Table 1 Summary of key CO-OP stroke publications

McEwen, S., Polatajko, P., Huijbregts, M., Ryan, J.

2009

Adults living in the community with chronic stroke; 3 single case experiments

Single case experiments. Intervention: CO-OP therapy was administered at the rate of one or two sessions per week, up to 10 sessions were completed. Single case paradigm, participants were their own control

-PQRS [10] scores showed significant improvement in at least 2/3 self-selected functional activities, further improvements at 1-month follow-up. Evidence of skill acquisition and retention

McEwen, S., Polatajko, P., Huijbregts, M., Ryan, J.

2010

Adults with chronic stroke living in the community; 3 single case experiments

Single case experiments. Intervention: Up to 10 CO-OP sessions were completed. Single case paradigm, participants were their own control

-PQRS scores improved for all participants at follow-up in all trained and untrained skills, providing evidence of retention and transfer

Skidmore, E., Holm, M., Whyte, E., Dew, M., Dawson, D., Becker, J.

2011

Single case admitted to an inpatient rehabilitation unit, cognitively impaired; Age 31; male; time since stroke 7 days

Single case study. Intervention 10 45-min CO-OP sessions. In addition, patient received usual inpatient rehabilitation

-Mean improvement of 6.1 on COPM [16] Performance scale score

-Pittsburgh Rehabilitation participation Scale [measure rehab engagement on 6 point scale] scores improved from 3.2 to 4.9

-FIM™ [25] scores improved from 68 to 97

-Improvement in self-care skills

Skidmore, E., Dawson, D., Whyte, E., Butters, M., Dew, M., Grattan, E., Becker, J., Holm, M

2014

Cognitively-impaired patients admitted to an inpatient rehabilitation unit; N = 10; mean age: 68; male: 70 %; mean time since stroke: 14.5 days; mean length of stay: 22 days

RCT. Intervention: CO-OP therapy was administered daily in 30–40 min sessions for the duration of length of stay

-CO-OP participants demonstrated less disability than control participants, FIM™ 117 vs 96

Control: dose-matched sessions using scripted and open-ended questions to promote reflection on rehabilitation activities and experiences

Both groups received usual inpatient rehabilitation in addition to the research interventions

McEwen, S., Polatajko, H., Baum, C., Rios, J., Cirone, D., Doherty, M., Wolf, T.

2014

Patients admitted to an outpatient rehabilitation program; N = 26; mean age: 56; male: 62.9 %; mean time since stroke: 43.3 days; mean number of sessions attended: 12.2 (CO-OP), 13.3 (control). Includes patients with cognitive impairment

RCT. Intervention: CO-OP therapy sessions were 45 min long and administered twice per week for a maximum of 10 sessions, instead of usual occupational therapy. More complex patients who required additional treatment received additional usual care OT

-CO-OP demonstrated a large effect over usual care on performance of functional activities (PQRS) on trained and untrained activities at follow-up, providing evidence of retention and transfer

Control: participants received usual occupational therapy

-CO-OP also demonstrated a medium effect on participation and self-efficacy, compared to usual care