Neurofunctional treatment targeting participation among chronic stroke survivors: a pilot randomised controlled study

Long-term disabilities are common among stroke survivors and are associated with reduced quality of life (QoL). Research on occupation-based intervention for chronic stroke survivors is sparse. The objective of this study was to examine the effectiveness of neurofunctional treatment (NFT), an occupation-based client-centred treatment approach, for attaining individualised goals in chronic stroke survivors. A pilot randomised control study with a crossover design was employed. The participants were randomly allocated to treatment or control groups, with the intervention replicated for the control group after three months. Twenty three community dwelling stroke survivors, at least one year post-stroke attending a community day centre participated in this study. The 12-week intervention included NFT with individualised occupational goal setting. The treatment methods included task-specific training, environmental or task adaptation, assistive devices, motivation recruitment, and advocacy. Significant differences between the groups were found on occupational performance measures, but not on QoL. These findings were replicated after crossover for the control group. The results support the efficacy of NFT for attaining occupational goals in individuals in the chronic stage after stroke, yet further research is needed to validate these findings in additional treatment settings and over time.