探索认知导向日常生活活动表现方法（CO-OP）在严重后天性脑损伤后执行功能障碍儿童中的应用：一项单病例实验设计研究。
Exploring the use of the Cognitive Orientation to daily Occupational Performance approach (CO-OP) with children with executive functions deficits after severe acquired brain injury: A single case experimental design study.
机构信息
Rehabilitation department for children with acquired congenital neurological injury, Saint-Maurice Hospitals, 94340 Saint-Maurice, France; Rehabilitation department for children with acquired neurological injury, Saint Maurice Hospitals, Saint Maurice, France; GRC 24, handicap moteur et cognitif et réadaptation (HaMCRe), Sorbonne Université, 75013 Paris, France.
Rehabilitation department for children with acquired neurological injury, Saint Maurice Hospitals, Saint Maurice, France.
出版信息
Ann Phys Rehabil Med. 2021 Sep;64(5):101535. doi: 10.1016/j.rehab.2021.101535. Epub 2021 Jul 17.
UNLABELLED
Children with acquired brain injury (ABI) often have cognitive and behavioral impairments that affect participation in everyday activities. Among them, executive function (EF) deficits are frequent. Cognitive Orientation to Daily Occupational Performance (CO-OP) is an individualized treatment that teaches cognitive strategies necessary to support successful performance. Few studies have examined the effectiveness of CO-OP in children with EF deficits after ABI.
OBJECTIVES
to assess whether the use of CO-OP could be of interest in children with EF deficits after ABI, to improve their occupational performance, their executive functioning in everyday life and their cognitive processes constituting EF.
METHODS
This was a single case experimental study with multiple baselines across individuals and behaviors. We included 2 children at least 6 months after severe ABI. The children received 14 individual sessions of the CO-OP intervention. Each child set 3 goals by using the Canadian Occupational Performance Measure; 2 goals were trained and the third was a control goal. The achievement of the goals was measured by using repeated measures of Goal Attainment Scales (GASs). Ecological assessments of EF included the Children's Cooking Task and parent and teacher ratings of the Behavior Rating Inventory of Executive Function (BRIEF) questionnaire.
RESULTS
both children improved their performance on both trained goals (and, to a lesser extent, on untrained goals). We found significant improvement on tests of EF and on the BRIEF questionnaire, reflecting executive functioning in everyday life, at home and at school.
CONCLUSIONS
these results are encouraging and suggest the feasibility and effectiveness of CO-OP for children with EF deficits after ABI. They should be replicated in a larger number of cases.
TRIAL REGISTRATION
ClinicalTrials.gov (NCT04718688).
背景
患有后天性脑损伤（ABI）的儿童常有认知和行为障碍，这会影响他们参与日常活动的能力。其中，执行功能（EF）缺陷较为常见。认知导向日常生活作业疗法（CO-OP）是一种个体化治疗方法，它教授认知策略，以支持成功的表现。很少有研究探讨 CO-OP 在 ABI 后 EF 缺陷儿童中的有效性。
目的
评估 CO-OP 是否对 ABI 后 EF 缺陷的儿童有益，以提高他们的职业表现、日常生活中的执行功能和构成 EF 的认知过程。
方法
这是一项单病例实验研究，对个体和行为进行了多个基线的比较。我们纳入了至少在严重 ABI 后 6 个月的 2 名儿童。儿童接受了 14 次 CO-OP 干预的个体治疗。每个孩子通过加拿大职业表现量表设定了 3 个目标；其中 2 个目标被训练，第 3 个是对照目标。目标的实现通过目标实现量表（GAS）的重复测量来衡量。EF 的生态评估包括儿童烹饪任务和父母和教师对执行功能行为评定量表（BRIEF）问卷的评分。
结果
两名儿童都提高了他们在两个训练目标（以及在较小程度上在未训练目标）上的表现。我们发现 EF 测试和 BRIEF 问卷上的显著改善，反映了日常生活、家庭和学校中的执行功能。
结论
这些结果令人鼓舞，表明 CO-OP 对 ABI 后 EF 缺陷的儿童是可行且有效的。它们应该在更多的病例中得到复制。
试验注册
ClinicalTrials.gov（NCT04718688）。
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