Supporting Re-engagement in Life: Coaching to Enhance Participation in Valued Activities Following Stroke
ConditionStroke
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorQueen's University
About this trial
The goal of this clinical trial is to determine whether Occupational Performance Coaching (OPC), a person-centered, strength-based intervention, can improve participation in valued activities among adults who have experienced a stroke and recently completed community- or clinic-based stroke rehabilitation.
The main questions it aims to answer are:
Does OPC improve performance and satisfaction with participation in personally valued activities?
Does OPC improve participation self-efficacy, physical activity, cognition, and emotional well-being compared to an active attention control intervention?
Researchers will compare the OPC group to an active attention control group to see if OPC leads to greater improvements in participation and secondary outcomes.
Participants will:
Be randomized to receive either OPC (delivered virtually, including collaborative goal-setting and problem-solving) or an active attention control intervention.
Complete assessments of participation in valued activties, physical activity (using movement sensors), self-efficacy, cognition, and mood immediately after treatment and at 3 months.
A subset of 20 participants from intervention group will take part in interviews to share their experiences.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Be living in the community (home, retirement home)
Have completed publicly funded rehabilitation
Are 3 to 12 months post-first stroke.
Be able to communicate in English
Disqualifiers
We will exclude individuals with unstable major psychiatric conditions or neurodegenerative conditions.
Trial design
Design model
Parallel
Treatments tested in this trial
Occupational Performance Coaching (OPC)
BehavioralOccupational Performance Coaching (OPC) is an innovative, person-centered, strengths-based intervention designed to enhance participation in valued activities after stroke. OPC targets modifiable factors such as goal setting, self-efficacy, emotional support, problem-solving, and individualized education. Through a collaborative process, therapists partner with stroke survivors to identify challenges, set meaningful goals, and experiment with tailored solutions, refining them until successful strategies are found. Research shows OPC is feasible, acceptable, and effective, with participants demonstrating significant improvements in performance, satisfaction, and re-engagement in valued activities within 8-10 sessions, both in-person and via telerehabilitation. By fostering physical, cognitive, and emotional well-being, OPC addresses barriers like social isolation, physical inactivity, and low self-efficacy. Delivered virtually, OPC overcomes challenges in accessing rehabilitation, parti
computer cognitive training program (CogniFit)
DeviceActive control (AC) group will receive access to the CogniFit computer-based cognitive training program, a personalized brain training tool designed to target perception, attention, memory, and reasoning.While cognitive training can improve global cognition, working memory, attention, and executive function, it has not shown effects on daily activities or depression.
Treatment groups
118 Participants
are divided into 2 treatment groupsGroup A: OPC Intervention Group (occupational performance couching groupsExperimental treatment 1 intervention
Group B: Active Control (AC) GroupActive comparator 1 intervention
Trial outcomes
Primary outcomes
1
Canadian Occupational Performance Measure (COPM)
The Canadian Occupational Performance Measure (COPM) is a reliable, valid, and responsive tool frequently used in stroke rehabilitation outcome studies. Using the COPM, participants identify problems related to participation in valued activities that are then rated by participants for performance and satisfaction with current status on a scale of 1-10, where 10 indicates optimal performance or satisfaction. Numbers are summed and divided by the number of goals.
Time frame
Baseline, periprocedural, and 3-months after periprocedural assessmentSecondary outcomes
1
Participation Strategies Self-Efficacy Scale (PS-SES)
The Participation Strategies Self-Efficacy Scale (PS-SES) is a 35-item scale that measures self-efficacy in using strategies for participation in home, community, work, and social activities. Each item is scored on a scale of 1 (not at all confident) to 10 (totally confident) total score ranges from 35 to 350 with higher scores indicating higher self-efficacy.
Time frame
Baseline, periprocedural, and 3-months after periprocedural assessment2
Time spent in active veruss sedentary activity
Time spent in active (i.e., standing, walking) versus sedentary (i.e., sitting, lying) activites willk be measured using the ActivPal 4 activity monitor (PAL Technologies Ltd., Glasgow, UK). The ActivPal is a small, lightweight wearable device that measures movement with a triaxial accelerometer and body posture with a gyroscope. Consistent with recommendations for obtaining a good representation of typical physical activity, it will be worn for seven consecutive days ateach data colleciton timepoint. An average of active versus sedentary time will be calculated.
Time frame
Baseline, periprocedural, and 3-months after periprocedural assessment3
Generalized Anxiety Disorders Scale-7 (GAD-7)
The Generalized Anxiety Disorders Scale-7 (GAD-7) is a brief 7-item screening tool for anxiety that captures the frequency of anxiety-related symptoms. The GAD-7 is a valid, reliable, and responsive measure commonly used in stroke rehabilitation research. Items are socred on a scale of 0 (not at all) to 3 (nearly everyday). Total score ranges from 0-21 with higher scores indicating higher anxiety.
Time frame
Baseline, periprocedural, and 3-months after periprocedural assessment4
Executive Functioning
Executive functioning will be measured using the following CogniFit computerized assessments : a) the Trail Making Test (TMT) measures processing speed, shifting and visual attention; b) the Stroop test measures inhibition, updating, visual perception, naming, processing speed and response time; and c) the Visual Working Memory Span Test measures spatial perception, short-term memory, visual short-term memory, non-verbal memory, working memory, planning, processing speed, and response time. These tests have demonstrated reliability and validity with older adults. Overall executive functioning will be represented using Z scores.
Time frame
Baseline, periprocedural, and 3-months after periprocedural assessmentSponsors and contacts
Click on the lead sponsor to view all of their trials.
Queen's University
Lead sponsor
Providence Care Hospital
Collaborator
Bruyère Health Research Institute.
Collaborator
Source ClinicalTrials.gov