A Performance-Based Teleintervention for Adults in the Chronic Stage after Acquired Brain Injury: An Exploratory Pilot Randomized Controlled Crossover Study

Abstract

This pilot study aimed to investigate the initial effect of a remotely delivered performance-based client-centered intervention on activity performance and participation among adults in the chronic phase after acquired brain injury (ABI). Sixteen participants living at home with little to no assistance in basic daily activities were allocated into intervention or waitlist control groups. Assessments were conducted at the baseline, after the 3-month intervention/wait period, and at a 3-month follow-up. The primary outcomes were activity performance using the Canadian Occupational Performance Measure (COPM) and the Performance Quality Rating Scale (PQRS) and participation using the Mayo-Portland Adaptability Inventory-4 (MPAI-4). The intervention included weekly videoconferencing sessions using the Cognitive Orientation to Daily Occupational Performance approach (tele-CO-OP). The participants identified five functional goals, of which three were directly addressed. Wilcoxon signed-ranks test results showed no significant improvements in the control group at the end of the 3-month wait period. Pooled data from both groups showed significant improvements in COPM scores for trained and untrained goals following the intervention. Significant improvements were also found in the PQRS and MPAI-4 scores. Improvements were partially maintained at follow-up. Our preliminary results suggest that tele-CO-OP may positively impact the lives of adults after ABI who are coping with long-term disability.

Exploring the Multidimensional Participation of Adults Living in the Community in the Chronic Phase following Acquired Brain Injury

“…The current study was an exploratory cross-sectional study with descriptive and analytical methods. This study included the baseline data collected as part of a research project devoted to the development and assessment of a home-based telerehabilitation program for community-dwelling adults in the chronic stage following acquired brain injury (ABI) [ 58 , 59 ].…”

“…The study was conducted according to the Declaration of Helsinki, with informed consent provided by all participants. The current study was performed as part of the baseline assessment in our intervention study [ 59 ]. Assessment was conducted in the participants’ homes by two licensed occupational therapists with more than five years of experience in geriatric and neurological rehabilitation and was performed in two sessions (approximately 1.5 h each session).…”

Cognitive retraining and functional treatment (CRAFT) for adults with cancer related cognitive impairment: A randomized controlled trial

“…By using a global meta cognitive strategy 'goal-plan-do-check', clients set functional goals, create, and carry out action plans and monitor their performance. Evidence from studies assessing the CO-OP show that participants improve on goals directly addressed during treatment as well as on novel and untrained goals [14][15][16].…”

Remote Delivery of Service: A Survey of Occupational Therapists’ Perceptions

“… 5 Efficacy had also been established in multiple studies analyzing interventions for varying populations such as children with autism, 6 adolescents with myelomeningocele, 7 adults cancer-survivors, 8 , 9 and people with acquired brain injury. 10 , 11 …”

“…5 Efficacy had also been established in multiple studies analyzing interventions for varying populations such as children with autism, 6 adolescents with myelomeningocele, 7 adults cancer-survivors, 8,9 and people with acquired brain injury. 10,11 The World Federation of Occupational Therapists affirmed the efficacy of telehealth for the delivery of rehabilitation and OT services, stating its use "leads to similar or better clinical outcomes when compared to conventional inperson interventions." 12 However, despite the encouraging declarations, 13,14 and the robust research evidence that showed its effectiveness, 15 studies done before the outbreak of coronavirus disease (COVID- 19) shows that most occupational therapists in Israel as well as around the world did not use it in their routine clinical practice.…”