title: Telerehabilitation for addressing executive dysfunction after traumatic brain injury.
abstract: OBJECTIVE
  To investigate the feasibility of implementing the Cognitive Orientation to daily Occupational Performance approach (CO-OP) in a telerehabilitation format and to examine its impact on community integration and executive dysfunction for adults with traumatic brain injury (TBI).
  
  
  METHODS
  A pilot series of three case studies with 3-month follow-up was conducted.
  
  
  METHODS
  Three adults (all males, >10 years post-TBI) and their significant others were recruited. The CO-OP intervention, a meta-cognitive approach, was delivered through videoconferencing via Internet to train three of five participant-identified goals. Two goals were not trained to allow examination of transfer. Outcome measures included the Canadian Occupational Performance Measure, the Mayo-Portland Adaptability Inventory-4 Participation Index, and the Dysexecutive Questionnaire. Descriptive statistical analysis was used.
  
  
  RESULTS
  The CO-OP approach administered in a telerehabilitation format was found to be feasible. All participants indicated self-reported improvement in both trained and untrained goals. Trends toward fewer symptoms of executive dysfunction and greater community integration were demonstrated. All participants expressed satisfaction with the Internet delivery method.
  
  
  CONCLUSIONS
  Telerehabilitation shows promise as a way to deliver the CO-OP approach and may help promote community integration of individuals living with TBI. Further study is warranted.
authors.affiliation: Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada. edith.ng@uhn.ca
authors.forename: Edith M W
authors.initials: EM
authors.lastname: Ng
authors.forename: Helene J
authors.initials: HJ
authors.lastname: Polatajko
authors.forename: Elsa
authors.initials: E
authors.lastname: Marziali
authors.forename: Anne
authors.initials: A
authors.lastname: Hunt
authors.forename: Deirdre R
authors.initials: DR
authors.lastname: Dawson
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000328:Adult; D001930:Brain Injuries / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D002170:Canada / Q000453:epidemiology; D003072:Cognition Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009788:Occupational Therapy / Q000379:methods*; D010358:Patient Participation; D017060:Patient Satisfaction; D010865:Pilot Projects; D015397:Program Evaluation; D012984:Software; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000379:methods; D014584:User-Computer Interface; D049269:Videoconferencing