Erin Henshaw, Helen Polatajko, Sara McEwen, Jennifer D. Ryan, Carolyn M. Baum; Cognitive Approach to Improving Participation After Stroke: Two Case Studies. Am J Occup Ther 2011;65(1):55–63. https://doi.org/10.5014/ajot.2011.09010
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© 2020 American Occupational Therapy Association
Despite the need for occupational therapy to emphasize client-specific occupational performance, primary emphasis in stroke rehabilitation continues to be on the remediation of client factors and self-care. Such practice leaves many survivors of stroke with continuing performance deficits. Two case studies demonstrate a novel, alternative approach. The Cognitive Orientation to Daily Occupational Performance (CO–OP) treatment is a performance-based, problem-solving approach to developing functional skills that are client centered. CO–OP was used to guide treatment with 2 older women. The findings suggest that the approach has the potential to successfully help clients with stroke achieve their everyday occupational goals and support continued research in this area. This work will lead to a pilot randomized controlled trial.
Use lamp to increase task lighting.
Place lamp in front of sewing machine.
Check to see that glasses are on.
Sit on pillow to increase height in chair.
Use needle-threading device.
Start from the front side when ripping out the seam.
Use sharp scissors as backup plan to seam ripper.
Clear off the table to provide more space to work.
Place pants on table instead of lap.
Feel the tension of the fabric.
Feel for the hole.
Apply pressure to front of earring to prevent slippage.
Use mirror to check performance.
Take a break when frustrated.
Wear bracelet on left hand instead of right hand as backup plan.
Use magnetic clasp.
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