Article

The purpose of this study was to estimate the effect of the Cognitive
Orientation to daily Occupational Performance (CO-OP) approach compared with
usual outpatient rehabilitation on activity and participation in people <3 months
poststroke. METHODS: An exploratory, single-blind, randomized controlled trial,
with a usual-care control arm, was conducted. Participants referred to 2 stroke
rehabilitation outpatient programs were randomized to receive either usual care
or CO-OP. The primary outcome was actual performance of trained and untrained
self-selected activities, measured using the Performance Quality Rating Scale
(PQRS). Additional outcomes included the Canadian Occupational Performance
Measure (COPM), the Stroke Impact Scale Participation Domain, the Community
Participation Index, and the Self-Efficacy Gauge. RESULTS: A total of 35 eligible
participants were randomized; 26 completed the intervention.
Post intervention,
PQRS change scores demonstrated that CO-OP had a medium effect over usual care on
trained self-selected activities (d = 0.5) and a large effect on untrained
activities (d = 1.2). At a 3-month follow-up, PQRS change scores indicated a
large effect of CO-OP on both trained (d = 1.6) and untrained activities (d =
1.1). CO-OP had a small effect on COPM and a medium effect on the Community
Participation Index perceived control and on the Self-Efficacy Gauge. CONCLUSION:
CO-OP was associated with a large treatment effect on follow-up performances of
self-selected activities and demonstrated transfer to untrained activities. A
larger trial is warranted.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS