Ianes Patrizia Gabriella, Martini Rose, Bertholom Yann, Montecchi Maria Giulia, Salvatore Giulio, Cutrona Costanza, Moriconi Federica, Quintiliani Michela, Borroni Simona, Rega Filomena Rita, Rosaria Chieffo Daniela Pia, Battaglia Domenica Immacolata
Villa Rosa Rehabilitation Hospital Occupational Therapy Department, Azienda Provinciale Servizi Sanitari Trento, Via Spolverine 80, Pergine Valsugana, TN 38057, Italy.
Occupational Therapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, 200 Lees avenue, Ottawa, ON K1N 6N5, Canada.
Epilepsy Behav. 2025 Jun 24;172:110548. doi: 10.1016/j.yebeh.2025.110548.
Dravet syndrome (DS) is a severe form of epilepsy that affects a child's cognitive, language, behavioral, and physical abilities, leading to reduced adaptive functioning. Despite its impact, there is limited evidence supporting effective interventions for these children, particularly in addressing their occupational performance.
To explore the effectiveness of the Cognitive Orientation to Daily Occupational Performance (CO-OP) approach in a telerehabilitation format for children with DS.
A single-subject design with multiple baselines across goals was used with four children (aged 9-13 years) with DS, who received eight online CO-OP sessions. Five goals were set using the Canadian Occupational Performance Measure (COPM), three of which were targeted in the intervention. Activity performance was rated using the Performance Quality Rating Scale (PQRS) and analyzed using the 3SD band method. Children and parents rated perceived performance and satisfaction on the COPM. Secondary outcomes included parents' sense of competency, children's adaptive behavior, and quality of life.
Significant improvements in PQRS scores were seen for 8 of the 12 trained goals and 3 of the 7 untrained (transfer) goals. COPM scores showed changes greater than 2 points in both children's and parents' perceived performance and satisfaction for trained and untrained goals. Improvements were also noted on the secondary measures for 3 of 4 participants.
These findings provide preliminary evidence that the CO-OP approach in a telerehabilitation format improves both trained and untrained goals, with a positive effect on parent self-efficacy, adaptive functioning, and quality of life. Further research is needed to confirm these results.
德雷维特综合征（DS）是一种严重的癫痫形式，会影响儿童的认知、语言、行为和身体能力，导致适应性功能下降。尽管其影响较大，但支持针对这些儿童的有效干预措施的证据有限，尤其是在解决他们的职业表现方面。
探讨以远程康复形式对患有DS的儿童采用日常职业表现认知取向（CO-OP）方法的有效性。
对4名患有DS的儿童（年龄在9至13岁之间）采用跨目标多基线单受试者设计，他们接受了8次在线CO-OP课程。使用加拿大职业表现测量量表（COPM）设定了5个目标，其中3个目标在干预中作为重点。使用表现质量评定量表（PQRS）对活动表现进行评分，并采用3标准差带法进行分析。儿童和家长对COPM上的感知表现和满意度进行评分。次要结果包括家长的能力感、儿童的适应性行为和生活质量。
在12个训练目标中的8个以及7个未训练（迁移）目标中的3个上，PQRS分数有显著提高。COPM分数显示，在训练和未训练目标方面，儿童和家长的感知表现和满意度变化均大于2分。4名参与者中有3名在次要指标上也有改善。
这些发现提供了初步证据，表明远程康复形式的CO-OP方法改善了训练和未训练目标，对家长自我效能感、适应性功能和生活质量产生了积极影响。需要进一步研究来证实这些结果。
