Abstract A125: CPASS Upper Extremity Therapy Improves Patient-Reported Outcomes After Stroke

Introduction: Stroke survivors often experience persistent upper extremity (UE) deficits and diminished ADLs. The Critical Periods After Stroke Study (CPASS) found that intensive UE therapy initiated 2–3 months post-stroke produced greatest motor recovery at 12 months. (Dromerick et al., 2021). The Stroke Impact Scale (SIS) determined if benefits extended to patient-reported outcomes. Hypothesis: SIS scores would parallel UE motor recovery for participants randomized to early acute&subacute additional therapy. Methods: 72 patients were adaptively randomized to acute, subacute, chronic, or control groups. Intervention groups received usual care and 20 hours of individualized, task-specific UE therapy. The Activity Card Sort (ACS) identified preferred UE activity goals (Barth et al., 2023). A standardized protocol anchored to participant-selected activities guided therapy while maintaining standardization and quantification. SIS domains were assessed at baseline, 6 months, and 12 months. Longitudinal analyses used generalized estimating equations (GEE) adjusting for baseline, with group, time, and group-by-time terms included. Results: All SIS domains showed significant group&time main effects. Early intervention groups demonstrated strongest SIS recovery curves. Physical Function: Acute and subacute groups scored higher at 6 and 12 months than control (12-month mean: acute 77.6, subacute 76.2, control 70.4). Communication: Acute participants demonstrated significant gains versus controls (p=0.001),controls declined over time. Memory: Acute and subacute groups preserved memory function, surpassing controls at 12 months (p