RecruitingNot ApplicableNCT06782321

Emotional Recovery Post-Stroke

Centering Emotional Recovery Post-Stroke

Sponsor

Medical University of South Carolina

Enrollment

80 participants

Start Date

May 1, 2025

Study Type

INTERVENTIONAL

Conditions

Stroke Mental Health Wellness 1

Summary

The purpose of this study is to evaluate whether adding an emotional wellness component to occupational therapy (OT) and/or speech therapy (ST) telerehabilitation improves overall emotional well-being and activity participation for people with stroke.

Eligibility

Min Age: 21 Years

Inclusion Criteria8

Self-reported stroke-related deficits in emotional wellness such as anxiety, sleep disturbance, dread, fear, loss of hope, sadness.
Have experienced ischemic or hemorrhagic stroke at least 30 days prior
Stroke-related aphasia and/or upper extremity hemiparesis
Aged 21 years or older
English as primary language
Have corrected vision to be able to read text on a screen
Able to participate fully in the study's tele-rehabilitation (Aim 1) and/or virtual group programing (Aim 2) with personally owned device (i.e., phone, tablet, or laptop) and personal Wi-Fi connection or cellular service
Cognitive, language, and motor capacity to participate fully in the study's assessment session as per the judgment of the licensed, experienced stroke tele-rehabilitation occupational or speech therapist

Exclusion Criteria3

Unable to follow 1-2 step instructions given by the study team member during the informed consent procedures.
Pain that interferes with ability to participate in the study's upper extremity movement tasks.
Have impaired decision making capacity as determined by the U-ARE protocol for assessing capacity to provide informed consent.

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Interventions

BEHAVIORALmodified Cognitive Behavioral Therapy (mCBT)

The theoretical model underling Cognitive Behavioral Therapy (CBT) explains the interaction of thoughts, feelings, and behaviors during life situations. This model suggests that a person's thoughts/feeling/behaviors affect their functioning during life situations. This contrasts with a common belief that one's functioning during life situations is the only way to effect thoughts/feelings/behaviors. Applied to stroke, this model suggests that the stroke survivor can alter his/her functioning during life situations by altering his/her thoughts/feelings/behaviors. The purpose of CBT is to empower the person with the skills to alter his/her thoughts/feelings/behaviors in order to positively affect function in life situations. The mCBT intervention includes 4 elements: psychoeducation, education about unhelpful thinking, behavioral activation therapy, education on sleep hygiene, and relaxation training.

BEHAVIORALOccupational or Speech Therapy

If the participant demonstrates aphasia of any severity level on the Revised Western Aphasia Battery (WAB-R) assessment given at the PRE session, the subject will receive ST, provided by a Speech Language Pathologists (SLP), stroke telerehabilitation. If there is no aphasia, the subject will receive OT stroke telerehabilitation. The OT and ST stroke telerehabilitation sessions will utilize a similar metacognitive strategy training approach which is focused on enabling the stroke survivor to re-engage with meaningful life activities. In the Occupational Therapy literature this approach is called Cognitive Orientation to Occupational Performance (CO-OP) and in the Speech Language Pathology Literature this approach is called the Life Participation Approach to Aphasia (LPAA). Telerehabilitation CO-OP and LPAA within the OT or ST session include three common elements: Shared decision-making for goal setting, guidance/coaching from the therapist, and self-evaluation.