Timothy J. Wolf, Helene Polatajko, Carolyn Baum, Jorge Rios, Dianne Cirone, Meghan Doherty, Sara McEwen; Combined Cognitive-Strategy and Task-Specific Training Affects Cognition and Upper-Extremity Function in Subacute Stroke: An Exploratory Randomized Controlled Trial. Am J Occup Ther 2016;70(2):7002290010. https://doi.org/10.5014/ajot.2016.017293
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© 2021 American Occupational Therapy Association
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.
CO–OP, a top-down performance-based approach, has a positive effect on performance and impairment reduction in this early-phase study.
The generalizability of these findings is currently limited, and future research is necessary to confirm them.
These findings call into question the continued use of impairment-based rehabilitation methods to improve occupational performance and reduce impairment after stroke.
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