utilizing metacognitive training and learning transfer. Aim: This study aimed to analyze the effects of a cognitive rehabilitation program based on a multicontextual approach, implemented alongside remedial approaches, on cognitive function, functional independence, and social participation.

Methods:

Twenty individuals with chronic stroke were randomly assigned to two groups. The intervention group (n=10) received cognitive rehabilitation and standard physiotherapy. Cognitive rehabilitation program was grounded in a multicontextual approach, implemented alongside remedial approaches. The control group (n=10) received standard physiotherapy. Both groups participated in intervention sessions three times per week over an eight-week period. This study was registered at ClinicalTrials.gov (NCT06186661; December 9, 2022).

Results:

One-way analysis of covariance and mixed-design analysis of variance were used for statistical analysis. The multicontextual approach, implemented alongside remedial approaches, improved the cognitive skills, occupational performance and satisfaction of individuals with chronic stroke (p<0.05). In addition, the training provided to the intervention group demonstrated moderate to large clinical effects (ɳ2 p =0.163; ɳ2 p =0.088), although no statistically significant difference was observed between the two groups in terms of functional independence and participation outcomes (p> 0.05).

Conclusion:

This study provides preliminary evidence that cognitive rehabilitation, employing a multicontextual approach in combination with remedial strategies, may enhance cognitive functioning and occupational performance, and may positively affect functional independence and social participation among individuals with chronic stroke. ClinicalTrials.gov Identifier: NCT06186661; December 9, 2022.