Effectiveness of Cognitive Orientation to daily Occupational Performance over and above functional hand splints for children with cerebral palsy or brain injury: a randomized controlled trial
Abstract Background Functional hand splinting is a common therapeutic intervention for children with neurological conditions. The aim of this study was to investigate the effectiveness of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach over and above conventional functio...
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doaj-461343af0cce434cbcee653aca28075d2020-11-25T02:11:16ZengBMCBMC Pediatrics1471-24312018-07-0118111210.1186/s12887-018-1213-9Effectiveness of Cognitive Orientation to daily Occupational Performance over and above functional hand splints for children with cerebral palsy or brain injury: a randomized controlled trialMichelle Jackman0Iona Novak1Natasha Lannin2Elspeth Froude3Laura Miller4Claire Galea5School of Child and Adolescent Medicine, The University of SydneySchool of Child and Adolescent Medicine, The University of SydneyAlfred Health, La Trobe UniversitySchool of Health Science, Australian Catholic UniversitySchool of Health Science, Australian Catholic UniversityCerebral Palsy Alliance Research Institute, The University of SydneyAbstract Background Functional hand splinting is a common therapeutic intervention for children with neurological conditions. The aim of this study was to investigate the effectiveness of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach over and above conventional functional hand splinting, and in combination with splinting, for children with cerebral palsy or brain injury. Methods A multisite, assessor-blinded, parallel, randomized controlled trial was conducted in Australia. Participants (n = 45) were randomly allocated to one of three groups; (1) splint only (n = 15); (2) CO-OP only (n = 15); (3) CO-OP + splint (n = 15). Inclusion: age 4–15 years; diagnosis of cerebral palsy or brain injury; Manual Ability Classification System I–IV; hand function goals; sufficient language, cognitive and behavioral ability. Primary outcome measures were the Canadian Occupational Performance Measure (COPM) and Goal Attainment Scale (GAS). Treatment duration for all groups was 2 weeks. CO-OP was provided in a group format, 1 h per day for 10 consecutive weekdays, with parents actively involved in the group. Hand splints were wrist cock-up splints that were worn during task practice. Three individual goals were set and all participants were encouraged to complete a daily home program of practicing goals for 1 h. Analyses were conducted on an intention to treat basis. Results The COPM showed that all three groups improved from baseline to immediately post-treatment. GAS showed a statistically significant difference immediately post-intervention between the splint only and CO-OP only groups p = 0.034), and the splint only and CO-OP + splint group (p = 0.047) favoring CO-OP after controlling for baseline. Conclusions The CO-OP Approach™ appeared to enhance goal achievement over and above a functional hand splint alone. There was no added benefit of using hand splints in conjunction with CO-OP, compared to CO-OP alone. Hand splints were not well tolerated in this population. Practice of functional goals, through CO-OP or practice at home, leads to goal achievement for children with cerebral palsy or brain injury. Trial registration Registered with the Australian New Zealand Clinical Trials Registry (ACTRN12613000690752) on 24/06/2013.http://link.springer.com/article/10.1186/s12887-018-1213-9Upper limbTask-specific trainingMotor trainingCognitionOrthosesGoal-directed |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Michelle Jackman Iona Novak Natasha Lannin Elspeth Froude Laura Miller Claire Galea |
spellingShingle |
Michelle Jackman Iona Novak Natasha Lannin Elspeth Froude Laura Miller Claire Galea Effectiveness of Cognitive Orientation to daily Occupational Performance over and above functional hand splints for children with cerebral palsy or brain injury: a randomized controlled trial BMC Pediatrics Upper limb Task-specific training Motor training Cognition Orthoses Goal-directed |
author_facet |
Michelle Jackman Iona Novak Natasha Lannin Elspeth Froude Laura Miller Claire Galea |
author_sort |
Michelle Jackman |
title |
Effectiveness of Cognitive Orientation to daily Occupational Performance over and above functional hand splints for children with cerebral palsy or brain injury: a randomized controlled trial |
title_short |
Effectiveness of Cognitive Orientation to daily Occupational Performance over and above functional hand splints for children with cerebral palsy or brain injury: a randomized controlled trial |
title_full |
Effectiveness of Cognitive Orientation to daily Occupational Performance over and above functional hand splints for children with cerebral palsy or brain injury: a randomized controlled trial |
title_fullStr |
Effectiveness of Cognitive Orientation to daily Occupational Performance over and above functional hand splints for children with cerebral palsy or brain injury: a randomized controlled trial |
title_full_unstemmed |
Effectiveness of Cognitive Orientation to daily Occupational Performance over and above functional hand splints for children with cerebral palsy or brain injury: a randomized controlled trial |
title_sort |
effectiveness of cognitive orientation to daily occupational performance over and above functional hand splints for children with cerebral palsy or brain injury: a randomized controlled trial |
publisher |
BMC |
series |
BMC Pediatrics |
issn |
1471-2431 |
publishDate |
2018-07-01 |
description |
Abstract Background Functional hand splinting is a common therapeutic intervention for children with neurological conditions. The aim of this study was to investigate the effectiveness of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach over and above conventional functional hand splinting, and in combination with splinting, for children with cerebral palsy or brain injury. Methods A multisite, assessor-blinded, parallel, randomized controlled trial was conducted in Australia. Participants (n = 45) were randomly allocated to one of three groups; (1) splint only (n = 15); (2) CO-OP only (n = 15); (3) CO-OP + splint (n = 15). Inclusion: age 4–15 years; diagnosis of cerebral palsy or brain injury; Manual Ability Classification System I–IV; hand function goals; sufficient language, cognitive and behavioral ability. Primary outcome measures were the Canadian Occupational Performance Measure (COPM) and Goal Attainment Scale (GAS). Treatment duration for all groups was 2 weeks. CO-OP was provided in a group format, 1 h per day for 10 consecutive weekdays, with parents actively involved in the group. Hand splints were wrist cock-up splints that were worn during task practice. Three individual goals were set and all participants were encouraged to complete a daily home program of practicing goals for 1 h. Analyses were conducted on an intention to treat basis. Results The COPM showed that all three groups improved from baseline to immediately post-treatment. GAS showed a statistically significant difference immediately post-intervention between the splint only and CO-OP only groups p = 0.034), and the splint only and CO-OP + splint group (p = 0.047) favoring CO-OP after controlling for baseline. Conclusions The CO-OP Approach™ appeared to enhance goal achievement over and above a functional hand splint alone. There was no added benefit of using hand splints in conjunction with CO-OP, compared to CO-OP alone. Hand splints were not well tolerated in this population. Practice of functional goals, through CO-OP or practice at home, leads to goal achievement for children with cerebral palsy or brain injury. Trial registration Registered with the Australian New Zealand Clinical Trials Registry (ACTRN12613000690752) on 24/06/2013. |
topic |
Upper limb Task-specific training Motor training Cognition Orthoses Goal-directed |
url |
http://link.springer.com/article/10.1186/s12887-018-1213-9 |
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