350
T. D. Withiel et al.
may not be generalizable to individuals with more se-
vere memory impairment. Future research should seek
to explore factors that may impact treatment response
(e.g. mood and severity of objective impairment).
Lastly, our sample size and exclusion criteria limit
generalizability. Although the sample size was con-
sidered sufficient to power this Phase II exploration,
replication in a Phase III trial with a larger sample
remains an important goal. Our modest sample size
may also account for chance differences on prognostic
factors (i.e. hemisphere and aetiology of infarction),
which may mediate the relationship between interven-
tion and outcome (41). Predictors of treatment response
including location and aetiology of stroke will be exa-
mined in a separate study. In addition, exploration of
the cost-effectiveness of these 2 interventions is being
explored separately and will further assist in facilitating
ecological translation.
These limitations noted, the results of this study
support the use of MSG training to improve everyday
memory functioning for survivors of stroke. These
Phase II data indicate MSG rehabilitation was effective
in improving functional goal attainment and internal
strategy use. Importantly, gains were maintained
and consolidated for 6 weeks after the intervention
was completed. In contrast, CCT did not result in a
significant improvement on functional, objective or
subjective measures of memory. Given our somewhat
modest sample size, we view this as preliminary
evidence for the use of compensatory approaches to
memory rehabilitation after stroke.
ACKNOWLEDGEMENTS
The authors would like to acknowledge all the participants who
very generously gave their time for the project. In addition, we
disclose that the CCT intervention was provided free of charge
by Lumos Labs. However, all aspects of design, analysis and
reporting were undertaken independently.
The authors have no conflicts of interest to declare.
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