The study will administer an intervention called strategy training to adult stroke survivors living in the community who do and do not have pets, and will examine the role of a pet in promoting cognitive performance and community participation outcomes.
Primary diagnosis of acute stroke
At least 3 months after the stroke onset
Living in a community residence with a pet
Cognitive impairment as indicated by an Executive Interview score of 3 or higher
Dementia as indicated by Montreal Cognitive Assessment score of 18 or lower
Severe aphasia as indicated by the Boston Diagnostic Aphasia Examination Severity Score of 0 or 1
Self-report of a central nervous system disorder other than stroke
Recent drug or alcohol addiction/abuse within 3 months prior to the Mini-Neuropsychiatric Interview
Parallel
Strategy Training
BehavioralStrategy training is comprised of participant-selected activity based goals, self evaluation, global problem solving strategies, and therapist-delivered guided training. The strategy training therapist will guide participants using prompting questions, as well as work sheets that facilitate learning and aid the participants in implementing the process.
Mean engagement score as measured by the Pittsburgh Rehabilitation Participation Scale
The scale is a valid and reliable criterion referenced measure that assesses engagement in rehabilitation therapy sessions. Each session is scored by the occupational therapist, 1 (no participation, refusal) to 6 (excellent participation). Scores are averaged across the 10-15 intervention sessions to generate the mean engagement score.
Change in attention as measured by the Color Trail Test 1
This measure assesses perceptual tracking, sustained attention and grapho-motor skills. It is a pencil and paper, timed test. Completion time in seconds for each task is recorded, with a lower score representing better function. Change in attention will be calculated by subtracting the time to do the task at baseline from the time to do the task at 3 months.
Change in executive function as measured by the Color Trail Test 2
This measure assesses divided attention and sequencing skills, which are executive function performance. It is a pencil and paper, timed test of effortful executive processing abilities that assesses the ability to alternate between two colors. Completion time in seconds for each task is recorded, with a lower score representing better function. Change in executive function will be calculated by subtracting the time to do the task at baseline from the time to do the task at 3 months.
Change in community participation as measure by Community Participation Indicators score
This participant reported questionnaire will measure the frequency of community participation over a 7 days period. Each item is measured on a 5-point Likert scale, with 1=no participation in that activity and 5=7 days of participation in that activity. A total of 20 items are summed to yield a total score. Change in community participation will be calculated by subtracting baseline total score from the 3 month total score.
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