Pilot randomized controlled trial investigating cognitive strategy use to improve goal performance after stroke

Area of Science:

• Neurorehabilitation
• Occupational Therapy

Background:

• Stroke survivors often experience significant challenges in daily occupational performance.
• Standard occupational therapy (SOT) provides task-specific and component-based training.
• The Cognitive Orientation to daily Occupational Performance (CO-OP) is a client-centered cognitive strategy approach.

Purpose of the Study:

• To compare the effectiveness of the CO-OP intervention versus SOT on post-stroke goal performance.
• To determine the magnitude and direction of changes in occupational performance after stroke.

Main Methods:

• A randomized trial involving eight community-dwelling stroke survivors.
• Participants were assigned to either CO-OP (n=4) or SOT (n=4).
• Goal performance was assessed using the Performance Quality Rating Scale (PQRS) and Canadian Occupational Performance Measure (COPM).

Main Results:

• CO-OP participants showed significantly greater improvements in performance (PQRS, p=.02; COPM Performance, p=.02) compared to SOT.
• No significant difference was found in participant satisfaction (COPM Satisfaction, p=.38).

Conclusions:

• The CO-OP intervention demonstrated superior performance improvements in stroke survivors compared to SOT.
• The findings suggest CO-OP as a promising approach for post-stroke rehabilitation.
• Larger sample studies are warranted to confirm these results.