Research Article  |   December 2014
Effectiveness of Interventions to Improve Occupational Performance of People With Cognitive Impairments After Stroke: An Evidence-Based Review
Author Affiliations
  • Glen Gillen, EdD, OTR, FAOTA, is Associate Professor of Rehabilitation and Regenerative Medicine (Occupational Therapy), Programs in Occupational Therapy, Columbia University Medical Center, Columbia University, New York, NY; GG50@Columbia.edu
  • Dawn M. Nilsen, EdD, OTL, is Assistant Professor of Rehabilitation and Regenerative Medicine (Occupational Therapy), Columbia University Medical Center, New York, NY
  • Jessica Attridge, MS, OTR, Erasmia Banakos, MS, OTR, Marie Morgan, MS, OTR, Lauren Winterbottom, MS, OTR, and Wesley York, MS, OTR, were Graduate Students, Programs in Occupational Therapy, Columbia University, New York, NY, at the time of this review
Article Information
Evidence-Based Practice / Neurologic Conditions / Stroke / Special Issue
Research Article   |   December 2014
Effectiveness of Interventions to Improve Occupational Performance of People With Cognitive Impairments After Stroke: An Evidence-Based Review
American Journal of Occupational Therapy, December 2014, Vol. 69, 6901180040p1-6901180040p9. doi:10.5014/ajot.2015.012138
American Journal of Occupational Therapy, December 2014, Vol. 69, 6901180040p1-6901180040p9. doi:10.5014/ajot.2015.012138
Abstract

This evidence-based review was conducted to determine which interventions are effective in improving occupational performance after stroke. Forty-six articles met the inclusion criteria and were examined. Interventions for the following impairments were reviewed: general cognitive deficits, executive dysfunction, apraxia, memory loss, attention deficits, visual field deficits (included because of their close relationship with neglect), and unilateral neglect. Evidence is available from a variety of clinical trials to guide interventions regarding general cognition, apraxia, and neglect. The evidence regarding interventions for executive dysfunction and memory loss is limited. There is insufficient evidence regarding impairments of attention and mixed evidence regarding interventions for visual field deficits. The effective interventions have some commonalities, including being performance focused, involving strategy training, and using a compensatory as opposed to a remediation approach. The implications of the findings for practice, research, and education are discussed.