Pilot Randomized Controlled Trial of Self-Regulation in Promoting Function in Acute Poststroke Patients

Abstract

ObjectiveTo test the efficacy of self-regulation (SR) for promoting task performance and motor and cognitive functions. DesignPilot randomized controlled trial. SettingRehabilitation unit. ParticipantsInpatients with acute poststroke (N=44) after a cerebral infarction aged ≥60 years. InterventionsPatients were randomly assigned to the SR (n=24) or functional rehabilitation (control; n=20) intervention. The SR intervention consisted of 1 week of therapist-supervised practices of daily tasks using SR of one's own performance (five 1-h sessions). Patients in the control intervention practiced the same daily tasks with a therapist's demonstration and guidance. Main Outcome MeasuresPerformance of tasks, including household and monetary transaction tasks; FIM; Fugl-Meyer Assessment (FMA); and Color Trails Test (CTT). ResultsThe SR group showed significant improvement in all tasks (median difference, 1–2; effect size [r]=.74–.89) versus none (median difference, 0–0.5) in the control group. Results of the FIM (P<.001, r=.87 in the motor subscale; P<.001, r=.49 in the cognitive subscale), FMA (P<.001, r=.84 for upper extremity motor function and r=.63 for lower extremity motor function), and CTT (P=.002, r=.72) of the SR group improved. The SR group outperformed their control counterparts in 4 of the 5 tasks (median difference, 1; r=.30–.52) and in the FIM motor subscale (P=.002, r=.47), but not in the cognitive subscale and motor and cognitive functions. ConclusionsSR appears useful for improving task performance that demands both motor and cognitive abilities by promoting information processing and active learning.