Introduction
Children with brain lesions, including cerebral palsy or acquired brain injury, present with a variety of impairments in fine and gross motor function.
The Cognitive Orientation to daily Occupational Performance approach (CO-OP) is a task-orientated approach with the primary aim to improve performance in personally relevant daily activities. Although some studies have found CO-OP to be a successful approach in children with DCD, there remains uncertainty in children with brain lesions. As CO-OP treatment was closely related to the cognitive level, it is needed to confirm whether the effect of CO-OP treatment depends on the cognitive level.
Therefore, this research aimed to determine if the CO-OP intervention aids in the improvement of outcomes associated with impairment and participation levels depending on the cognitive level in children with brain lesions.
Methods
A single-group, pre- and post-test design was used.
16 children with brain lesions showing coordination difficulties participated in the 24 session intervention based on the CO-OP. Each session was conducted two or three times a week for 50 minute, in a 1-1 format, and run by two Occupational Therapists trained and experienced in the use of the CO-OP. Sessions were focused on the specific problem-solving strategy, described as the Goal-Plan-Do-Check method, to create strategies to improve the child’s functional performance and goal achievement. Outcome measures relating to impairment (MABC-2, motor overflow assessment), participation Canadian Occupational Performance Measure, (COPM) and the Performance Quality Rating Scale (PQRS) were measured at weeks 0 and 10 in the intervention group.
Results
The demographic characteristics of sixteen patients were provided in Table 1.
Children who participated in the CO-OP intervention displayed statistically significant improvements in outcome measures for impairment and participation (Table 2). Performance and satisfaction ratings on the COPM, PQRS, and M-ABC improved from baseline to week 10: the mean changes in COPM performance score 3.54 (Standard Deviation, SD = 1.55, range = 2.71-4.37), COPM satisfaction score 4.38 (Standard Deviation, SD = 1.82, range = 3.40-5.35), PQRS 8.31(Standard Deviation, SD = 1.08, range = 7.74-8.89), MABC-2 8.31(Standard Deviation, SD = 1.08, range = 7.74-8.89).
All participants were grouped into high level and low level, based on 100 points according to the individual baseline IQ score. The CO-OP effect between two groups showed no significant difference in three outcome factors (Graph 1).
Conclusion
This study shows that CO-OP can lead to improvements across outcomes associated with impairment and participation. The CO-OP effect was found to be significant in the three outcome factors without significant differences between the high IQ level and low IQ level groups. In view of CO–OP’s positive treatment effect in this study, a larger-scale investigation with additional control is warranted. |
