Integrating Functional Cognitive Rehabilitation With Activity-Based Stroke Telerehabilitation: Intervention Design and Development Study.
6 affiliations
- 1Department of Health Sciences & Research, College of Health Professions, Medical University of South Carolina, 77 President Street, Charleston, SC, 29425, United States, 1 8437922956.
- 2Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, United States.
- 3Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States.
- 4School of Communication Sciences and Disorders, College of Health Professions, University of Central Florida, Orlando, FL, United States.
- 5VA San Diego Healthcare System, San Diego, CA, United States.
- 6Department of Psychiatry, University of California San Diego, San Diego, CA, United States.
Abstract
Background
Many stroke survivors experience chronic cognitive deficits that, together with motor impairments, negatively impact well-being and daily function. Critically, poststroke cognitive deficits can interfere with successful engagement in rehabilitation programs aimed at improving participation in home and community activities. To address this issue, we developed a new telehealth intervention that integrates brief, functional cognitive rehabilitation (COG) into an existing upper extremity-focused, activity-based occupational therapy (OT) telerehabilitation program.Objective
To describe the development and specification of a telehealth intervention (COG+OT) that integrates functional cognitive rehabilitation into activity-based stroke telerehabilitation.Methods
COG+OT was developed using a multi-disciplinary, theory-informed process guided by principles of functional cognitive rehabilitation. It is reported according to the Template for Intervention Description and Replication checklist for rehabilitation (TIDieR-Rehab). The intervention was developed by a team with expertise in stroke rehabilitation from the fields of OT, neuropsychology, clinical psychology, and speech-language pathology. Cognitive rehabilitation content was adapted from an evidence-based compensatory strategy program and condensed into a brief "primer" format. The COG component was iteratively integrated into an existing upper-extremity, activity-based OT telerehabilitation program to support engagement and transfer of strategies to real-world functional tasks. In this paper, we describe the intervention structure, content, delivery, and tailoring procedures.Results
COG+OT is an 8-week, 13-session telehealth intervention delivered in three phases: (1) cognitive strategy training ("primer"; sessions 1-4), (2) review and guided application of strategies within OT activities (sessions 5-10), and (3) integration of strategies to support generalization to everyday contexts (sessions 11-13). The intervention combines individualized, strategy-based cognitive rehabilitation with goal-oriented OT using a titrated approach. Patient-facing materials, structured session workflows, and therapist-guided metacognitive strategies support tailoring and real-world application.Conclusions
COG+OT is a theory-informed, user-centered intervention that provides a structured approach for integrating functional cognitive rehabilitation into stroke telerehabilitation. This work establishes a well-specified, replicable intervention model and supports future feasibility, effectiveness, and implementation studies.
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BibTeX
@article{finetto2026integrating,
title = {{Integrating Functional Cognitive Rehabilitation With Activity-Based Stroke Telerehabilitation: Intervention Design and Development Study.}},
author = {Patricia Finetto and Michelle L Woodbury and Julianne Laura and Kelly Rishe and Stephanie Garner and Lisa M McTeague and Deena Schwen Blackett and Elizabeth W Twamley and Stephanie Aghamoosa},
journal = {JMIR rehabilitation and assistive technologies},
year = {2026},
month = oct,
doi = {10.2196/84627},
url = {https://europepmc.org/article/MED/42954143},
note = {CC BY},
}
RIS
TY - JOUR
TI - Integrating Functional Cognitive Rehabilitation With Activity-Based Stroke Telerehabilitation: Intervention Design and Development Study.
AU - Patricia Finetto
AU - Michelle L Woodbury
AU - Julianne Laura
AU - Kelly Rishe
AU - Stephanie Garner
AU - Lisa M McTeague
AU - Deena Schwen Blackett
AU - Elizabeth W Twamley
AU - Stephanie Aghamoosa
PY - 2026
DA - 2026/10/27
JO - JMIR rehabilitation and assistive technologies
DO - 10.2196/84627
UR - https://europepmc.org/article/MED/42954143
AB - Background Many stroke survivors experience chronic cognitive deficits that, together with motor impairments, negatively impact well-being and daily function. Critically, poststroke cognitive deficits can interfere with successful engagement in rehabilitation programs aimed at improving participation in home and community activities. To address this issue, we developed a new telehealth intervention that integrates brief, functional cognitive rehabilitation (COG) into an existing upper extremity-focused, activity-based occupational therapy (OT) telerehabilitation program.Objective To describe the development and specification of a telehealth intervention (COG+OT) that integrates functional cognitive rehabilitation into activity-based stroke telerehabilitation.Methods COG+OT was developed using a multi-disciplinary, theory-informed process guided by principles of functional cognitive rehabilitation. It is reported according to the Template for Intervention Description and Replication checklist for rehabilitation (TIDieR-Rehab). The intervention was developed by a team with expertise in stroke rehabilitation from the fields of OT, neuropsychology, clinical psychology, and speech-language pathology. Cognitive rehabilitation content was adapted from an evidence-based compensatory strategy program and condensed into a brief "primer" format. The COG component was iteratively integrated into an existing upper-extremity, activity-based OT telerehabilitation program to support engagement and transfer of strategies to real-world functional tasks. In this paper, we describe the intervention structure, content, delivery, and tailoring procedures.Results COG+OT is an 8-week, 13-session telehealth intervention delivered in three phases: (1) cognitive strategy training ("primer"; sessions 1-4), (2) review and guided application of strategies within OT activities (sessions 5-10), and (3) integration of strategies to support generalization to everyday contexts (sessions 11-13). The intervention combines individualized, strategy-based cognitive rehabilitation with goal-oriented OT using a titrated approach. Patient-facing materials, structured session workflows, and therapist-guided metacognitive strategies support tailoring and real-world application.Conclusions COG+OT is a theory-informed, user-centered intervention that provides a structured approach for integrating functional cognitive rehabilitation into stroke telerehabilitation. This work establishes a well-specified, replicable intervention model and supports future feasibility, effectiveness, and implementation studies.
SN - 2369-2529
ER -