Strategy Training for Optimizing Awareness in Rehabilitation for Individuals With Spatial Neglect Living

NCT ID: NCT07331896

Last Updated: 2026-01-12

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 45 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2026-01-31
• Study Completion Date: 2029-01-31

Brief Summary

It is common for individuals after stroke to have a cognitive perceptual impairment called unilateral spatial neglect (neglect). Individuals with neglect have difficulty paying attention to one side of their body or one side of the environment and therefore experience difficulty performing daily activities. There are a lack of effective treatments for neglect and new interventions are needed to help reduce disability for these individuals. Metacognitive strategy training (strategy training) is an intervention that has the potential to reduce neglect-related disability and improve individuals' awareness of their neglect. This study seeks to examine the effects of strategy training on self-awareness, disability, and neglect specifically for individuals who are living in the community after their stroke.

Detailed Description

Unilateral spatial neglect (neglect) post stroke is characterized by a lack of attention to one side of the body or one side of the environment. Individuals with neglect experience significant disability and are often unaware of their neglect symptoms which can make it even more difficult to treat. There are a lack of effective treatments for neglect and new interventions are needed to help reduce disability for these individuals. Metacognitive strategy training (strategy training) is an intervention that has the potential to reduce neglect-related disability and improve individuals' awareness of their neglect. Strategy training teaches individuals to develop personalized goals, self-assess their performance of daily activities, and develop and evaluate strategies designed to overcome barriers and improve their performance of daily activities. While strategy training shows promise for individuals with neglect, no studies have tailored the intervention for this group of individuals or examined the effects of strategy training for individuals with neglect specifically with individuals living in the community. This study examines whether strategy training facilitates reductions in disability and neglect and improves self-awareness after stroke.

Conditions

Stroke; Neglect, Hemispatial

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Strategy Training

The strategy training intervention teaches individuals to develop personalized goals, self-assess their performance of daily activities, and develop and evaluate strategies designed to overcome barriers and improve their performance of daily activities. Participants use a workbook to support their application of the strategy training.

Group Type: EXPERIMENTAL

Strategy Training

Intervention Type: BEHAVIORAL

This intervention will use an adapted form of strategy training for people with neglect.

Attention Control

The attention control intervention controls for the non-specific effects of strategy training. The study team will administer the standardized and dose-matched protocol, using scripted open-ended questions to facilitate participants' reflections on their rehabilitation activities and experiences. Participants complete a daily journal, merely reviewing their rehabilitation activities.

Group Type: ACTIVE_COMPARATOR

Attention Control

Intervention Type: BEHAVIORAL

This intervention will use a reflective listening protocol.

Interventions

Strategy Training

This intervention will use an adapted form of strategy training for people with neglect.

Intervention Type: BEHAVIORAL

Attention Control

This intervention will use a reflective listening protocol.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• had a stroke
• presence of neglect as determined by score of <18 or 2 or more collisions on the Virtual Reality Lateralized Attention Test (VRLAT) or score below established cutoff for neglect on one of the six subtests of the Behavioral Inattention Test (BIT);
• score of 4 or higher on any item of the Self-Regulation Skills Interview (SRSI)
• ≥18 years old
• lives within 30 miles of the University of Pittsburgh in a community dwelling.

Exclusion Criteria

• Boston Diagnostic Aphasia Examination (BDAE) Severity Scale score of 0
• dementia per medical record
• active major depressive disorder per medical record
• not willing to be videotaped

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University of Pittsburgh

OTHER

Sponsor Role: lead

Responsible Party

Emily Grattan

Assistant Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Emily Grattan, PhD, OTR/L

Role: PRINCIPAL_INVESTIGATOR

University of Pittsburgh

Locations

University of Pittsburgh

Pittsburgh, Pennsylvania, United States

Countries

United States

Central Contacts

Emily Grattan, PhD, OTRlL

Role: CONTACT

esg39@pitt.edu

412-648-0619

Other Identifiers

STUDY25090119

Identifier Type: -

Identifier Source: org_study_id