Clinical Trials Logo

Clinical Trial Summary

Stroke and Acquired Brain Injury (ABI) represent a major cause of long-term disability among survivors. Many psychological difficulties can also occur including: depression, anxiety, fatigue, and post-traumatic stress disorder. This has a marked impact on health service usage. Despite certain interventions being offered to support stroke survivors and individuals with brain injury, there is still an outstanding need to increase and improve psychological resources for this population. This research proposes to evaluate the effectiveness of a group therapy intervention, using a model called Acceptance and Commitment Therapy (ACT), for stroke survivors and adults with ABI. This ACT group aims to promote positive adjustment and improve wellbeing, whilst also aiming to reduce levels of distress. The research will comprise of two parts (one quantitative and the other qualitative).


Clinical Trial Description

Stroke and Acquired Brain Injury (ABI) are major health problems and a leading cause of disability. In England and Wales, over 900,000 people are living with the long-term effects of stroke, and 345,000 the long-term effects of brain injury. These can result in survivors being highly dependent on others for their care. A wide range of psychological difficulties have been reported to develop post stroke and brain injury. As well as impacting on psychological wellbeing these problems are associated with poor social outcome, lower quality of life, poor functional outcome, and increased mortality (Fleminger & Ponsford, 2005; Lincoln et al., 2012). This is consistent with data indicating that post stroke and ABI psychological problems can have a significant impact on the usage of health services (Graves et al., 2015; Naylor et al., 2012). Whilst there is emerging evidence that some psychological interventions improve wellbeing post stroke and ABI, there remains an outstanding need to demonstrate further the effectiveness of psychological interventions within stroke and ABI services. The model used in this research - Acceptance and Commitment Therapy (ACT) - has a well-established evidence base for reducing psychological distress in individuals with mental illness and physical health conditions (including: cancer, epilepsy and chronic pain). ACT sees psychological distress as a universal aspect of human experience and encourages individuals to be present with their distress whilst simultaneously moving towards values-driven action. As a trans-diagnostic model it seems that ACT is well-placed to support the widespread sequelae experienced by stroke and brain injury survivors. This research aims to contribute to this area by: 1. Evaluating the effectiveness of an adapted Acceptance and Commitment Therapy (ACT) group for stroke survivors and adults with ABI, using outcome data in comparison to a waiting list control across three time points (pre, post and 10-week follow-up). (Quantitative Research) 2. Exploring individuals' experiences of attending the group and their perceptions of change from group attendance. (Qualitative Research). Quantitative Research: Design: The study will employ a randomised-controlled, two group (immediate versus waitlist) by three time-points (pre, post and follow-up) experimental design. Quantitative outcome measures will be taken at each time-point. The study will not be blinded. Participants and Recruitment: Participants will be recruited from Aneurin Bevan University Health Board (ABUHB) and from third sector organisations. Individuals may be recruited at any stage of the care pathway after discharge from hospital. Potential participants will be identified by clinicians and health care professionals. Individuals interested in participating will be provided with a group leaflet, written information sheet and consent form. Once consent has been obtained, participants will be randomly allocated into the intervention or waitlist control group. Participants randomised to the waitlist control group will wait 6 weeks before commencing their active treatment group. Intervention: The intervention will consist of a five-week, 2.5 hours skills-based group. It will be delivered by two facilitators, with the lead facilitator having considerable knowledge of ACT and its applications. An extended refreshment break will be offered approximately 1 hour into the session; facilitators will leave the room at this time to enable survivors time to talk freely and access peer support. A workbook will be provided to participants to support materials and skills covered in the group. Sample Size: A minimum of 38 participants will be recruited for this study, as indicated by power analysis for a 2 x 3 ANOVA with mixed effect design, a medium effect size (f=0.25), and the potential for up to 10 participants dropping out Control Group: After the intervention group is finishes, the waitlist control group will be offered the intervention which will consist of the exact same process as above. Data Protection: Data will be anonymised with numerical identifiers. Identifiable personal data will be stored separately in a locked unit. Analysis: A 2 (group) x 3 (time-point) Analysis of Variance (ANOVA) will be conducted to explore changes in outcome measures across groups and time. Planned comparisons and exploratory analysis will also be conducted, should these be considered necessary. Qualitative Research: Design: Semi-structured interviews will be conducted following the ACT intervention to explore the subjective experience in a subset of participants. These interviews will be conducted by a member of the research team who is not affiliated with the delivery of the intervention or known to participants. Interviews will be conducted at a venue of the participant's choice (either in consultation rooms across research sites or in the participants home); and will last no longer than 1 hour. Interviews will be framed around 12 main questions. Interviews will be audio-recorded to support transcription and data analysis. Participants will be made aware of this in advance on the consent form. Recruitment: Similar to above, participants will be recruited from Aneurin Bevan University Health Board and third sector organisations. Sample Size: the researchers envisage data saturation will be achieved anywhere between 10 - 20 participant interviews. This is based on the qualitative research guidelines provided by Braun & Clarke (2013, p50), Glaser (1965) and Hammersley (2015), which account for the type of data collection, the size of the project and the importance of data saturation (i.e. continuing interviews until no further themes are found). Data Protection: All data will be stored on a password protected and encrypted USB device for the duration of the study, and will subsequently be destroyed after use. Participants will be assigned a numerical identifier during transition to protect their identity. Analysis: Thematic Analysis will be used to analyse the data from interviews. It will intend to identify and explore common emerging themes and patterns in participant responses. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT04995705
Study type Interventional
Source Aneurin Bevan University Health Board
Contact
Status Terminated
Phase N/A
Start date April 8, 2019
Completion date March 23, 2020

See also
  Status Clinical Trial Phase
Recruiting NCT04043052 - Mobile Technologies and Post-stroke Depression N/A
Recruiting NCT03869138 - Alternative Therapies for Improving Physical Function in Individuals With Stroke N/A
Completed NCT04101695 - Hemodynamic Response of Anodal Transcranial Direct Current Stimulation Over the Cerebellar Hemisphere in Healthy Subjects N/A
Completed NCT04034069 - Effects of Priming Intermittent Theta Burst Stimulation on Upper Limb Motor Recovery After Stroke: A Randomized Controlled Trial N/A
Terminated NCT03052712 - Validation and Standardization of a Battery Evaluation of the Socio-emotional Functions in Various Neurological Pathologies N/A
Completed NCT00391378 - Cerebral Lesions and Outcome After Cardiac Surgery (CLOCS) N/A
Recruiting NCT06204744 - Home-based Arm and Hand Exercise Program for Stroke: A Multisite Trial N/A
Active, not recruiting NCT06043167 - Clinimetric Application of FOUR Scale as in Treatment and Rehabilitation of Patients With Acute Cerebral Injury
Active, not recruiting NCT04535479 - Dry Needling for Spasticity in Stroke N/A
Completed NCT03985761 - Utilizing Gaming Mechanics to Optimize Telerehabilitation Adherence in Persons With Stroke N/A
Recruiting NCT00859885 - International PFO Consortium N/A
Recruiting NCT06034119 - Effects of Voluntary Adjustments During Walking in Participants Post-stroke N/A
Completed NCT03622411 - Tablet-based Aphasia Therapy in the Chronic Phase N/A
Completed NCT01662960 - Visual Feedback Therapy for Treating Individuals With Hemiparesis Following Stroke N/A
Recruiting NCT05854485 - Robot-Aided Assessment and Rehabilitation of Upper Extremity Function After Stroke N/A
Active, not recruiting NCT05520528 - Impact of Group Participation on Adults With Aphasia N/A
Completed NCT03366129 - Blood-Brain Barrier Disruption in People With White Matter Hyperintensities Who Have Had a Stroke
Completed NCT03281590 - Stroke and Cerebrovascular Diseases Registry
Completed NCT05805748 - Serious Game Therapy in Neglect Patients N/A
Recruiting NCT05621980 - Finger Movement Training After Stroke N/A