title: Pilot randomized controlled trial investigating cognitive strategy use to improve goal performance after stroke.
abstract: OBJECTIVE
  The authors compared changes in client performance on three goals poststroke after the Cognitive Orientation to daily Occupational Performance (CO-OP) intervention or standard occupational therapy (SOT) to determine the magnitude and direction of change.
  
  
  METHODS
  Eight people living in the community following a stroke were randomly assigned to receive CO-OP (n = 4) or SOT (n = 4). CO-OP is a 10-session, cognitive-oriented approach to improving performance that uses client-driven cognitive strategies. SOT was therapist driven and combined task-specific and component-based training. Goal performance was measured by the therapist-rated Performance Quality Rating Scale (PQRS) and the participant-rated Canadian Occupational Performance Measure (COPM).
  
  
  RESULTS
  Using Mann-Whitney U test, we found that CO-OP participants showed significantly greater improvement in performance (PQRS, p = .02; COPM Performance, p = .02) compared with SOT but no improvement in satisfaction (COPM Satisfaction, p = .38).
  
  
  CONCLUSIONS
  The CO-OP group demonstrated larger performance improvements than the SOT group. Because of the promising results, an investigation using a larger sample is warranted.
authors.forename: Helene J
authors.initials: HJ
authors.lastname: Polatajko
authors.forename: Sara E
authors.initials: SE
authors.lastname: McEwen
authors.forename: Jennifer D
authors.initials: JD
authors.lastname: Ryan
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Baum
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D003071:Cognition; D015928:Cognitive Behavioral Therapy / Q000379:methods; D006040:Goals; D006801:Humans; D009788:Occupational Therapy / Q000379:methods; D011340:Problem Solving; D020521:Stroke / Q000523:psychology; D000071939:Stroke Rehabilitation; D013647:Task Performance and Analysis