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.