A Performance-Based Teleintervention for Adults in the Chronic Stage after Acquired Brain Injury: An Exploratory Pilot Randomized Controlled Crossover Study.

Aviva Beit Yosef,Jeffrey Shames,Yafit Gilboa,Jeremy Michael Jacobs,Isabella Schwartz

doi:10.3390/brainsci12020213

Abstract

This pilot study aimed to investigate the initial effect of a remotely delivered performance-based client-centered intervention on activity performance and participation among adults in the chronic phase after acquired brain injury (ABI). Sixteen participants living at home with little to no assistance in basic daily activities were allocated into intervention or waitlist control groups. Assessments were conducted at the baseline, after the 3-month intervention/wait period, and at a 3-month follow-up. The primary outcomes were activity performance using the Canadian Occupational Performance Measure (COPM) and the Performance Quality Rating Scale (PQRS) and participation using the Mayo-Portland Adaptability Inventory-4 (MPAI-4). The intervention included weekly videoconferencing sessions using the Cognitive Orientation to Daily Occupational Performance approach (tele-CO-OP). The participants identified five functional goals, of which three were directly addressed. Wilcoxon signed-ranks test results showed no significant improvements in the control group at the end of the 3-month wait period. Pooled data from both groups showed significant improvements in COPM scores for trained and untrained goals following the intervention. Significant improvements were also found in the PQRS and MPAI-4 scores. Improvements were partially maintained at follow-up. Our preliminary results suggest that tele-CO-OP may positively impact the lives of adults after ABI who are coping with long-term disability.

Highlights

Telerehabilitation has emerged as a promising service-delivery method to provide rehabilitation treatment for adults following acquired brain injury (ABI) living in the community [1–4]
1 = very low; 2 = low; 3 = medium; 4 = high; 5 = very high. This pragmatic exploratory pilot study set out to examine the initial efficacy of the tele-Cognitive Orientation to Daily Occupational Performance (CO-OP) intervention on activity performance and participation among adults in the chronic phase after ABI compared to a waitlist control group
The results of within-group analysis indicated some significant improvements in activity performance in the tele-CO-OP group post-intervention; no significant improvements were found in the control group after a 3-month wait period

Summary

Introduction

Telerehabilitation has emerged as a promising service-delivery method to provide rehabilitation treatment for adults following acquired brain injury (ABI) living in the community [1–4] It is defined as the use of information and communication technologies to provide remote rehabilitation services to people in their homes or other environments [5]. Telerehabilitation offers the advantage of enabling people to receive therapeutic services at home without having a therapist on site, increasing accessibility in rural areas and for those with limited access to transportation due to health conditions or socioeconomic factors. Another major advantage of this approach is that it allows us to observe how people perform their daily activities in their own environment and identify any barriers in 4.0/). The application of telerehabilitation has intensified with the rapid shift to telemedicine brought on by the COVID-19 pandemic, requiring healthcare professionals to adapt to caring for individuals remotely [6]

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