This thesis reports on a multi-phased research project conducted to evaluate the use of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach with adults with stroke. Current approaches to motor recovery, called systems approaches, suggest that movement arises from a dynamic interaction among several different systems, including perception, cognition, and action, all within the context of the individual and his or her environment. CO-OP is an established treatment approach for children with motor-based performance problems that takes into account interactions among several systems, as well as individual needs and environmental factors. CO-OP is a client-centred, problem solving approach based on the theoretical foundations of learning and motor learning theory. The objectives of this project were: to examine the efficacy of CO-OP to improve motor skill acquisition and performance in adults living with chronic stroke; to explore other benefits of the approach; and to identify adaptations for use with adults with stroke. Two series of single case experimental studies were conducted, with three participants completing each. In addition, semi-structured interviews were conducted. Findings from the single case experiments provide evidence that CO-OP is associated with performance improvements in both trained and untrained self-selected goals in adults more than one year post stroke. As well, pre-post measures suggest there may be changes in performance satisfaction, motor control, generalized use of the affected upper extremity, and self-efficacy. Interview findings provided valuable information about the experiences of participants with the approach; the interview respondents enjoyed the increased sense of responsibility that came with problem solving on their own, but expressed a desire to have ongoing professional support. Suggestions for modifications to CO-OP for use adults with stroke are made. CO-OP is a promising approach to improve functional independence in adults with stroke. Future research is warranted.
| Identifer | oai:union.ndltd.org:TORONTO/oai:tspace.library.utoronto.ca:1807/26470 |
| Date | 08 March 2011 |
| Creators | McEwen, Sara Elizabeth |
| Contributors | Polatajko, Helene J. |
| Source Sets | University of Toronto |
| Language | en_ca |
| Detected Language | English |
| Type | Thesis |
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