Comparison of CO-OP and goal-directed training on occupational performance and functional status in children with cerebral palsy: Three-armed randomised trial

IF 1.6 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal Pub Date : 2025-06-10 DOI:10.1111/1440-1630.70033

Zeynep Kolit, Rüya Gül Temel, Gamze Ekici

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引用次数: 0

Abstract

Introduction

Cerebral palsy (CP) is a neurological disorder that impacts motor skills and daily functioning in children. While conventional occupational therapy aims to improve these areas, newer approaches like ‘Cognitive Orientation to Daily Occupational Performance’ (CO-OP) and ‘Goal-Directed Training’ (GDT) show promise. However, their comparative effectiveness in enhancing occupational performance and functional status in children with CP remains underexplored. This study aimed to investigate and compare the effects of the CO-OP and GDT on the occupational performance and functional status of children with CP.

Methods

Sixty children were randomly assigned to three intervention groups: CO-OP approach in addition to conventional occupational therapy (COT) (Group A; n = 20), GDT in addition to COT (Group B, n = 20), and only COT (Group C; n = 20). The outcomes regarding occupational performance via the Canadian Occupational Performance Measure and functional status via the Paediatric Evaluation of Disability Inventory were evaluated by the blind evaluators before and after the interventions. All participants received two sessions per week over a 12-week period.

Consumer and Community Involvement

No consumer and community involvement in these studies.

Results

All groups demonstrated statistically significant improvements in occupational performance and functional status (p < 0.001). Between-group comparisons revealed that Group A achieved greater improvements in occupational performance and functional status, which particularly in the areas of self-care, mobility, and total Paediatric Assessment of Disability Inventory (PEDI) scores (p < 0.05), compared to the other groups.

Conclusions

Although significant gains were achieved on occupational performance and functional status levels of both the CO-OP approach and GDT, it was revealed that the group receiving the CO-OP approach had superior effects.

PLAIN LANGUAGE SUMMARY

Cerebral palsy (CP) is a condition that affects how children move and use their muscles. It can make everyday tasks like getting dressed or playing more difficult. Occupational therapy helps children with CP build their skills and become more independent in daily life.

This study looked at two types of therapy: cognitive orientation to daily occupational performance (CO-OP) and goal-directed training (GDT). The aim was to find out which approach worked better for improving everyday activities and skills in children with CP.

The results showed that the children who took part in the CO-OP program made the most progress. They improved more in both daily tasks and skills compared to the children who received GDT. Both groups showed some improvement, but CO-OP had stronger results.

These findings suggest that CO-OP could be a helpful part of therapy programs for children with CP. It may support them in doing more things on their own. More research with larger groups of children is needed to learn more about how these therapies work in the long term.

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合作培训和目标导向培训对脑瘫儿童职业表现和功能状态的影响：三臂随机试验

脑瘫是一种影响儿童运动技能和日常功能的神经系统疾病。虽然传统的职业治疗旨在改善这些领域，但像“日常职业表现认知导向”（CO-OP）和“目标导向培训”（GDT）这样的新方法显示出希望。然而，它们在提高CP儿童的职业表现和功能状态方面的相对有效性仍未得到充分探讨。本研究旨在探讨和比较CO-OP和GDT对CP儿童职业表现和功能状态的影响。方法将60名儿童随机分为三个干预组：在常规职业治疗（COT）的基础上采用CO-OP方法(A组；n = 20)， GDT除COT外（B组，n = 20），仅COT (C组；n = 20)。在干预前后，盲评员分别对加拿大职业表现量表和儿科残疾评估量表的职业表现和功能状态进行评估。所有参与者在12周的时间内每周接受两次治疗。消费者和社区参与在这些研究中没有消费者和社区参与。结果各组患者的职业表现和功能状态均有显著改善（p < 0.001）。组间比较显示，与其他组相比，A组在职业表现和功能状态方面取得了更大的改善，特别是在自我护理、活动能力和儿科残疾评估量表（PEDI）总分方面（p < 0.05）。结论：虽然CO-OP方法和GDT在职业绩效和功能状态水平上都取得了显著的进步，但我们发现，接受CO-OP方法的组效果更好。脑瘫（CP）是一种影响儿童运动和使用肌肉的疾病。它会让穿衣服或玩游戏等日常任务变得更加困难。职业疗法帮助患有CP的儿童建立他们的技能，并在日常生活中变得更加独立。本研究着眼于两种类型的治疗：日常职业表现认知导向（CO-OP）和目标导向训练（GDT）。目的是找出哪种方法更有效地改善了CP儿童的日常活动和技能。结果表明，参加CO-OP项目的儿童取得了最大的进步。与接受GDT的儿童相比，他们在日常任务和技能方面都有了更大的提高。两组都有所改善，但CO-OP的效果更强。这些发现表明，CO-OP可能是治疗CP儿童的一个有用的部分。它可以帮助他们自己做更多的事情。需要对更大的儿童群体进行更多的研究，以更多地了解这些疗法的长期效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australian Occupational Therapy Journal 医学-康复医学

CiteScore

2.80

自引率

16.70%

发文量

审稿时长

6-12 weeks

期刊介绍： The Australian Occupational Therapy Journal is a leading international peer reviewed publication presenting influential, high quality innovative scholarship and research relevant to occupational therapy. The aim of the journal is to be a leader in the dissemination of scholarship and evidence to substantiate, influence and shape policy and occupational therapy practice locally and globally. The journal publishes empirical studies, theoretical papers, and reviews. Preference will be given to manuscripts that have a sound theoretical basis, methodological rigour with sufficient scope and scale to make important new contributions to the occupational therapy body of knowledge. AOTJ does not publish protocols for any study design The journal will consider multidisciplinary or interprofessional studies that include occupational therapy, occupational therapists or occupational therapy students, so long as ‘key points’ highlight the specific implications for occupational therapy, occupational therapists and/or occupational therapy students and/or consumers.