title: Combined Cognitive-Strategy and Task-Specific Training Affects Cognition and Upper-Extremity Function in Subacute Stroke: An Exploratory Randomized Controlled Trial.
abstract: The purpose of this study was to estimate the effect of Cognitive Orientation to Daily Occupational Performance (CO-OP) compared with usual occupational therapy on upper-extremity movement, cognitive flexibility, and stroke impact in people less than 3 mo after stroke. An exploratory, single-blind randomized controlled trial was conducted with people referred to outpatient occupational therapy services at two rehabilitation centers. Arm movement was measured with the Action Research Arm Test, cognitive flexibility with the Delis-Kaplan Executive Function System Trail Making subtest, and stroke impact with subscales of the Stroke Impact Scale. A total of 35 participants were randomized, and 26 completed the intervention. CO-OP demonstrated measurable effects over usual care on all measures. These data provide early support for the use of CO-OP to improve performance and remediate cognitive and arm movement impairments after stroke over usual care; however, future study is warranted to confirm the effects observed in this trial.
authors.affiliation: Timothy J. Wolf, OTD, MSCI, OTR/L, FAOTA, is Associate Professor and Chair, Department of Occupational Therapy, University of Missouri, Columbia; wolftj@health.missouri.edu.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Wolf
authors.affiliation: Helene Polatajko, PhD, OT Reg. (Ont.), is Professor, Rehabilitation Sciences Institute and Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Helene
authors.initials: H
authors.lastname: Polatajko
authors.affiliation: Carolyn Baum, PhD, OTR/L, FAOTA, is Professor and Chair, Program in Occupational Therapy, and Professor, Department of Neurology, Washington University School of Medicine, St. Louis, MO.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Baum
authors.affiliation: Jorge Rios, BSc, is Lab Manager, St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.
authors.forename: Jorge
authors.initials: J
authors.lastname: Rios
authors.affiliation: Dianne Cirone, MSc(RS), OT Reg. (Ont.), is Lecturer, Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada, and Occupational Therapist, St. John's Rehab Outpatient Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
authors.forename: Dianne
authors.initials: D
authors.lastname: Cirone
authors.affiliation: Meghan Doherty, MSOT, OTR/L, is Clinical Specialist, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO.
authors.forename: Meghan
authors.initials: M
authors.lastname: Doherty
authors.affiliation: Sara McEwen, PhD, is Assistant Professor, Rehabilitation Sciences Institute and Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada, and Scientist, St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.
authors.forename: Sara
authors.initials: S
authors.lastname: McEwen
mesh_terms: D000203:Activities of Daily Living; D003071:Cognition; D006801:Humans; D000066530:Neurological Rehabilitation / Q000379:methods; D009788:Occupational Therapy / Q000379:methods*; D020127:Recovery of Function; D016037:Single-Blind Method; D000071939:Stroke Rehabilitation; D013647:Task Performance and Analysis; D034941:Upper Extremity