Journal:PM & R
Year, Volume, Issue, Page(s):15, 7, 6, 562-570
Study examined the effects of strategy training, a behavioral intervention used to augment usual inpatient rehabilitation, on apathy symptoms over the first 6 months after stroke. Thirty participants with acute stroke who exhibited cognitive impairments and were admitted for inpatient rehabilitation were randomized to receive strategy training (1 session per day, 5 days per week, in addition to usual inpatient rehabilitation) or reflective listening (same dose). Strategy training sessions focused on participant-selected goals and participant-derived strategies to address these goals, using a global strategy training method (Goal-Plan-Do-Check). Reflective listening sessions focused on participant reflections on their rehabilitation goals and experiences, facilitated by open-ended questions and active listening skills (attending, following, and responding). Trained raters blinded to group assignment administered the Apathy Evaluation Scale at study admission, 3 months, and 6 months. Data were analyzed with repeated-measures fixed-effects models. Participants in both groups had similar subsyndromal levels of apathy symptoms at study admission. A significant group-by-time interaction indicated that changes in apathy symptom levels differed between groups over time. The magnitude of group differences in change scores was large at month 3 and moderate to large at month 6. Strategy training shows promise as an adjunct to usual rehabilitation for maintaining low levels of post-stroke apathy.