The cognitive augmented mobility program (CAMP): feasibility and preliminary efficacy. (3rd June 2022)

• Record Type: Journal Article
• Authors: Dittmann, Katherine; Allen, Kay-Ann; Bergner, Ashley; Chen, Joyce; Inness, Elizabeth; Linkewich, Elizabeth; Pacione, Sandra; Shaffer, Jennifer; Tang, Ada; McEwen, Sara
• Is Part Of: Physiotherapy theory and practice. Volume 38:Number 6(2022)
• Page Start: 737
• Page End: 749
• Publication Date: 2022-06-03
• Subjects: Stroke -- rehabilitation -- cognitive strategies -- physiotherapy -- best evidence; Physical therapy -- Periodicals; 615.82
• DOI: 10.1080/09593985.2020.1790068
• Languages: English
• ISSNs: 0959-3985

Abstract

ABSTRACT: Background: Best evidence suggests incorporating task-specific training, aerobics, and strengthening to improve mobility and gait in persons with stroke (PWS). Related research suggests incorporating cognitive problem-solving strategy training may lead to better skill maintenance and transfer. The present study examined the feasibility and preliminary outcomes of an evidence-based cognitive augmented mobility program (CAMP) for PWS. Methods: A single-arm pre-post and follow-up design was conducted, in two blocks (NCT03683160). Participants completed an exercise intervention with an integrated cognitive strategy component and had weekly 1:1 sessions with a physiotherapist trained in Cognitive Orientation to daily Occupational Performance (CO-OP), focusing on goal practice and cognitive strategy use. CAMP consisted of a pre-intervention education and goal-setting session and 16 90-minute sessions held in a group format, 2x/wk for 8 weeks. Assessments were conducted 1 week prior to beginning the intervention, 1 week post-intervention, and at a 4–5 week follow-up. Results: CAMP was found to be feasible with 96% session attendance and strong participant satisfaction. Pre to post-CAMP intervention, a large effect was found for endurance (r = 0.53), balance (r = 0.59), mobility (r = 0.63) and goal attainment (r = 0.63) indicators, and large effects were maintained at follow-up for balance, mobility, and goal attainment. A medium effect was found for functional independence (r = 0.38), gait speed (r = 0.39), and balance confidence (r = 0.38). A small effect was found for participation (r = 0.27) and overall stroke recovery (r = 0.25). Conclusions: Preliminary results suggest CAMP is feasible; there may be a beneficial effect of combining best evidence for mobility and fitness with cognitive strategy training. The positive results for skill maintenance and transfer suggest further investigation is warranted.