{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T04:37:03Z","timestamp":1793162223777,"version":"4.5.0"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,10,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Returning to societal participation is an important goal for stroke survivors, but evidence for effective rehabilitation remains inconclusive. This study evaluated the efficacy of participation\u2010focused strategy training in improving poststroke participation among community\u2010dwelling survivors with cognitive impairments.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">This multicenter, randomized trial enrolled stroke survivors with executive function impairments between January 2019 and March 2023. Participants received either strategy training (n=96) or an attention\u2010control intervention (n=99) in 12 to 15 sessions over 8\u2009weeks. The primary outcome was the postintervention change in participation across productivity, social, and community domains from the baseline, measured by the Participation Measure\u20103 Domains, 4 Dimensions. Secondary outcomes included changes in activity performance, self\u2010efficacy, and global cognition from baseline.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Eligible 195 participants were included in the intention\u2010to\u2010treat analysis (64 women, 32.8%; median [interquartile range] age: 62 [52\u201368] years). After adjusting for baseline primary outcome, stroke severity, and dose of regular rehabilitation, the strategy training group showed greater improvements in productivity and social participation compared with the control group (adjusted mean difference between groups [95% CI]: 7.89 [2.61\u201313.16] (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.004) and 0.29 [0.08\u20130.51] (\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.009), respectively) from baseline to postintervention. These effects remained without adjustment, but did not persist at 3\u2010month follow\u2010up. No significant between\u2010group differences were observed for any other outcomes.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Participation\u2010focused strategy training significantly improved productivity and social participation among enrolled stroke survivors compared with the control intervention postintervention. Further research is warranted to confirm these findings in the oldest survivors and to explore approaches for enhancing the long\u2010term benefits of strategy training.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT03792061.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.125.042295","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T11:17:57Z","timestamp":1758280677000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Enhancing Societal Participation for Stroke Survivors With Cognitive 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