Supporting Re-engagement in Life: Coaching to Enhance Participation in Valued Activities Following Stroke

Condition(s) studied

Investigational drug(s) / intervention(s)

Occupational Performance Coaching (OPC): Occupational 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): Active 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.

Study summary

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

Primary outcome measure(s)

• Canadian Occupational Performance Measure (COPM) — Baseline, periprocedural, and 3-months after periprocedural assessment
  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.

Trial sites (2)

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