Occupational Therapy Department, Tabriz University of Medical Sciences, Tabriz, Iran.
Occupational Therapy Department, Faculty of Allied Health Sciences, Kuwait University, Kuwait; Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Res Dev Disabil. 2017 Dec;71:24-34. doi: 10.1016/j.ridd.2017.09.007. Epub 2017 Oct 5.
Cerebral palsy (CP) is the most common cause of physical disabilities during childhood. Therapeutic interventions mainly focus on impairment reduction to address motor-based difficulties. In contrast, Cognitive Orientation to daily Occupational Performance (CO-OP) is a cognitive approach, providing intervention at the level of activity and participation.
This study aims to determine whether the CO-OP approach improves motor skills and achievement in motor-based occupational performance goals in children with CP.
In this mixed design research (i.e., a multiple baseline single case experimental design and a one-group pretest-posttest design), five children with CP participated in 12 CO-OP intervention sessions. Repeated measures of motor skills for the multiple baseline single case experimental design were taken using the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP); pre- and post-measures of parent/child perception of performance and satisfaction were identified using the Canadian Occupational Performance Measure (COPM); level of achievement was identified using Goal Attainment Scaling (GAS).
According to the BOTMP results, all children were able to engage in the CO-OP intervention to improve motor performance. Significant differences after treatment were found in both performance and performance satisfaction ratings using the COPM as rated by parents and children. The GAS results showed progress in achievement levels for all children; all goals were achieved or exceeded.
CO-OP intervention can be helpful in improving motor skills and achieving self-identified, motor-based goals in children with CP.
脑瘫（CP）是儿童时期最常见的身体残疾原因。治疗干预主要集中在减少损伤以解决基于运动的困难。相比之下，认知导向日常生活活动表现（CO-OP）是一种认知方法，在活动和参与层面提供干预。
本研究旨在确定 CO-OP 方法是否能提高脑瘫儿童的运动技能和基于运动的职业表现目标的完成度。
在这项混合设计研究（即，多个基线单案例实验设计和一个单组前测后测设计）中，五名脑瘫儿童参加了 12 次 CO-OP 干预课程。使用布鲁因克斯-奥塞尔斯基运动能力测试（BOTMP）对多个基线单案例实验设计进行了运动技能的重复测量；使用加拿大职业表现测量（COPM）确定了父母/孩子对表现和满意度的前测和后测；使用目标达成量表（GAS）确定了达成度。
根据 BOTMP 的结果，所有儿童都能够参与 CO-OP 干预以提高运动表现。COPM 对父母和孩子的表现和表现满意度的评分显示，治疗后在两个方面都有显著差异。GAS 的结果显示，所有儿童的达成度水平都有所提高；所有目标都已实现或超过。
CO-OP 干预可以帮助脑瘫儿童提高运动技能和实现自我确定的、基于运动的目标。
