Modified Approach to Stroke Rehabilitation (MAStR)-Feasibility Study (P5.016)

Objective: Training and implementation for a novel stroke rehabilitation method emphasizing procedural memory. Background: Current practice in stroke rehabilitation relies strongly on explicit memory, often compromised by stroke, while failing to capitalize on better-preserved procedural memory skills. Improvement in procedural memory requires consistency and practice. We designed a method (MAStR) to maximize consistency and practice for transfer training (e.g., moving from bed to wheelchair). Design/Methods: MAStR has two innovations: 1) simplification of instructions to only 3 words with all other direction provided nonverbally; 2) having all rehabilitation staff use the same approach every time the patient is moved. Staff training in MAStR included review of written material describing the rationale for MAStR and demonstration of a transfer using MAStR. Each trainee was certified following accurate responses to 4 written questions and correct completion of two transfers using MAStR. Physical Therapy, Occupational Therapy, Therapeutic Recreation, Nursing, and Nursing aide staff were trained prior to treatment group enrollment. Stroke patients assigned to control group (C) received standard rehabilitation therapy. Patients assigned to treatment (T) group completed each transfer with MAStR. Results: The MAStR method was taught to a large, multidisciplinary rehabilitation staff (n=32). Training and certification required 15 minutes per staff member. Ten patients (C n=5, T n=5) were enrolled. No transfers with MAStR resulted in injury, no negative feedback was received from staff or patients. Staff reported satisfaction with the brief MAStR training and reported transfers were easier to complete with the MAStR method. Conclusions: This study demonstrated feasibility of an innovative stroke rehabilitation method that emphasizes procedural memory skills. All rehabilitation disciplines were successfully trained and certified. MAStR was well-tolerated and liked by rehabilitation staff and patients. Use of MAStR by all staff promotes consistent transfer training across the entire rehabilitation stay (24 hours day/7 days per week). Disclosure: Dr. Pavol has nothing to disclose. Dr. Bassile has nothing to disclose. Dr. Callender has nothing to disclose. Dr. Ferreira has nothing to disclose. Dr. Harmon has nothing to disclose. Dr. Lehman has nothing to disclose. Dr. Shinn has nothing to disclose. Dr. St. James has nothing to disclose. Dr. Stein has nothing to disclose.