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Research Article  |   September 2002
Occupational Therapy and Achievement of Self-Identified Goals by Adults With Acquired Brain Injury: Phase II
Catherine A. Trombly; Mary Vining Radomski; Christine Trexel; Sandra E. Burnett-Smith
Author Affiliations
  • Catherine A. Trombly, ScD, OTR/L, FAOTA, is ProfessorEmerita, Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Boston, Massachusetts 02215; ctrombly@bu.edu
  • Mary Vining Radomski, MA, OTR/L, is Coordinator, Rehabilitation Outcomes, Quality, and Clinical Research, and Occupational Therapist, Outpatient Brain Injury Clinic, Sister Kenny Rehabilitation Services, Minneapolis, Minnesota
  • Christine Trexel, OTR/L, is Program Specialist, Occupational Therapy, Brain Injury Rehabilitation Center, Progressive Rehabilitation Associates, Portland, Oregon. At the time of this study, she was Program Specialist, Occupational Therapy, Community Re-Entry Program of Legacy Health Systems, Portland, Oregon
  • Sandra E. Burnett-Smith, MA, OTR, MFT, is Professor, Acquired Brain Injury Program, Disabled Student Services, Santa Monica College, Santa Monica, California
Article Information
Neurologic Conditions / Traumatic Brain Injury / Assessment and Stroke
Research Article   |   September 2002
Occupational Therapy and Achievement of Self-Identified Goals by Adults With Acquired Brain Injury: Phase II
American Journal of Occupational Therapy, September/October 2002, Vol. 56, 489-498. doi:10.5014/ajot.56.5.489
American Journal of Occupational Therapy, September/October 2002, Vol. 56, 489-498. doi:10.5014/ajot.56.5.489
Abstract

OBJECTIVE. The purpose of this study was to investigate the association between participation in goal-specific outpatient occupational therapy and improvement in self-identified goals in adults with acquired brain injury.

METHOD. Thirty-one persons with traumatic brain injury of mixed chronicity participated at three sites located in different regions of the United States. Using a repeated-measures design, therapy that usually was offered at each site to achieve specific goals was followed by a no-treatment period. Participants completed the Canadian Occupational Performance Measure Performance subscale (COPM-P) and Satisfaction subscale (COPM-S), and the Community Integration Questionnaire (CIQ) at admission, discharge, and 1 to 18 weeks after discharge. Goal attainment scales were developed at admission and scored at discharge; the differences for each site were tested, using dependent t tests. Gains for the treatment period (admission to discharge) in COPM subscales and the CIQ were compared with gains during the no-treatment period (discharge to followup) for each site, using dependent t tests. The results were synthesized meta-analytically across the sites.

RESULTS. The participants identified a total of 149 goals, 81% of which were achieved. Goal attainment T scores improved significantly (Z = 7.52, p < .001), and the combined effect size was large (r = .94). The COPM-P (Z = 4.13, p < .001) and COPM-S (Z = 4.25, p < .001) showed significantly greater gains during the treatment (average 15.3 weeks) versus the no-treatment (average 9.9 weeks) period. Effect size estimates were large: .71 and .76, respectively. Gain scores of the CIQ did not differ significantly (Z = .75, p = .22, r = .29) between periods.

CONCLUSION. Participation in goal-specific outpatient occupational therapy that focused on teaching compensatory strategies was strongly associated with achievement of self-identified goals and reduction of disability in adults with mild to moderate brain injury.