Background:

Cognitive orientation to daily occupational performance (CO-OP) is a client-centered treatment approach that was developed in the 1990s by occupational therapists. Purpose: Exploring current evidence about the effectiveness of CO-OP on children with cerebral palsy (CP). Method: Major electronic databases were searched. A narrative synthesis of current literature and meta-analyses on randomized control trials (RCTs) were conducted on changes in occupational performance. Findings: Seven studies with 103 participants were included. Four studies were RCTs with moderate levels of evidence, and three studies had single-subject designs. Although beneficial effects of CO-OP on goal achievement and transferring learned skills were reported, meta-analyses showed that CO-OP had no significant effect on the performance (WMD = 1.52, 95% CI = −1.58 to 4.63, P = .33) and satisfaction domains (WMD = 1.71, 95% CI = −1.14 to 4.57, P = .24) of Canadian Occupational Performance Measure scores compared to alternative interventions. Implications: CO-OP improves occupational performance but not more than alternative interventions. Results are inconclusive due to small sample sizes and heterogeneity of alternative interventions and participants. Therefore, research with a larger number of participants with sound RCT methods is needed.

中文翻译：

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脑性瘫痪儿童日常职业表现 (CO-OP) 的认知导向：荟萃分析的系统评价：L'approcheCO-OP auprès des enfants atteints de paralysie cérébrale: revue systématique et méta-analysis

背景：

日常职业表现的认知导向 (CO-OP) 是一种以客户为中心的治疗方法，由职业治疗师在 1990 年代开发。目的：探索关于 CO-OP 对脑瘫 (CP) 儿童有效性的现有证据。方法：检索主要电子数据库。对当前文献的叙述性综合和随机对照试验 (RCT) 的荟萃分析对职业表现的变化进行了分析。发现：包括 103 名参与者的 7 项研究。四项研究是具有中等证据水平的随机对照试验，三项研究采用单受试者设计。尽管报告了 CO-OP 对实现目标和转移学习技能的有益影响，但荟萃分析显示 CO-OP 对绩效没有显着影响（WMD = 1.52, 95% CI = -1.58 至 4.63, P  = .33 ) 和满意度域 (WMD = 1.71, 95% CI = -1.14 至 4.57, P  = .24) 与替代干预措施相比，加拿大职业绩效测量得分。影响：CO-OP 提高了职业表现，但不超过替代干预措施。由于样本量小以及替代干预措施和参与者的异质性，结果尚无定论。因此，需要有大量参与者和健全的 RCT 方法进行研究。