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Physiotherapy Theory and Practice
An International Journal of Physical Therapy
Volume 38, 2022 - Issue 6
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Research Report

The cognitive augmented mobility program (CAMP): feasibility and preliminary efficacy

Katherine Dittmanna St. John’s Rehab Research Program, Sunnybrook Research Institute, Toronto, ON, CanadaCorrespondence[email protected]
View further author information
, BSc, MSc, MPT,
Kay-Ann Allena St. John’s Rehab Research Program, Sunnybrook Research Institute, Toronto, ON, CanadaORCID Iconhttps://orcid.org/0000-0002-3815-1045View further author information
, BScORCID Icon,
Ashley Bergnera St. John’s Rehab Research Program, Sunnybrook Research Institute, Toronto, ON, CanadaView further author information
, BHS,
Joyce Chenb Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada;c Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, CanadaView further author information
, BSc, PhD,
Elizabeth Innessd Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada;e Department of Physical Therapy, University of Toronto, Toronto, ON, CanadaORCID Iconhttps://orcid.org/0000-0002-9217-4619View further author information
, PhDORCID Icon,
Elizabeth Linkewichf North & East GTA Stroke Network, Sunnybrook Health Sciences Centre, Toronto, ON, Canada;g Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, CanadaView further author information
, MPA,
Sandra Pacionea St. John’s Rehab Research Program, Sunnybrook Research Institute, Toronto, ON, Canada;c Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, CanadaView further author information
, BSc,
Jennifer Shaffera St. John’s Rehab Research Program, Sunnybrook Research Institute, Toronto, ON, Canada;e Department of Physical Therapy, University of Toronto, Toronto, ON, Canada;h Professional Practice and Education, Sunnybrook Health Sciences Centre, Toronto, ON, CanadaView further author information
, BSc PT, MSc,
Ada Tangi School of Rehabilitation Science, McMaster University, Hamilton, ON, CanadaView further author information
, PT, PhD &
Sara McEwena St. John’s Rehab Research Program, Sunnybrook Research Institute, Toronto, ON, Canada;e Department of Physical Therapy, University of Toronto, Toronto, ON, Canada;j Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, CanadaView further author information
, PhD show all
Pages 737-749 | Received 12 Jul 2019, Accepted 25 May 2020, Published online: 04 Aug 2020
 
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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.

Acknowledgments

The study was supported by the Heart and Stroke Foundation of Canada, Canadian Partnership for Stroke Recovery, Catalyst Grant (SM).

Disclosure of interest

The authors report no conflict of interest.

Additional information

Funding

This work was supported by the Canadian Partnership for Stroke Recovery [Catalyst].

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