A randomized controlled trial of self‐regulated modified constraint‐induced movement therapy in sub‐acute stroke patients

Liu, Karen P.Y.; Balderi, K.; Leung, Teresa Lai Fong; Yue, Aiping; Lam, Ngai-yan; Cheung, Joyce T Y; Fong, Shirley S.M.; Sum, Cecilia M W; Bissett, Michelle; Rye, Ruth Anne; Mok, Vincent

doi:10.1111/ene.13037

Cited by 25 publications

(20 citation statements)

References 18 publications

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“…Therefore, the children received the SRL intervention might have enhanced school-related functions. These findings concur with previous studies (15,16,39) that demonstrated an improvement in daily functioning after self-regulation had been implemented. Learning skills, while monitoring difficulties and applying problem-solving strategies, assists with improving self-awareness and motivation to learn, leading to success in task performance.…”

Section: Resultssupporting

confidence: 92%

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Self-Regulated Learning versus Activity-based Intervention to Reduce Behavioral Problems and Enhance School-related Function for Children with Autism Spectrum Disorders: A Randomized Control Trial

Yunus

Bissett

Penkala

et al. 2019

Preprint

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Background: Self-regulated learning is an active learning cognitive approach which helps individuals to be aware of their own ability and environment and control their own learning. This study examined the therapeutic effects on reducing behavioral problems and enhancing school-related function in children with Autism Spectrum Disorders. Methods: Forty children (aged 6–12) were randomized into a 12-week self-regulated learning or activity-based group. Three outcome measures, assessing the behavioral problems and school-related function, were administered before and after the intervention and at one-month follow-up. The results between the two groups were also compared using two-way repeated measure multivariate analysis of variance tests. Results: Children in the self-regulated learning group reported a significant reduction in ‘Maladaptive Behavior’. Both groups showed better school-related function after the intervention with greater improvement found in the self-regulated learning group including ‘Functional Communication’, ‘Memory and Understanding’ and ‘Positive Interaction’. In the one-month follow-up, the self-regulated learning group showed significant better results in the ‘Maladaptive Behavior’ in addition to the ‘Functional Communication’, ‘Memory and Understanding’, ‘Following Social Conversations’, ‘Positive Interaction’ and ‘Behavior Regulation’ in the school-related function. Conclusions: The self-regulated learning and activity-based interventions are effective in enhancing school-related functions. In addition, the self-regulated learning intervention is effective in reducing behavioral problems of children with ASD. The SRL intervention was seen to be effective compared to the activity-based intervention with particular benefits for on-going learning and improvements. Trial registration: ClinicalTrials.gov, NCT02496819. Registered 14 July 2015.

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Section: Resultssupporting

confidence: 92%

“…Self-regulated learning (SRL) has been shown to enhance individuals' participation in daily activities as a result of underlying psychological, cognitive or sensory-motor problems (14)(15)(16). SRL originates from Albert Bandura's social-cognitive theory (17), involving self-monitoring and self-modification of one's behavior (18).…”

Section: Introductionmentioning

confidence: 99%

Self-Regulated Learning versus Activity-based Intervention to Reduce Behavioral Problems and Enhance School-related Function for Children with Autism Spectrum Disorders: A Randomized Control Trial

Yunus

Bissett

Penkala

et al. 2019

Preprint

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“…Two RCTs exploring the benefits of Constraint induced movement therapy (CIMT) upon older stroke survivors were identified [ 32 – 33 ]. Both were conducted using rehabilitative outpatient departments, but one was conducted in Taiwan [ 33 ] and the other in China [ 32 ].…”

Section: Resultsmentioning

confidence: 99%

Non-pharmacological interventions for the improvement of post-stroke activities of daily living and disability amongst older stroke survivors: A systematic review

et al. 2018

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Globally, stroke remains a leading cause of death and disability, with older adults disproportionately affected. Numerous non-pharmacological stroke rehabilitation approaches are in use to address impairments, but their efficacy in older persons is largely unknown. This systematic review examined the evidence for such interventions as part of the Optimal Evidence-Based Non-Drug Therapies in Older Persons (ONTOP) project conducted under an European Union funded project called the Software Engine for the Assessment and Optimisation of Drug and Non-Drug Therapies in Older Persons (SENATOR) [http://www.senator-project.eu]. A Delphi panel of European geriatric experts agreed activities of daily living and disability to be of critical importance as stroke rehabilitation outcomes. A comprehensive search strategy was developed and five databases (Pubmed, CINAHL, Embase, PsycInfo and Cochrane Database of Systematic Reviews) searched for eligible systematic reviews. Primary studies meeting our criteria (non-pharmacologic interventions, involving stroke survivors aged ≥65 years, assessing activities of daily living and/or disability as outcome) were then identified from these reviews. Eligible papers were double reviewed, and due to heterogeneity, narrative analysis performed. Cochrane risk of bias and GRADE assessment tools were used to assess bias and quality of evidence, allowing us to make recommendations regarding specific non-pharmacologic rehabilitation in older stroke survivors. In total, 72 primary articles were reviewed spanning 14 types of non-pharmacological intervention. Non-pharmacological interventions based on physiotherapy and occupational therapy techniques improved activities of daily living amongst older stroke survivors. However, no evidence was found to support use of any non-pharmacological approach to benefit older stroke survivors’ disability. Evidence was limited by poor study quality and the small number of studies targeting older stroke survivors. We recommend future studies explore such interventions exclusively in older adult populations and improve methodological and outcome reporting.

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“…The IADL scale has good psychometric properties including test-retest reliability [ 38 , 39 ]. The IADL scale has been sensitive to change after constraint-induced movement therapy in stroke survivors [ 40 ]. Furthermore, cognitive impairment before enrollment in stroke rehabilitation could predict IADL scores at 6 months follow-up [ 41 ].…”

Section: Methodsmentioning

confidence: 99%

The influence of computer-based cognitive flexibility training on subjective cognitive well-being after stroke: A multi-center randomized controlled trial

et al. 2017

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BackgroundStroke can result in cognitive complaints that can have a large impact on quality of life long after its occurrence. A number of computer-based training programs have been developed with the aim to improve cognitive functioning. Most studies investigating their efficacy used only objective outcome measures, whereas a reduction of subjective cognitive complaints may be equally important for improving quality of life. A few studies used subjective outcome measures but were inconclusive, partly due to methodological shortcomings such as lack of proper active and passive control groups.ObjectiveThe aim of the current study was to investigate whether computer-based cognitive flexibility training can improve subjective cognitive functioning and quality of life after stroke.MethodsWe performed a randomized controlled double blind trial (RCT). Adults (30–80 years old) who had a stroke 3 months to 5 years ago, were randomly assigned to either an intervention group (n = 38), an active control group (i.e., mock training; n = 35), or a waiting list control group (n = 24). The intervention and mock training consisted of 58 half-hour sessions within 12 weeks. The primary subjective outcome measures were cognitive functioning (Cognitive Failure Questionnaire), executive functioning (Dysexecutive Functioning Questionnaire), quality of life (Short Form Health Survey), instrumental activities of daily living (IADL; Lawton & Brody IADL scale), and participation in society (Utrecht Scale for Evaluation of Rehabilitation-Participation). Secondary subjective outcome measures were recovery after stroke, depressive symptoms (Hospital Anxiety Depression Scale—depression subscale), fatigue (Checklist Individual Strength—Fatigue subscale), and subjective cognitive improvement (exit list). Finally, a proxy of the participant rated the training effects in subjective cognitive functioning, subjective executive functioning, and IADL.Results and conclusionsAll groups improved on the two measures of subjective cognitive functioning and subjective executive functioning, but not on the other measures. These cognitive and executive improvements remained stable 4 weeks after training completion. However, the intervention group did not improve more than the two control groups. This suggests that improvement was due to training-unspecific effects. The proxies did not report any improvements. We, therefore, conclude that the computer-based cognitive flexibility training did not improve subjective cognitive functioning or quality of life after stroke.

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A randomized controlled trial of self‐regulated modified constraint‐induced movement therapy in sub‐acute stroke patients

Abstract: A combination of SR and mCIMT could produce an added effect in functional regain in patients post stroke.

Cited by 25 publications

References 18 publications

Self-Regulated Learning versus Activity-based Intervention to Reduce Behavioral Problems and Enhance School-related Function for Children with Autism Spectrum Disorders: A Randomized Control Trial

Self-Regulated Learning versus Activity-based Intervention to Reduce Behavioral Problems and Enhance School-related Function for Children with Autism Spectrum Disorders: A Randomized Control Trial

Non-pharmacological interventions for the improvement of post-stroke activities of daily living and disability amongst older stroke survivors: A systematic review

The influence of computer-based cognitive flexibility training on subjective cognitive well-being after stroke: A multi-center randomized controlled trial

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