Abstract T P110: Combined Task-Specific and Cognitive Strategy Training in Subacute Stroke: A Phase II Randomized Controlled Trial
Bibliographic record
Abstract
Background and Objectives: Task-specific training (TST) may improve basic mobility and activities of daily living; however, used alone, these improvements are not generalized and transferred to home, community, or work settings, nor do they impact overall health status. In contrast, approaches incorporating cognitive strategy training have shown great promise in these areas, suggesting that a combined approach may have a greater overall effect. Cognitive Orientation to daily Occupational Performance (CO-OP) is an approach that uses cognitive strategies in combination with TST. The objective of this trial is to estimate the effect of CO-OP compared to standard out-patient rehabilitation on health status and functional skill performance in adults less than 3 months post stroke Methods: Participants less than 3 months post ischemic stroke (ICD-10 codes 163, 164) and admitted to outpatient rehabilitation services at 2 sites were randomized to receive either standard out-patient therapy (ST) or CO-OP. The main outcomes, administered pre, post, and at 3-month follow-up by a blind assessor, were health status (Stroke Impact Scale-SIS), and functional skill performance (Performance Quality Rating Scale-PQRS). Results: At the time of interim analysis, 21 participants (mean age 60.2 years, 33% female) were enrolled, 11 CO-OP and 10 ST. Post-test data were available for 14, follow-up for 8. SIS scores indicated larger changes for CO-OP for 7 of 9 domains, moderate effect for the composite physical health outcome SIS-16 at post-test (Cohen’s d=0.6), and large effect at follow-up (Cohen’s d=2.2). CO-OP had a large effect on PQRS scores for functional skills not trained in therapy (Cohen’s d=3.2), suggesting transfer beyond the clinical setting. Conclusions: The CO-OP treatment approach is associated with greater improvements than standard rehabilitation in most health status domains and in performance of skills untrained in therapy, indicating transfer beyond the clinical setting. A multi-site Phase III trial is warranted.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.016 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".