BUS TRIPS-A Self-Management Program for People with Cognitive Impairments after Stroke

Area of Science:

• Rehabilitation Science
• Occupational Therapy
• Neuroscience

Background:

• Stroke is a leading cause of global disability, often resulting in impairments affecting daily activities like travel.
• Independent travel is crucial for societal participation, yet cognitive impairments post-stroke present significant barriers.
• Existing interventions may not adequately address the specific challenges of public transportation use for stroke survivors.

Purpose of the Study:

• To evaluate the feasibility of the BUS TRIPS, a novel self-management intervention designed to enhance bus travel skills.
• To explore the potential of BUS TRIPS to improve bus travel ability in individuals with post-stroke cognitive impairments.
• To gather preliminary data on the effectiveness and participant experience of the intervention.

Main Methods:

• A pilot study employing a multiple case study design with a mixed-methods approach.
• Involved five individuals with cognitive impairments following a stroke.
• Utilized quantitative assessments (Stroke Impact Scale, Self-Efficacy Scale, Life Satisfaction Scale) and qualitative data (leader notes, interviews, surveys) before, during, and after the intervention.

Main Results:

• The BUS TRIPS intervention was deemed feasible, with participants appreciating the group format and skilled leadership.
• Session materials required minor revisions, and homework was valuable when supported by group discussions.
• Individual case narratives indicated progress in bus travel, though not all quantitative measures consistently supported these gains.
• Feasibility was supported by participant engagement and leader expertise, despite limitations in session length and material adaptation.

Conclusions:

• The BUS TRIPS intervention is feasible and shows potential for improving bus travel abilities in stroke survivors with cognitive impairments.
• Further research is warranted to address recruitment challenges and identify suitable assessments for larger clinical trials.
• The findings suggest a need for tailored interventions to support community mobility and societal participation for this population.