Efficacy of metacognitive strategy training on reducing disability of post-stroke survivor: A pilot study

Abstract

Background: Post-stroke survivors experience significant challenges with their functional health. Despite advances in neuro-rehabilitation, they cannot participate in meaningful daily life activities, leading to disability. Many intervention approaches are applied in stroke rehabilitation to make them independent and lead a quality life. Objectives: The objective of this pilot study was to investigate the effect of the Metacognitive Strategy Training (MCST) on Conventional Occupational Rehabilitation Therapy on improving independence and reducing the disability of post-stroke survivors. Materials and methods: Thirty subjects with post-stroke syndrome participated in an exploratory, double-blind, randomized controlled trial with pre-post and follow-up studies. Subjects were randomized over two intervention groups. Group-1 received MCST with conventional therapy (n=15), and Group-2 conventional therapy only (n=15). The Functional Independence Measure (FIM) measures independence at baseline (Time1), post-intervention (Time2), and after six months (Time3). Results: Changes in Functional Independence Measure scores for the two groups over six months showed significant effects of group (F(1,24)=9.422, p<0.005), time (F(1.160, 27.848)=21.449, p<0.0001) but time and group interaction was not significantly affected (F(1.160, 27.848)=0.172, p=0.719). Post hoc analysis with a Bonferroni adjustment revealed that FIM was statistically significantly increased from pre-intervention to post-intervention (22.597 (95% CI, 34.511 to 10.683), p<0.0001), and from pre-intervention to six month follow up. (24.203 (95% CI,37.554 to 10.853), p=0.0001), but not from post-intervention to six months (1.606 (95% CI, -5.988 to 2.776), p=1.000). Conclusion: MCST has better efficiency in reducing disability and improving the independence of post-stroke survivors in the long term.