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Comparing the CO-OP ApproachTM to Usual Occupational Therapy for Adults with Executive Dysfunction Following Acquired
Deirdre R Dawson1,2, Nicole D Anderson2,3, Yael Bar2
1Department of Occupational Science & Occupational Therapy & Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Toronto, ON M5G 1V7, Canada.
The Cognitive Orientation to daily Occupational Performance (CO-OP) Approach shows promise in improving daily task performance for adults with acquired brain injury (ABI). However, the benefits were not sustained long-term, highlighting a challenge in maintaining improvements in executive function.
Area of Science:
- Neuroscience
- Occupational Therapy
- Rehabilitation Medicine
Background:
- Executive function impairments are common after acquired brain injury (ABI), leading to persistent daily life challenges.
- Pilot studies suggest the Cognitive Orientation to daily Occupational Performance (CO-OP) Approach may improve cognitive flexibility and task performance in ABI survivors.
- This study aimed to rigorously evaluate the CO-OP Approach's efficacy compared to usual occupational therapy (UOT) for adults with ABI and executive dysfunction.
Purpose of the Study:
- To determine the efficacy of the CO-OP Approach compared to usual occupational therapy (UOT) for community-dwelling adult survivors of ABI with executive dysfunction.
- To assess improvements in personally meaningful everyday life goals following the intervention.
Main Methods:
- Eighty-seven adult ABI survivors with executive dysfunction were randomized to the CO-OP Approach (n=45) or UOT (n=42).
- Participants identified five personal goals, with three trained and two untrained, receiving up to 15 sessions over ~10 weeks.
- The CO-OP group used a meta-cognitive strategy, while the UOT group received standard care; outcomes were measured using the Canadian Occupational Performance Measure (COPM).
Main Results:
- The CO-OP group demonstrated statistically significant improvements in COPM performance and satisfaction scores for both trained and untrained goals at post-test (~10 weeks).
- These improvements in executive function and daily task performance were not retained at the three-month follow-up.
- Participant demographics showed slight differences in mean age and gender distribution between the CO-OP and UOT groups.
Conclusions:
- The CO-OP Approach shows potential as an effective intervention for enhancing everyday goal performance in individuals with chronic ABI compared to usual community occupational therapy.
- Sustaining the observed benefits of the CO-OP Approach over time remains a significant challenge that requires further investigation.
- Future research should focus on strategies to promote long-term retention of functional gains after ABI rehabilitation.
