Randomized Controlled Trial of the Skill-Building Task-Oriented Motor Practice Intervention to Improve Performance in People With Mild to Moderate Dementia

PURPOSE: We sought to examine outcome differences by dose level using the Skill-building through Task-Oriented Motor Practice (STOMP) intervention.

DESIGN: RCT with experimental and control groups receiving two different doses of STOMP. Participants were aged 50-90, diagnosed with mild-moderate dementia, Mini-Mental Status Examination scores (>10 <25), lived in the community, & could identify 3 areas of occupational dysfunction.

METHOD: STOMP is task-oriented training delivered through massed practice and errorless learning. The original protocol (3 hrs/day, 5 d/wk for 2 wks) was compared to a less-intensive protocol (1 hr/day, 2 d/wk for 2 wks) delivered by an OTA in the participant’s home. Examiners rated participant performance through the Goal Attainment Scale (GAS), and rated caregiver-rated performance through the Canadian Occupational Performance Measure (COPM). An OT blind to treatment condition assessed at baseline, post-intervention and 90 days post-intervention. Outcomes between groups were analyzed using student’s T-tests and analysis of variance. We had a power of 80% to examine differences between groups of 18.

RESULTS: Both groups were equally distributed (N=18) and did not differ by age or MMSE score. Primary outcome measures: Within-group assessment revealed significant improvements for both groups (p<.05). Post-intervention GAS and COPM scores and 90-day GAS and COPM scores were significantly different between groups. In both assessments, participants in the less-intensive group performed more poorly.

CONCLUSIONS: Both groups demonstrated examiner- and caregiver rated improvement in occupational performance but those with the more intensive therapy held an advantage. Retention of learning in dementia appears to be supported by more intensive therapy.

IMPACT STATEMENT: Our findings suggest that OT practitioners can use the STOMP intervention to increase function and delay decline in people with dementia across practice settings.

References

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Ciro, C. A., Stoner, J., Prodan, C., & Hershey, L. (2016). Skill-building through Task-Oriented Motor Practice (STOMP) intervention for activities of daily living: study protocol for a randomized, single blinded clinical trial. Clinical trials in degenerative diseases, 1(2), 45. https://doi.org/10.4103/2468-5658.184743