OBJECTIVE: To examine the effects of a time pressure management (TPM) strategy taught to stroke patients with mental slowness, compared with the effects of care as usual. DESIGN: Randomized controlled trial with outcome assessments conducted at baseline, at the end of treatment (at 5 to 10wk), and at 3 months. SETTING: Eight Dutch rehabilitation centers. PARTICIPANTS: Stroke patients (n = 37; mean age +/- SD 51.5 +/- 9.7y) in rehabilitation programs who had a mean Barthel score +/- SD at baseline of 19.6 +/- 1.1. INTERVENTION: Ten hours of treatment teaching patients a TPM strategy to compensate for mental slowness in real-life tasks. MAIN OUTCOME MEASURES: Mental Slowness Observation Test and Mental Slowness Questionnaire. RESULTS: Patients were randomly assigned to the experimental treatment (n = 20) and to care as usual (n = 17). After 10 hours of treatment, both groups showed a significant decline in number of complaints on the Mental Slowness Questionnaire. This decline was still present at 3 months. At 3 months, the Mental Slowness Observation Test revealed significantly higher increases in speed of performance of the TPM group in comparison with the care-as-usual group (t = -2.7, p = 0.01). CONCLUSIONS: Although the TPM group and the care-as-usual group both showed fewer complaints after a 3-month follow-up period, only the TPM group showed improved speed of performance on everyday tasks. Use of TPM treatment therefore is recommended when treating stroke patients with mental slowness.

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