A feasibility randomized-controlled trial of an executive functioning telerehabilitation intervention for stroke survivors

Abstract

Background: Executive dysfunction affects most stroke survivors, limiting their ability to adapt post-stroke. Despite clinical guidelines recommending executive functioning rehabilitation, robust evidence for interventions is lacking. Aims: This study assessed the feasibility and acceptability of an executive functioning telerehabilitation intervention for stroke survivors. It examined recruitment and retention rates, adherence, completion of outcome measures, intervention usability, and participant experience. Preliminary changes in executive functioning, self-efficacy, and wellbeing were explored to inform the design of a future efficacy trial. Methods: A feasibility randomized-controlled trial was conducted with 19 adult stroke survivors randomized to receive either an executive functioning telerehabilitation intervention or stroke psychoeducation. Interventions were two 30-minute videos with accompanying homework delivered asynchronously over two weeks. Outcome measures validated in stroke populations assessed executive functioning, wellbeing, and self-efficacy at baseline, post-intervention, and one-month follow-up. Feedback was collected on usability and acceptability. Results: Recruitment and drop-out rates were acceptable. Participants indicated that both interventions were acceptable, relevant, useful, and easy to engage with, though some found the homework tasks challenging. Conclusion: The executive functioning and psychoeducation interventions are feasible and acceptable for research. A larger RCT is needed to evaluate efficacy, retaining multiple recruitment sources, including public healthcare services, for representative samples. ClinicalTrials Registration: NCT05461937.