Comparison of Cognitive Orientation to daily Occupational Performance and conventional occupational therapy on occupational performance in individuals with stroke: A randomized controlled trial

Abstract

This study suggests that the CO-OP approach is beneficial effects on the occupational performance to improvement in individuals with hemiparetic stroke, and have positive effects on generalization and transfer of acquired skills.

Evidence based practice and knowledge translation: A survey of Australian occupational therapy practice with clients experiencing neurocognitive impairments

“…Approximately half the sample reported being aware of evidence supporting the PRPP Intervention and rated this evidence as either emerging or strong (Aubin, Stip, Gelinas, Rainville, & Chapparo, ; Chapparo, Ranka, & Nott, ; Nott & Chapparo, ; Nott, Chapparo, & Heard, ). In contrast, less than 5% of respondents reported using CO‐OP and 85% of respondents were unsure of the evidence to support using CO‐OP with adults experiencing neurocognitive impairments (Ahn et al, ; Dawson et al, , Dawson et al, ; Henshaw, Polatajko, McEwen, Ryan, & Baum, ; McEwen et al, ).…”

Cognitive strategy training for adults with neurological conditions: a systematic review and meta-analysis exploring effect on occupational performance

“…Low: Has 1 or fewer criteria listed in ‘a’. Internal validity concern: * Selection bias: Risk of bias in allocation to interventions due to inadequate generation of randomisation sequence or inadequate concealment. § Performance bias: Risk of bias due to knowledge of the allocated interventions by participants and personnel during the study. † Detection bias: Risk of bias due to knowledge of allocated interventions by outcome assessors. ‡ Attrition bias: Risk of bias due to the amount, nature or handling of incomplete data. ⁑ Selective reporting: Risk of bias due to selective outcome reporting or outcomes of interest reported incompletely. ҂ Other bias: Threat of maturation or baseline imbalance. ** Design does not control for threats to bias. External validity concern: *** Treatment may not represent current practice. §§§ Treatment does not have strong theoretical support or insufficient information presented to make an assessment. ††† Participants may not be representative of population. ⁑⁑⁑ Study not conducted in natural setting or insufficient information presented to make an assessment. summarise the method of each study and the methodological quality and level of evidence ratings. Twenty studies provided level II evidence (good quality RCTs) (Ahn, 2019; Ahn et al., 2017; Bertens et al., 2015; Bertilsson et al., 2014; Donkervoort et al., 2001; Geusgens et al., 2006; Goverover et al., 2007; Guidetti and Ytterberg, 2011; Guidetti and colleagues, 2010, 2015; Kessler et al., 2017; Liu and Chan, 2014; Liu et al., 2004a; McEwen et al., 2015; Ownsworth et al., 2008; Polatajko et al., 2012; Skidmore et al., 2015; Song et al., 2019; Spikman et al., 2010; Winkens et al., 2009), two studies provided level III-1 evidence (quasi-RCTs) (Dawson et al., 2013; Poulin et al., 2017). Of the remaining studies, two studies pr...…”

“…Of the 22 RCTs and quasi-RCTs, 16 were included in the meta-analysis (Ahn, 2019;Ahn et al, 2017;Bertilsson et al, 2014;Dawson et al, 2013;Donkervoort et al, 2001;Goverover et al, 2007;Kessler et al, 2017;Liu and Chan, 2014;Liu et al, 2004a;McEwen et al, 2015;Polatajko et al, 2012;Poulin et al, 2017;Skidmore et al, 2015;Song et al, 2019;Spikman et al, 2010;Winkens et al, 2009). Six studies were not included for the following reasons: Guidetti et al (2010) reported median and interquartile range and subsequently data could not be pooled in the meta-analysis.…”

“…Cognitive strategy training improved activity performance compared to usual or standard care (SMD 0.63, 95% CI 0.07-01.19); however, again heterogeneity was high (I 2 ¼ 80%). The effect of cognitive strategy training conducted in the chronic stage of recovery (greater than 3 months from onset) was explored by pooling data from 10 studies with 314 participants (Ahn, 2019;Ahn et al, 2017;Dawson et al, 2013;Goverover et al, 2007;Kessler et al, 2017;Polatajko et al, 2012;Poulin et al, 2017;Song et al, 2019;Spikman et al, Figure 2. Standard mean difference (SMD) (95% confidence interval (CI)) of the effect of cognitive strategy training compared with any comparative intervention or no intervention on activity performance outcomes immediately after intervention for people with nonprogressive brain injury.…”

Does training in a top-down approach influence recorded goals and treatment plans?

“…CO-OP is associated with improvements in client-chosen functional goals and functional independence for persons with stroke, including those with cognitive impairment (Ahn et al, 2017;McEwen et al, 2015;Skidmore et al, 2015). In practice, the percentage of persons with cognitive impairments following a stroke who access rehabilitation is lower than targeted by the local health provincial policy, and those who do access rehabilitation tend to be treated with outdated impairment reduction approaches (Linkewich, Tahair, & Quant, 2014).…”