Alignment between goals and subjective memory concerns in measuring outcomes of memory rehabilitation post-stroke.

Abstract

Memory rehabilitation can improve memory problems post-stroke, however gains can be difficult to measure, and may change over time. We aimed to characterise whether memory problems aligned with participants' rehabilitation goals responded differently to intervention than goal-inconsistent memory problems, to identify more targeted approaches to evaluating rehabilitation outcomes. This sub-study was nested within the Memory-SuSTAIN trial, which evaluated maintenance interventions (booster sessions, electronic reminders, usual care) following a Stroke Memory Skills Group (SMSG). Self-reported memory lapses across Forgetting and Attention domains were measured using the Everyday Memory Questionnaire Revised (EMQ-R), and Goal Attainment Scaling (GAS) measured memory-related goal attainment. Goal-consistent subjective memory concerns aligned with participants' main nominated memory goal domain, whereas goal-inconsistent concerns did not. Outcomes were measured by blinded assessors at 6, 12, 18, and 24 weeks post-SMSG. Participants were 38 stroke-survivors (median_age=53 years, median_{time-since-stroke}=13 months, 42% male). Goal-consistent, but not goal-inconsistent EMQ-R domain scores significantly reduced (improved) following initial SMSG intervention (mean change 7.68 vs 3.63 points). Both goal-consistent and goal-inconsistent subjective memory concerns improved following maintenance interventions. Tracking goal-consistency may provide a more tailored, individualised approach to standardised measurement of cognitive rehabilitation outcomes, and optimise delivery of post-stroke memory rehabilitation.