Evidence-based approaches to improve function in individuals with cerebral palsy are needed.
Purpose.
To investigate the effectiveness of the Cognitive Orientation to daily Occupational Performance approach™ (CO-OP) to improve performance on self-chosen, functional goals as compared to traditional occupational therapy for cerebral palsy.
Method.
Crossover design with 12 participants, aged 6–15 years, randomly assigned to CO-OP and traditional intervention groups, followed by crossover and a 3-month follow-up. The participants identified three occupation-based goals for CO-OP and each group received ten 45-minutes intervention twice weekly in clinical context. Occupational performance, manual dexterity and Gross Motor Function Measures were analysed using generalized estimating equations.
Findings.
There were clinical and statistically significant improvements in functional goals following CO-OP and not traditional therapy. There were gains in dexterity but not in gross motor skills.
Implications.
CO-OP was effective to improve functional performance in young people with cerebral palsy and should be more utilized.
CameronD.CraigT.EdwardsB.MissiunaC.SchwellnusH.PolatajkoH. J. (2017). Cognitive Orientation to daily Occupational Performance (CO-OP): A new approach for children with cerebral palsy. Physical and Occupational Therapy in Pediatrics, 37(2), 183–198. https://doi.org/10.1080/01942638.2016.1185500.Epub 2016 Jun 9.
2.
CarswellA.McCollM. A.BaptisteS.LawM.PolatajkoH.PollockN. (2004). The Canadian Occupational Performance Measure: A research and clinical literature review. Canadian Journal of Occupational Therapy, 71(4), 210–222, https://doi.org/10.1177/000841740407100406.
3.
DawsonD. R.BinnsM. A.HuntA.LemskyC.PolatajkoH. J. (2013). Occupation-based strategy training for adults with traumatic brain injury: A pilot study. Archives of Physical Medicine and Rehabilitation, 94(10), 1959–1963. https://doi.org/10.1016/j.apmr.2013.05.021.
4.
DawsonD.McEwenS.PolatajkoH. (Eds.). (2017). Cognitive Orientation to daily Occupational Performance in occupational therapy: Using the CO-OP approach to enable participation across the lifespan. AOTA Press.
5.
EliassonA. C.Krumlinde-SundholmL.RosbladB.BeckungE.ArnerM.OhrvallA. M. (2006). The Manual Ability Classification System (MACS) for children with cerebral palsy: Scale development and evidence of validity and reliability. Developmental Medicine and Child Neurology, 48(7), 549–554. https://doi.org/10.1017/S0012162206001162.
6.
EngelenV.KetelaarM.GorterJ. W., (2007). Selecting the appropriate outcome in paediatric physical therapy: How individual treatment goals of children with cerebral palsy are reflected in GMFM-88 and PEDI. Journal of Rehabilitation Medicine, 39(3), 225–231. https://doi.org/10.2340/16501977-0040.
7.
GeerdinkY.AartsP.van der BurgJ.SteenbergenB.GeurtsA. (2015). Intensive upper limb intervention with self-management training is feasible and promising for older children and adolescents with unilateral cerebral palsy. Research in Developmental Disabilities, 43(44), 97–105. https://doi.org/10.1016/j.ridd.2015.06.013.
8.
GharebaghyS.RassafianiM.CameronD. (2015). Effect of cognitive intervention on children with ADHD. Physical and Occupational Therapy in Pediatrics, 35(1), 13–23. https://doi.org/10.3109/01942638.2014.957428.
9.
GhorbaniN.RassafianiM.Izadi-NajafabadiS.YazdaniF.AkbarfahimiN.HavaeiN.GharebaghyS. (2017). Effectiveness of Cognitive Orientation to (daily) Occupational Performance (CO-OP) on children with cerebral palsy: A mixed design. Research in Developmental Disabilities, 71, 24–34. https://doi.org/10.1016/j.ridd.2017.09.007.
10.
GimenoH.BrownR. G.LinJ.CorneliusV.PolatajkoH. J. (2019). Cognitive approach to rehabilitation in children with hyperkinetic movement disorders post-DBS. American Academy of Neurology, 92(11), 1212–1224. https://doi.org/10.1212/WNL.0000000000007092.
11.
HuntA. W.PanicciaM.MahK.DawsonD.ReedN. (2019). Feasibility and effects of the CO-OP approach in postconcussion rehabilitation. The American Journal of Occupational Therapy, 73(1), 7301205060p1. https://doi.org/10.5014/ajot.2019.027995.
12.
JackmanM.NovakI.LanninN.FroudeE.MillerL.GaleaC. (2018). Effectiveness of Cognitive Orientation to daily Occupational Performance over and above functional hand splints for children with cerebral palsy or brain injury: A randomized controlled trial. BMC Pediatrics, 18(1), 248. https://doi.org/10.1186/s12887-018-1213-9.
13.
Jongbloed-PereboomM.Nijhuis-van der SandenM. W.SteenbergenB. (2013). Norm scores of the box and block test for children ages 3–10 years. The American Journal of Occupational Therapy, 67(3), 312–318. https://doi.org/10.5014/ajot.2013.006643.
KlepperS. E.Clayton KrasinskiD.GilbM. C.KhalilN. (2017). Comparing unimanual and bimanual training in upper extremity function in children with unilateral cerebral palsy. Pediatric Physical Therapy, 29(4), 288–306. https://doi.org/10.1097/pep.0000000000000438.
16.
LawM.BaptisteS.CarswellA.McCollM. A.PolatajkoH.PollockN. (2014). Medida Canadense de Desempenho Ocupacional, 5ª ed. (COPM). Trad. Lívia de Castro Magalhães, Lilian Vieira Magalhães and Ana Amélia Cardoso. Belo Horizonte: Editora UFMG.
17.
LiangK. Y.ZegerS. L. (1986). Longitudinal data analysis using generalized linear models. Biometrika, 73(1), 13–22.
18.
MartiniR.RiosJ.PolatajkoH.WolfT.McEwenS. (2015). The Performance Quality Rating Scale (PQRS): Reliability, convergent validity, and internal responsiveness for two scoring systems. Disability and Rehabilitation, 37(3), 231–238. https://doi.org/10.3109/09638288.2014.913702.
MillerL. T.PolatajkoH. J.MissiunaC.MandichA. D.MacnabJ. J. (2001) A pilot trial of a cognitive treatment for children with developmental coordination disorder. Human Movement Science, 20(1–2), 183–210. https://doi.org/10.1016/s0167-9457(01)00034-.
21.
MillsE. J.ChanA. W.WuP.VailA.GuyattG. H.AltmanD. G. (2009). Design, analysis, and presentation of crossover trials. Trials, 10(27), 1–6. https://doi.org/10.1186/1745-6215-10–27.
22.
MissiunaC.DeMatteoC.HannaS.MandichA.LawM.MahoneyW.ScottL. (2010). Exploring the use of cognitive intervention for children with acquired brain injury. Physical and Occupational Therapy in Pediatrics, 30(3), 205–219. https://doi.org/10.3109/01942631003761554.
23.
MissiunaC.PollockN.LawM. (2004). Perceived efficacy and goal setting system (PEGS). Psychological Corporation.
24.
MissiunaC.PollockN.LawM.WalterS.CaveyN. (2006). Examination of the Perceived Efficacy and Goal Setting System (PEGS) with children with disabilities, their parents, and teachers. The American Journal of Occupational Therapy, 60(2), 204–214. https://doi.org/10.5014/ajot.60.2.204.
25.
NovakI.MorganC.FaheyM.Finch-EdmondsonM.GaleaC.HinesA.LangdonK.NamaraM. M.PatonM. C.PopatH.ShoreB.KhamisA.StantonE.FinemoreO. P.TricksA.VeldeA. T.DarkL.MortonN.BadawiN. (2020). State of the evidence traffic lights: Systematic review of interventions for preventing and treating children with cerebral palsy. Current Neurology and Neuroscience Reports, 20(3), 3. https://doi.org/10.1007/s11910-020-1022-z.
26.
OeffingerD.BagleyA.RogersS.GortonG.KryscioR.AbelM.DamianoD.BarnesD.TylkowskiC. (2008). Outcome tools used for ambulatory children with cerebral palsy: Responsiveness and minimum clinically important differences. Developmental Medicine and Child Neurology, 50(12), 918–925. https://doi.org/10.1111/j.1469-8749.2008.03150.x.
27.
PalisanoR. J.HannaS. E.RosenbaumP. L.RussellD. J.WalterS. D.WoodE. P.GaluppiB. E. (2000). Validation of a model of gross motor function for children with cerebral palsy. Physical and Occupational Therapy in Pediatrics, 80(10), 974–985. https://doi.org/10.1093/ptj/80.10.974.
28.
PalisanoR. J.RosenbaumP. L.BartletD.LivingstonM. H. (2008). Content validity of the expanded and revised Gross Motor Function Classification System. Developmental Medicine and Child Neurology, 50(10),744–750. https://doi.org/10.1111/j1469-87492008.03089x.
29.
PolatajkoH. J.MandichA. (2004). Enabling occupation in children: The Cognitive Orientation to Daily Occupational Performance (CO-OP) approach (1st ed.). CAOT Publications ACE.
30.
PolatajkoH. J.MandichA. D.MillerL. T.MacnabJ. J. (2001). Cognitive Orientation to daily Occupational Performance (CO-OP): Part II—the evidence. Physical and Occupational Therapy in Pediatrics, 20(2–3), 83–106. https://doi.org/10.1080/J006v20n02_06.
31.
RuggioC. I. B.MissiunaC.CostaS. A.AraújoC. R. S.MagalhãesL. C. (2018). Validity and reliability of the Perceived Efficacy and Goal Setting System (PEGS) for Brazilian children. Cadernos Brasileiros de Terapia Ocupacional, 26(4), 328–836. https://doi.org/10.4322/2526-8910.ctoAO1702
32.
RussellD. J.RosenbaumP. L.AveryL.LaneM. (2002). Clinics in developmental medicine, No. 159: Gross Motor Function Measure (GMFM-66 and GMFM-88)—User’s manual. Mac Keith Press.
33.
SalavatiM.KrijnenW. P.RameckersE. A.LooijestijnP. L.MaathuisC. G.van der SchansC. P.SteenbergenB. (2015). Reliability of the modified Gross Motor Function Measure-88 (GMFM-88) for children with both spastic cerebral palsy and cerebral visual impairment: A preliminary study. Research in Developmental Disabilities, 45(46), 32–48. https://doi.org/10.1016/j.ridd.2015.07.013.
34.
SilvaD. B.DiasL. B.PfeiferL. I., (2016). Reliability of the Gross Motor Function Classification System Expanded & Revised (GMFCS E & R) among students and health professionals in Brazil. Fisioterapia e Pesquisa, 23(2),142–147. https://doi.org/10.1590/1809-2950/14396823022016.
35.
SilvaD. B. R.FunayamaC. A. R.PfeiferL. I. (2015). Manual Ability Classification System (MACS): Reliability between therapists and parents. Brazilian Journal of Physical Therapy, 19(1), 26–33. https://doi.org/10.1590/bjpt-rbf.2014.0065.
36.
ThorntonA.LicariM.ReidS.ArmstrongJ.FallowsR.ElliotC. (2016). Cognitive Orientation to (daily) Occupational Performance intervention leads to improvements in impairments, activity and participation in children with developmental coordination disorder. Disability and Rehabilitation, 38(10), 979–986. https://doi.org/10.3109/09638288.2015.1070298.
37.
TogliaJ. P.RodgerS. A.PolatajkoH. J., (2012). Anatomy of cognitive strategies: A therapist’s primer for enabling occupational performance. Canadian Journal of Occupational Therapy, 79(4), 225–236. https://doi.org/10.2182/cjot.2012.79.4.4.
38.
TooveyR.BernieC.HarveyA. R.McGinleyJ. L.SpittleA. J. (2017). Task-specific gross motor skills training for ambulant school-aged children with cerebral palsy: A systematic review. BMJ Paediatrics Open, 1(1), e000078. https://doi.org/10.1136/bmjpo-2017-000078.
39.
Vroland-NordstrandK.EliassonA. C.JacobssonH.JohanssonU.Krumlinde-SundholmL. (2016). Can children identify and achieve goals for intervention? A randomized trial comparing two goal-setting approaches. Developmental Medicine & Child Neurology, 58(6), 589–596. https://doi.org/10.1111/dmcn.12925. Epub 2015 Sep16.
40.
WangM. (2014). Generalized estimating equations in longitudinal data analysis: A review and recent developments. Advances in Statistics, 21(1), 1–11. https://doi.org/10.1155/2014/303728.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
