Compensation-Based Intervention to Improve Activities of Daily Living in Individuals with Stroke: Randomized...

Area of Science:

• Rehabilitation Medicine
• Neuroscience
• Occupational Therapy

Background:

• Stroke survivors often face challenges with activities of daily living (ADL).
• Compensation-based approaches can aid functional adaptation and participation post-stroke.
• Occupational Adaptation Model principles guide the development of adaptive strategies.

Purpose of the Study:

• To develop and assess the feasibility of Compensation-Based Problem-Solving Therapy (CBPST).
• To evaluate the preliminary effects of CBPST on participation and ADL in stroke survivors.
• To investigate the integration of problem-solving and compensatory strategies for functional recovery.

Main Methods:

• CBPST was delivered by occupational therapists over four weeks, focusing on problem identification, strategy development, implementation, and evaluation.
• Fifty stroke survivors were randomized into an intervention (CBPST) or control group.
• Outcomes including the Functional Independence Measure (FIM), Lawton-Brody Instrumental Activities of Daily Living (Lawton-Brody IADL), Frenchay Activity Index (FAI), and Canadian Occupational Performance Measure (COPM) were assessed pre- and post-intervention.

Main Results:

• Both groups demonstrated significant improvements in participation and ADL (p < 0.05).
• The CBPST intervention group showed moderate to large effect sizes across all outcome measures (COPM: 0.62, FIM: 0.62, Lawton-Brody IADL: 0.53, FAI: 0.55).
• These findings support the preliminary efficacy of CBPST in enhancing functional outcomes.

Conclusions:

• CBPST is a feasible and promising intervention for improving adaptive participation in stroke survivors.
• The therapy effectively integrates problem-solving and compensatory strategies.
• Further research with larger sample sizes is recommended to confirm clinical effectiveness.