OptiCogs: Feasibility of a multicomponent intervention to rehabilitate people with cognitive impairment post-stroke

Abstract

Abstract Background: Stroke is a leading cause of death and disability worldwide. Despite the prevalence and associated burden of cognitive impairment post-stroke, there is uncertainty regarding optimal cognitive rehabilitation for people post-stroke. This study aimed to assess whether a multicomponent intervention, called OptiCogs, is feasible, acceptable and safe for people with cognitive impairment post-stroke. A secondary aim was to explore changes in cognitive function as a result of the intervention, on fatigue, quality of life, physical function and occupational performance, from pre-intervention to post-intervention. Methods: A feasibility study was conducted where people post-stroke with cognitive impairment enrolled in a 6-week multicomponent intervention. The primary outcomes recorded included recruitment rate, retention rate, adherence to the intervention protocol, adverse events and acceptability of the intervention to people post-stroke. Secondary outcomes included (i) change in cognitive functioning using the Addenbrooke’s Cognitive Examination III, (ii) fatigue using the Fatigue Severity scale, (iii) quality of life using the the Stroke Specific Quality of Life scale (iv) physical function using the Patient-Reported Outcomes Measurement Information System, and (v) patient-reported occupational performance using the Canadian Occupational Performance Measure. The Consolidated Standards of Reporting Trials extension reporting guidelines were followed, for pilot and feasibility studies, to standardise the conduct and reporting of this study. Results: Nine eligible participants were enrolled during the 4 month recruitment period, with eight participants completing the entire six-week intervention, as well as the pre and post-intervention outcome measures. There were no reported adverse events. Participants were satisfied with the intervention and found it acceptable overall. Results of the secondary outcomes were promising for cognitive function (ACE III, Pre: 63.3±23.9 to Post: 69±24.6), fatigue (FSS, Pre: 52.5±7.3 to Post: 45.6±7.2), quality of life (SSQoL, Pre: 131.0±26.3 to Post: 169.9±15.3), physical function (PROMIS-PF, Pre: 15.5±6.3 to Post: 15.8±5.3) and occupational performance (COPM Performance, Pre: 9.3±2.3 to Post: 22.9±4.2) and COPM Satisfaction, Pre: 9.9±2.1 to Post: 22.7±3.5). Conclusion: Preliminary results suggest low-modest recruitment and high retention rates to the OptiCogs intervention. Changes in cognitive function, fatigue, quality of life and self-reported occupational performance show improvement from pre to post-intervention. These potential benefits require further testing in a larger pilot trial. Trial Registration: NCT05414539