title: Exploring a cognitive-based treatment approach to improve motor-based skill performance in chronic stroke: Results of three single case experiments.
abstract: OBJECTIVE
  Early evidence suggests the use of cognitive strategies has potential to improve skill performance in people living with the effects of stroke, but no specific protocol has been identified. This study aimed to explore the potential of using the Cognitive Orientation to daily Occupational Performance (CO-OP) protocol to improve the functional performance of adults with chronic stroke.
  
  
  METHODS
  A single case experimental design study with two replications was conducted. Three community-dwelling participants were recruited. Each selected three functional goals for the focus of the CO-OP intervention. Multiple video recorded data points were collected at baseline, during intervention, post-intervention and at 1-month follow-up.
  
  
  RESULTS
  The nine goals selected varied widely, e.g. using a computer mouse, bicycling and yoga. An independent observer used the observational Performance Quality Rating Scale (PQRS) to rate performances throughout. Using the 2 SD band method to analyse the data, each participant showed significant performance improvements in at least two goals during the course of the intervention and at follow-up. Two participants had an additional goal show significant improvement at follow-up.
  
  
  CONCLUSIONS
  Results provide preliminary evidence that CO-OP is associated with significant performance improvements in self-selected functional goals.
authors.affiliation: Graduate Department of Rehabilitation Science, University of Toronto, Ontario, Canada. sara.mcewen@utoronto.ca
authors.forename: Sara E
authors.initials: SE
authors.lastname: McEwen
authors.forename: Helene J
authors.initials: HJ
authors.lastname: Polatajko
authors.forename: Maria P J
authors.initials: MP
authors.lastname: Huijbregts
authors.forename: Jennifer D
authors.initials: JD
authors.lastname: Ryan
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000328:Adult; D001642:Bicycling; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D016287:Computer Peripherals; D006801:Humans; D008297:Male; D008875:Middle Aged; D011597:Psychomotor Performance / Q000502:physiology*; D011932:Reading; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013647:Task Performance and Analysis; D016138:Walking; D014956:Writing; D015013:Yoga; D055815:Young Adult