Cognitive Oriented Strategy Training Augmented Rehabilitation (COSTAR) Treatment Approach for Stroke
| Status: | Completed |
|---|---|
| Conditions: | Neurology |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 11/30/2018 |
| Start Date: | August 2013 |
| End Date: | March 2016 |
Stroke is the most serious disabling condition in the United States and the developed world.
Novel stroke rehabilitation approaches, such as task-specific training, have shown promise in
improving an individual's recovery in the rehabilitation setting; however, evidence suggests
that these improvements are not generalized or transferred to the home, community, or work
settings. Thus, these interventions usually do not impact overall health and participation
outcomes. This research study seeks to improve task-specific training as a stroke
rehabilitation approach by integrating it with evidence-based cognitive-oriented strategies
which have shown great promise as a way to address the limitations of task-specific training.
The new treatment protocol is called Cognitive-Oriented Strategy Training Augmented
Rehabilitation, or COSTAR. The hypothesis of this study is that COSTAR will result in more
efficient functional skill acquisition, better long-term retention of skills learned, and
generalization and transfer of skills learned to home, community, and work settings.
Novel stroke rehabilitation approaches, such as task-specific training, have shown promise in
improving an individual's recovery in the rehabilitation setting; however, evidence suggests
that these improvements are not generalized or transferred to the home, community, or work
settings. Thus, these interventions usually do not impact overall health and participation
outcomes. This research study seeks to improve task-specific training as a stroke
rehabilitation approach by integrating it with evidence-based cognitive-oriented strategies
which have shown great promise as a way to address the limitations of task-specific training.
The new treatment protocol is called Cognitive-Oriented Strategy Training Augmented
Rehabilitation, or COSTAR. The hypothesis of this study is that COSTAR will result in more
efficient functional skill acquisition, better long-term retention of skills learned, and
generalization and transfer of skills learned to home, community, and work settings.
Inclusion Criteria:
1. age 18 or older;
2. have completed all physician recommended rehabilitation and currently not receiving
rehabilitation services;
3. at least one-month post-stroke;
4. have self-reported unmet functional goals; and
5. NIH Stroke Scale (NIHSS) total score of 2-12.
Exclusion Criteria:
1. have sustained a hemorrhagic stroke;
2. NIH Stroke Scale (NIHSS) aphasia rating of 1 or more (impaired speech);
3. MoCA cognitive screen score of less than 21 (impaired general cognitive ability);
4. neurological diagnoses other than stroke;
5. major psychiatric illness (bipolar disorder, OCD, panic disorder, PTSD, and/or
borderline personality disorder);
6. no major depressive symptoms (PHQ-9 < 20);
7. a score of 6 or less on the CIHI aphasia screen combined items 64 and 66;
8. terminal illness;
9. blindness; and
10. non-English speaking.
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