Effectiveness of the Functional and Cognitive Occupational Therapy (FaCoT) Intervention for Improving Daily Functioning and Participation of Individuals with Mild Stroke: A Randomized Controlled Trial

Abstract

Background: Mild stroke can cause subtle cognitive–behavioral symptoms, which although might be hidden, can restrict community reintegration and participation. Cognitive rehabilitation programs exist for stroke but not specifically for mild stroke and the research evidence varies. The Functional and Cognitive Occupational Therapy (FaCoT) intervention was developed specifically for this population. Objective: To examine the effectiveness of FaCoT intervention for improving daily functioning and participation compared with standard care. Method: A single blind randomized controlled trial with assessments pre (T1), post (T2) and 3-month follow-up (T3). Individuals in the FaCoT group received 10 weekly sessions practicing cognitive and behavioral strategies. The Canadian Occupational Performance Measure (COPM) was the primary outcome measure, IADL-questionnaire, Reintegration to Normal Living questionnaire (RNL) were secondary measures. Results: In total, 66 community-dwelling individuals with mild stroke were randomly allocated to FaCoT (n = 33, mean (SD) age 64.6 (8.2), 33% women), or control group (n = 33, mean (SD) age 64.4 (10.8), 45% women). Time X Group interaction effects were found for the COPM performance (F(1.4,90.3) = 11.75, p < 0.000) and satisfaction (F(1.5,96.8) = 15.70, p < 0.000), with large effect size values. Significant between-group effects were found for RNL (F = 10.02, p < 0.002, ɳP2 = 0.13). Most participants in FaCoT achieved a clinically important difference in COPM between T1–T2, T1–T3, and in RNL between T1 to T3 compared with the control group. Conclusions: FaCoT intervention is effective to improve daily functioning, participation and satisfaction of individuals with mild stroke compared with standard care, therefore FaCoT should be implemented in community rehabilitation settings.

Functional and Cognitive Occupational Therapy (FaCoT) Improves Self-Efficacy and Behavioral–Emotional Status of Individuals with Mild Stroke; Analysis of Secondary Outcomes

“…This paper focused on evaluating the impact of FaC o T on self-efficacy, behavior, emotional status, and self-perception of individuals with mild stroke compared to a control group. Previously, we reported that participants who received FaC o T improved their performance and satisfaction in daily living [ 27 ]. Findings of this study also demonstrated improvement in self-efficacy, which is a person’s belief in their own ability and our secondary outcome measure.…”

“…Findings of this study also demonstrated improvement in self-efficacy, which is a person’s belief in their own ability and our secondary outcome measure. We can carefully suggest that these two aspects are related and had a mutual effect, as improvement in self-efficacy could have led to the improved occupational performance and satisfaction, and vice versa [ 27 ]. This positive change was also apparent at the three-month follow-up.…”

“…The Functional and Cognitive Occupational Therapy (FaC o T) intervention [ 27 ] was developed according to the Template for Intervention Description and Replication (TI DieR) framework [ 28 ] (see Table S1 ) specifically to address the unique needs and consequences of mild stroke [ 29 ], in order to overcome functional barriers and to promote the health and wellbeing of patients [ 30 , 31 ]. The primary goal of FaCoT is to improve the daily performance and satisfaction with performance of individuals with mild stroke.…”

“…The primary goal of FaCoT is to improve the daily performance and satisfaction with performance of individuals with mild stroke. Our previous publication [ 27 ] demonstrated statistically and clinically significant improvements with large effect sizes in the primary outcome measures—daily performance and satisfaction with performance, as well as participation—compared to standard care. In this paper, we aim to assess changes in self-efficacy, behavior, emotional status, and self-perception (our secondary outcome measures).…”

Relieving the Burden of Cardiovascular Disease in Canada Using Current Therapies: A Literature Review

“…Participants were assessed pre (T1) and post (T2) intervention and at 3-month follow-up (T3) using patient-reported outcome measures (PROMS) to quantify functional status. Compared with the control (standard care), it was established that FaCoT achieved a clinically significant difference in improving occupational performance in individuals with mild stroke[22].Zartashahet al | URNCST Journal (2022): Volume 6, Issue 7 Page 6 of 12 DOI Link: https://doi.org/10.26685/urncst.376 In another study, McEwen et al investigated the Cognitive Orientation to daily Occupational Performance (CO-OP) approach for improving activity and participation post-stroke, compared with usual outpatient rehabilitation.…”