Table 1.
Summary of key CO-OP stroke publications
| Authors | Year | Population description | Study design, intervention and control | Main findings |
|---|---|---|---|---|
| McEwen, S., Polatajko, P., Huijbregts, M., Ryan, J. | 2009 | Adults living in the community with chronic stroke; 3 single case experiments | Single case experiments. Intervention: CO-OP therapy was administered at the rate of one or two sessions per week, up to 10 sessions were completed. Single case paradigm, participants were their own control | -PQRS [10] scores showed significant improvement in at least 2/3 self-selected functional activities, further improvements at 1-month follow-up. Evidence of skill acquisition and retention |
| McEwen, S., Polatajko, P., Huijbregts, M., Ryan, J. | 2010 | Adults with chronic stroke living in the community; 3 single case experiments | Single case experiments. Intervention: Up to 10 CO-OP sessions were completed. Single case paradigm, participants were their own control | -PQRS scores improved for all participants at follow-up in all trained and untrained skills, providing evidence of retention and transfer |
| Skidmore, E., Holm, M., Whyte, E., Dew, M., Dawson, D., Becker, J. | 2011 | Single case admitted to an inpatient rehabilitation unit, cognitively impaired; Age 31; male; time since stroke 7 days | Single case study. Intervention 10 45-min CO-OP sessions. In addition, patient received usual inpatient rehabilitation | -Mean improvement of 6.1 on COPM [16] Performance scale score |
| -Pittsburgh Rehabilitation participation Scale [measure rehab engagement on 6 point scale] scores improved from 3.2 to 4.9 | ||||
| -FIM™ [25] scores improved from 68 to 97 | ||||
| -Improvement in self-care skills | ||||
| Skidmore, E., Dawson, D., Whyte, E., Butters, M., Dew, M., Grattan, E., Becker, J., Holm, M | 2014 | Cognitively-impaired patients admitted to an inpatient rehabilitation unit; N = 10; mean age: 68; male: 70 %; mean time since stroke: 14.5 days; mean length of stay: 22 days | RCT. Intervention: CO-OP therapy was administered daily in 30–40 min sessions for the duration of length of stay | -CO-OP participants demonstrated less disability than control participants, FIM™ 117 vs 96 |
| Control: dose-matched sessions using scripted and open-ended questions to promote reflection on rehabilitation activities and experiences | ||||
| Both groups received usual inpatient rehabilitation in addition to the research interventions | ||||
| McEwen, S., Polatajko, H., Baum, C., Rios, J., Cirone, D., Doherty, M., Wolf, T. | 2014 | Patients admitted to an outpatient rehabilitation program; N = 26; mean age: 56; male: 62.9 %; mean time since stroke: 43.3 days; mean number of sessions attended: 12.2 (CO-OP), 13.3 (control). Includes patients with cognitive impairment | RCT. Intervention: CO-OP therapy sessions were 45 min long and administered twice per week for a maximum of 10 sessions, instead of usual occupational therapy. More complex patients who required additional treatment received additional usual care OT | -CO-OP demonstrated a large effect over usual care on performance of functional activities (PQRS) on trained and untrained activities at follow-up, providing evidence of retention and transfer |
| Control: participants received usual occupational therapy | -CO-OP also demonstrated a medium effect on participation and self-efficacy, compared to usual care |
Project team members’ names were italicized
CO-OP cognitive orientation to daily occupational performance, PQRS performance quality rating scale, COPM Canadian occupational performance measure, FIM™ functional independence measure