Rotman Research Institute, Baycrest, and the Department of Occupational Science & Occupational Therapy and Graduate Department of Rehabilitation Sciences, University of Toronto, Toronto, ON, Canada.
Arch Phys Med Rehabil. 2013 Oct;94(10):1959-63. doi: 10.1016/j.apmr.2013.05.021. Epub 2013 Jun 22.
To evaluate, before undertaking a larger trial, feasibility of the study processes to determine the effectiveness of occupation-based strategy training for producing changes on trained real-world behaviors, and to determine whether far transfer of training effects to measures of real-world impact, including participation in everyday life, could be achieved.
Partially randomized controlled trial with pre- and postintervention assessments done by assessors masked to the treatment arm.
Testing occurred at a research institute, interventions at participants' homes.
People (N=13) with chronic traumatic brain injury (TBI), 7 in the experimental group (mean age, 42.6y; mean time post-TBI, 9.8y; 4 men) and 6 in the control arm (mean age, 40.5y; mean time post-TBI, 10.8y; 3 men), were assessed immediately before and after the intervention phase.
Occupation-based strategy training, an adapted version of the Cognitive Orientation to daily Occupational Performance (CO-OP), was provided in two 1-hour sessions per week for 10 weeks.
Canadian Occupational Performance Measure, Dysexecutive Questionnaire, Mayo-Portland Adaptability Inventory-4 Participation Index, and Assessment of Motor and Process Skills.
The study processes (testing and intervention) were acceptable to all participants. Evidence of far transfer was found as the experimental group improved significantly more than the control group on performance and satisfaction with performance ratings on untrained goals (P<.05), and reported increased levels of participation (P<.01).
Findings must be interpreted with caution since the sample is small and comparisons are made with a no-treatment control. Nevertheless, they suggest that the training is feasible and a larger trial warranted.
在进行更大规模的试验之前，评估研究过程的可行性，以确定基于职业的策略训练是否能有效地改变训练过的现实行为，并确定是否可以实现训练效果向现实影响测量（包括日常生活中的参与）的远迁移。
部分随机对照试验，在干预前后由对治疗组不知情的评估人员进行评估。
在研究所进行测试，在参与者家中进行干预。
13 名患有慢性创伤性脑损伤（TBI）的患者，实验组 7 人（平均年龄 42.6 岁；TBI 后平均时间 9.8 年；4 名男性），对照组 6 人（平均年龄 40.5 岁；TBI 后平均时间 10.8 年；3 名男性），在干预阶段前后立即进行评估。
职业为基础的策略训练，是认知导向日常职业表现（CO-OP）的改编版，每周提供两次 1 小时的课程，共进行 10 周。
加拿大职业表现测量、执行功能问卷、梅奥-波特兰适应能力量表 4 参与指数和运动与加工技能评估。
所有参与者都对研究过程（测试和干预）表示接受。研究发现远迁移的证据，实验组在未训练目标的表现和对表现的满意度评分上的改善明显优于对照组（P<.05），并且报告了更高水平的参与度（P<.01）。
由于样本量小，且与无治疗对照组进行比较，因此必须谨慎解释研究结果。尽管如此，研究结果表明该培训是可行的，值得进行更大规模的试验。
