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Updated: Jan 3, 2026
Author Spotlight: Rehabilitation of Stroke Patients With a Digital Occupational Training System
Published on: December 29, 2023
Minimal Clinically Important Differences in Functional Independence After a Knowledge Translation Intervention in
Elizabeth Linkewich1, Lisa Avery2, Jorge Rios3
1Regional Stroke Centre, Sunnybrook Health Sciences Centre, Toronto, ON; Practice-Based Research, Sunnybrook Research Institute, Toronto, ON; Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON.
Stroke survivors with severe cognitive impairment (CI) are less likely to achieve functional independence. However, the Cognitive Orientation to daily Occupational Performance (CO-OP) knowledge translation (KT) intervention improved odds of achieving motor-based functional gains in inpatient rehabilitation.
Area of Science:
- Neurorehabilitation
- Occupational Therapy
- Knowledge Translation
Background:
- Stroke rehabilitation aims to improve functional independence.
- Cognitive impairment (CI) is a common stroke complication affecting rehabilitation outcomes.
- The Cognitive Orientation to daily Occupational Performance (CO-OP) approach is a client-centered, goal-directed intervention.
Purpose of the Study:
- To examine the odds of achieving minimal clinically important difference (MCID) in functional independence among stroke survivors.
- To investigate the relationship between cognitive impairment severity and achieving MCID.
- To determine the impact of a CO-OP knowledge translation (KT) intervention on functional independence outcomes.
Main Methods:
- A pre-post observational study design was utilized.
- Data were collected from 5 inpatient rehabilitation units.
- Logistic regression analysis was performed to assess the odds of achieving MCID, controlling for CI severity and site.
Main Results:
- Severe CI was associated with significantly lower odds of achieving total FIM MCID compared to no CI (OR=.18).
- Following the CO-OP KT intervention, patients demonstrated significantly higher odds of achieving MCID on the FIM motor subscale (OR=1.4).
- The best-fit model included intervention, admission score, CI severity, and site.
Conclusions:
- The CO-OP KT intervention is linked to increased likelihood of achieving motor-based functional gains in stroke survivors.
- Cognitive impairment severity is a critical factor influencing functional independence outcomes in inpatient rehabilitation.
- Targeted interventions like CO-OP KT may enhance rehabilitation effectiveness for stroke patients.
