Research Article  |   January 2016
Combined Cognitive-Strategy and Task-Specific Training Affects Cognition and Upper-Extremity Function in Subacute Stroke: An Exploratory Randomized Controlled Trial
Author Affiliations
  • Timothy J. Wolf, OTD, MSCI, OTR/L, FAOTA, is Associate Professor and Chair, Department of Occupational Therapy, University of Missouri, Columbia; wolftj@health.missouri.edu
  • Helene Polatajko, PhD, OT Reg. (Ont.), is Professor, Rehabilitation Sciences Institute and Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
  • Carolyn Baum, PhD, OTR/L, FAOTA, is Professor and Chair, Program in Occupational Therapy, and Professor, Department of Neurology, Washington University School of Medicine, St. Louis, MO
  • Jorge Rios, BSc, is Lab Manager, St. John’s Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
  • Dianne Cirone, MSc(RS), OT Reg. (Ont.), is Lecturer, Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada, and Occupational Therapist, St. John’s Rehab Outpatient Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
  • Meghan Doherty, MSOT, OTR/L, is Clinical Specialist, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO
  • Sara McEwen, PhD, is Assistant Professor, Rehabilitation Sciences Institute and Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada, and Scientist, St. John’s Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
Article Information
Hand and Upper Extremity / Neurologic Conditions / Stroke / Rehabilitation, Disability, and Participation
Research Article   |   January 2016
Combined Cognitive-Strategy and Task-Specific Training Affects Cognition and Upper-Extremity Function in Subacute Stroke: An Exploratory Randomized Controlled Trial
American Journal of Occupational Therapy, January 2016, Vol. 70, 7002290010p1-7002290010p10. doi:10.5014/ajot.2016.017293
American Journal of Occupational Therapy, January 2016, Vol. 70, 7002290010p1-7002290010p10. doi:10.5014/ajot.2016.017293
Abstract

The purpose of this study was to estimate the effect of Cognitive Orientation to Daily Occupational Performance (CO–OP) compared with usual occupational therapy on upper-extremity movement, cognitive flexibility, and stroke impact in people less than 3 mo after stroke. An exploratory, single-blind randomized controlled trial was conducted with people referred to outpatient occupational therapy services at two rehabilitation centers. Arm movement was measured with the Action Research Arm Test, cognitive flexibility with the Delis–Kaplan Executive Function System Trail Making subtest, and stroke impact with subscales of the Stroke Impact Scale. A total of 35 participants were randomized, and 26 completed the intervention. CO–OP demonstrated measurable effects over usual care on all measures. These data provide early support for the use of CO–OP to improve performance and remediate cognitive and arm movement impairments after stroke over usual care; however, future study is warranted to confirm the effects observed in this trial.