Effects of the Cognitive Orientation to Daily Occupational Performance approach on occupational performance and related outcomes in children with disabilities: A systematic review and meta-analysis

IF 2.1 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal Pub Date : 2026-10-05 DOI:10.1111/1440-1630.70129

Gülşah Zengin Yazıcı, Kardelen Yıldırım, Müberra Tanrıverdi

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引用次数: 0

Abstract

Background

The Cognitive Orientation to Daily Occupational Performance (CO-OP) approach is a cognitive strategy-based, occupation-focussed intervention designed to improve functional performance in children with neurodevelopmental conditions. Although CO-OP has been increasingly used in paediatric rehabilitation, evidence from randomised controlled trials examining its effectiveness across different populations and outcomes has not been comprehensively synthesised. This systematic review and meta-analysis examined the effects of CO-OP on occupational performance and related outcomes in children with disabilities.

Method

Randomised controlled trials involving children aged 3–18 years were identified through PubMed, Scopus, and CENTRAL. Seventeen eligible reports representing 13 distinct trial cohorts were included. Risk of bias was assessed using RoB 2. Where clinically appropriate, COPM Performance and Satisfaction outcomes were synthesised using random-effects meta-analysis; other outcomes were synthesised using a SWiM-informed approach. Certainty of evidence was assessed using GRADE.

Consumer and Community Involvement

There was no consumer or community involvement in the conduct of this systematic review.

Results

In five trials comparing CO-OP with active alternative interventions, meta-analysis did not demonstrate clear superiority for COPM Performance (MD = 1.03, 95% CI [−0.38, 2.44], I² = 77.7%) or Satisfaction (MD = 1.53, 95% CI [−0.13, 3.19], I² = 75.1%); certainty was very low. Low-certainty evidence from inactive/waitlist comparisons and trials adding CO-OP to background rehabilitation suggested improvements in individualised occupational performance. Evidence for generalised motor capacity, functional status, broader participation-related outcomes, and executive functioning was limited or inconsistent. Neuroimaging findings were exploratory.

Conclusion

CO-OP may improve individualised, goal-oriented occupational performance compared with inactive controls or when added to background rehabilitation. However, current evidence does not establish clear superiority over other active interventions. Further adequately powered trials examining participation, generalisation, and longer term outcomes are needed.

查看原文本刊更多论文

日常职业绩效认知取向对残疾儿童职业绩效和相关结果的影响：系统回顾和荟萃分析。

背景：日常职业表现的认知取向（CO-OP）方法是一种基于认知策略、以职业为中心的干预方法，旨在改善神经发育障碍儿童的功能表现。尽管CO-OP在儿科康复中的应用越来越多，但从随机对照试验中检验其在不同人群中的有效性和结果的证据尚未得到全面综合。本系统综述和荟萃分析考察了CO-OP对残疾儿童职业绩效和相关结果的影响。方法：通过PubMed、Scopus和CENTRAL检索涉及3-18岁儿童的随机对照试验。纳入17份符合条件的报告，代表13个不同的试验队列。偏倚风险采用RoB 2进行评估。在临床上适当的情况下，使用随机效应荟萃分析综合COPM绩效和满意度结果；其他结果采用泳图知情方法进行综合。使用GRADE评估证据的确定性。消费者和社区参与：没有消费者或社区参与本系统评价的实施。结果：在五项比较CO-OP与主动替代干预的试验中，meta分析并未显示COPM绩效（MD = 1.03, 95% CI [-0.38, 2.44], I2 = 77.7%）或满意度（MD = 1.53, 95% CI [-0.13, 3.19], I2 = 75.1%）的明显优势；确定性非常低。来自非活动/候补名单比较和在背景康复中加入CO-OP的试验的低确定性证据表明，个性化职业表现有所改善。一般运动能力、功能状态、更广泛的参与相关结果和执行功能的证据有限或不一致。神经影像学结果是探索性的。结论：与不活跃的对照组相比，或与背景康复相结合，CO-OP可以改善个性化的、目标导向的职业绩效。然而，目前的证据并没有明确表明其优于其他积极干预措施。需要进一步开展充分有力的试验，以检验参与性、普遍性和长期结果。

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.