Efficacy of an Occupation-Based Teleintervention for Improving Daily Life Participation in the Chronic Stage After Acquired Brain Injury

Acquired brain injury (ABI) remains a major health issue worldwide, resulting in chronic participation restrictions. This study aimed to explore the efficacy of a client-centered, occupation-based teleintervention based on the Cognitive Orientation to Daily Occupational Performance approach (tele-CO-OP) in improving activity and participation of adults with chronic ABI. We conducted a pilot partial randomized controlled trial (RCT) with a waitlist control crossover design. Sixteen adults in the chronic stage post ABI (≥ 6 months), with slight to moderately-severe disability and without severe cognitive decline were allocated into tele-CO-OP or waitlist control groups. Assessments were conducted before and after the three-month intervention/wait period, and at a three-month follow-up. The tele-CO-OP included 8-16 weekly synchronous video-conferencing sessions, over a three-month period. Each participant identified five prioritized functional goals of which three were the focus of the intervention. The primary outcomes were activity performance and participation limitations. The data were analyzed using descriptive and non-parametric statistics. Within-group analysis revealed that no significant improvements were found in the control group at the end of the three-month wait period. On the other hand, pooled data showed statistically significant and clinically meaningful improvements in the primary activity and participation outcomes post-intervention, with medium to large effect sizes. The results were partially maintained at three-month follow-up. Our findings demonstrated the preliminary efficacy of the tele-CO-OP in improving activity performance and participation limitations in the chronic stage following ABI. The tele-CO-OP can be a valuable addition to traditional occupational therapy services and provide continued treatment for adults in the chronic stage following ABI to improve their participation in the community.

References

Beit Yosef, A., Jacobs, J. M., Shames, J., Schwartz, I., & Gilboa, Y. (2022). A performance-based teleintervention for adults in the chronic stage after acquired brain injury: An exploratory pilot randomized controlled crossover study. Brain Sciences, 12(2), 213. https://doi.org/10.3390/brainsci12020213

Dawson, D. R., McEwen, S. E., & Polatajko, H. J. (2017). Cognitive Orientation to daily Occupational Performance in occupational therapy: Using the CO-OP approach to enable participation across the lifespan. AOTA Press.