Citation

Dawson DR, Binns M, Hunt A, Lemsky C, Polatajko HJ. Arch. Phys. Med. Rehabil. 2013; 94(10): 1959-1963.

Affiliation

Senior Scientist at the Rotman Research Institute, Baycrest, Associate Professor, Department of Occupational Science & Occupational Therapy and Graduate Department of Rehabilitation Sciences, University of Toronto. Electronic address: ddawson@research.baycrest.org.

Copyright

(Copyright © 2013, Elsevier Publishing)

DOI

10.1016/j.apmr.2013.05.021

PMID

23796683

Abstract

OBJECTIVE: To evaluate, prior to undertaking a larger trial, feasibility of the study processes to determine effectiveness of occupation-based strategy training for producing changes on trained real-world behaviours and to determine whether far transfer of training effects to measures of real-world impact, including participation in everyday life could be achieved. DESIGN: Partially randomized controlled trial with pre and post-intervention assessments done by assessors masked to the treatment arm. SETTING: Testing occurred at a research institute, interventions at participants' homes. PARTICIPANTS: Thirteen people with chronic traumatic brain injury, 7 in the experimental group (mean age 42.6 years, mean time post-TBI 9.8 years, 4 men,) and six in the control arm (mean age 40.5 years, mean time post-TBI 10.8 years, 3 men) were assessed immediately before and after the intervention phase. INTERVENTION: Occupation-based strategy training, an adapted version of the Cognitive Orientation to daily Occupational Performance (CO-OP), was provided in two, one-hour sessions per week for 10 weeks. MAIN OUTCOME MEASURES: Canadian Occupational Performance Measure (COPM), Dysexecutive Questionnaire (DEX), Mayo Portland Adaptability Inventory Participation Index (M2Pi), Assessment of Motor and Process Skills (AMPS). RESULTS: 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<0.05) and reported increased levels of participation (p<0.01). CONCLUSIONS: Findings must be interpreted with caution as 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.

Language: en