Effects of Combining Cognitive Behavioral Therapy with Bilateral Upper Limb Training in Stroke Patients: A Randomized Controlled Trial

Abstract

CBT has a beneficial effect on depression and anxiety; however, the number of cases where therapy was used in patients with stroke was rare. In addition, there is still a lack of research on the effects of occupation-based training and the effects of bilateral upper limb training that provides an intervention based on patients’ state of hemiplegic upper limb function. This study investigated the effects of combining CBT and occupation-based bilateral upper limb training on the depression, anxiety, upper limb function, and occupational performance. The experimental group was given 30-min cognitive behavioral therapy and occupation-based bilateral upper limb training, while the control group was given 30-min conventional occupational therapy and occupation-based bilateral upper limb training. For both groups, the intervention was given as a 30-min session once a day and five times a week for 4 weeks. Following intervention, the experimental group showed significant within-group variance for automatic thoughts, depression, anxiety, upper limb function, and occupational performance only ( p < 0.01 ). For between-group variance, a significant difference was found for automatic thoughts, depression, anxiety, and occupational performance ( p < 0.01 ), however, not for upper limb function ( p > 0.05 ). In this study, it is meaningful that this author provided good guidelines for therapists and caregivers by organizing and providing actual programs in a very rare situation where cognitive behavioral therapy was applied to stroke patients.

Cognitive behavioural therapy for depression, quality of life, and cognitive function in the post‐stroke period: systematic review and meta‐analysis

“…1. Finally 10 eligible studies [18][19][20][21][22][23][24][28][29][30] were included in the qualitative and quantitative analyses. The detailed information and findings are summarised in Table 1.…”

“…RCTs mentioning quality of life and cognitive function have also emerged. [19][20][21][22][23][24] Therefore, we initiated this systematic review and meta-analysis to evaluate RCTs on CBT's effects for PSD, quality of life, and cognitive function in the post-stroke period. We hypothesised that CBT might be effective to relieve PSD, improve quality of life and cognitive function in stroke survivors.…”

“…It seems that recently more RCTs have addressed this issue. RCTs mentioning quality of life and cognitive function have also emerged 19–24 . Therefore, we initiated this systematic review and meta‐analysis to evaluate RCTs on CBT's effects for PSD, quality of life, and cognitive function in the post‐stroke period.…”

Social participation, positive affect, and negative affect in postoperative patients with hip fractures: A cross-sectional study

“…Furthermore, another study regarding middle-aged Korean women indicated that those with more positive thoughts experienced greater happiness (Kim and Hur, 2019). Therefore, it is essential to provide psychological interventions (Reger et al, 2020) and cognitive behavioral therapies (Choi and Kim, 2022) to improve patients’ automatic thoughts, PA, and NA.…”

“…Social interactions, such as phone calls or letters, may function like website interactions (Seifert, 2020). Furthermore, providing patients with hip fractures with postoperative cognitive behavioral therapy may also improve automatic thoughts and negative emotions (Choi and Kim, 2022).…”