Kazuaki Oyake, Shota Watanabe, Ayano Takeuchi, Taiki Yoshida, Takashi Shigematsu, Yuuki Natsume, Shigeki Tsuzuku, Kunitsugu Kondo, Ichiro Fujishima, Yohei Otaka, Satoshi Tanaka
Archives of rehabilitation research and clinical translation 6(3) 100344-100344 2024年9月 査読有り
OBJECTIVE: To investigate the feasibility of poststroke interventions using a motivational instructional design model with occupational therapy (OT) and swallowing therapy (ST) and the model's potential physical and mental health effects. DESIGN: An open-label, single-arm, feasibility study on the Attention, Relevance, Confidence, and Satisfaction model. SETTING: Two convalescent rehabilitation wards. PARTICIPANTS: Twenty-five patients with stroke (N=25) (19 men; mean age, 62.4±11.9y; 61.9±36.8d from the first stroke) were recruited. INTERVENTIONS: Twelve participants received a motivational approach based on the Attention, Relevance, Confidence, and Satisfaction model during OT (OT group), and 13 received it during ST (ST group). The intervention lasted 40-60 minutes daily, 5 days weekly, for 4 weeks. MAIN OUTCOME MEASURES: The primary outcomes included the dropout rate, an adverse event, and the participants' acceptability of the intervention. Paretic arm function was assessed in the OT group; swallowing ability was assessed in the ST group; and activities of daily living, depressive symptoms, and apathy were assessed in both groups. RESULTS: No participants dropped out of the intervention or experienced an adverse event. Twenty-one participants (84%) were satisfied with the intervention, and 19 (76%) hoped to continue receiving it. The OT group showed statistically significant improvements in paretic arm function and activities of daily living (Cohen's r=0.68-0.77), whereas the ST group improved in swallowing ability, activities of daily living, and depressive symptoms (Cohen's r=0.62-0.85). CONCLUSIONS: The interventions using the motivational instructional model with OT and ST were feasible and could improve poststroke paretic arm function, swallowing ability, and activities of daily living after stroke.