Cognitive strategy on upper extremity function for stroke: A randomized controlled trials.

Abstract

Cognitive orientation to daily occupational performance (CO-OP) is a task-specific training applied using a cognitive behavioral approach to improve performance in daily activities and to enable the patient to overcome limitations related to them. The purpose of this study was to investigate the effects of the CO-OP approach in comparison with task-specific upper extremity training (TUET) on performance related to daily and functional activities in individuals with chronic hemiparetic stroke. Forty-nine participants diagnosed with stroke for the first time underwent 30 minutes of either the CO-OP approach or TUET 5 days a week for 4 weeks. We evaluated their performance on the box-and-block test (BBT), Canadian occupational performance measure (COPM), and community integration questionnaire (CIQ) and Wolf motor function test-functional score (WMFT-F) before and after the training. Our results show a significantly improvement in the WMFT-F, COPM-P, COPM-S, BBT, and CIQ scores after training in the CO-OP group, but only COPM-S score was significantly improvement after training in TUET group (p < 0.05). This study also found higher increases in the mean WMFT-F, COPM-P, COPM-S and BBT scores in the CO-OP group than in the TUET group, but CIQ score did not have a significantly higher increase between-group after training. The results of this study suggest that the CO-OP approach resulted in a positive therapeutic effect on self-selected occupational performance and daily and functional activities in individuals with chronic hemiparetic stroke.