Related Experiment Video
Updated: May 26, 2026
Randomized, Triple-Blind, and Parallel-Controlled Trial of Transcranial Direct Current Stimulation for Cognitive Rehabilitation after Stroke
Published on: June 6, 2025
The DRESS trial: a feasibility randomized controlled trial of a neuropsychological approach to dressing therapy for
Marion F Walker1, Alan Sunderland, Joanna Fletcher-Smith
1Division of Rehabilitation and Ageing, Community Health Sciences, University of Nottingham, UK. marion.walker@nottingham.ac.uk
Objective:
To investigate two approaches to treating patients with persistent dressing problems and cognitive difficulties following stroke.
Design:
Pilot randomized controlled trial.
Setting:
Inpatient stroke rehabilitation service.
Subjects:
Seventy consecutive stroke patients with persistent dressing problems and accompanying cognitive difficulties at two weeks after their stroke.
Interventions:
Patients were randomly allocated to six weeks of either a systematic neuropsychological approach, based on analysis of dressing problems and further cognitive testing, or to the control group who received conventional (functional) dressing practice. Both groups received treatment three times a week in accordance with two separately prepared manuals.
Main Measures:
Nottingham Stroke Dressing Assessment (NSDA), Line Cancellation, 10-hole peg transfer test, Object Decision, Gesture Imitation. Patients were assessed at six weeks after randomization by an independent assessor masked to group allocation.
Results:
Both neuropsychological and functional groups improved performance on the NSDA over the treatment period (31% and 22%, respectively) but there was no significant difference between groups at six weeks. However, the neuropsychological group showed a significantly greater improvement on a line cancellation test of visual neglect (t(62) = 2.1, P < 0.05) and a planned subanalysis for those with right hemisphere damage showed a trend towards better dressing outcome (P = 0.07, one-tailed).
Conclusions:
Results demonstrate the potential benefits of a systematic neuropsychological approach to dressing therapy, particularly for patients with right hemisphere damage. This study suggests the need for a phase III study evaluating the efficacy of a systematic neuropsychological approach in treating dressing difficulties, targeting patients with right hemisphere stroke and visuospatial impairments.
