https://orcid.org/0000-0003-1844-6206
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ABSTRACT
Children with cerebral palsy (CP) may experience challenges with motivation to engage in motor activities during rehabilitation sessions, which can impact therapy outcomes. This study investigated the effect of the Cognitive Orientation to daily Occupational Performance (CO-OP) intervention on the motivation and achievement of motor-based goals in rehabilitation sessions for children with CP. In this pilot randomized trial, eighteen children aged 8–13 years with CP participated and were randomly assigned to either the CO-OP or bottom-up usual care group. The CO-OP group received 12 performance-based cognitive intervention sessions. The CO-OP intervention significantly enhanced the motivation of children with CP to engage and participate in therapeutic activities, as evidenced by the Pediatric Motivation Scale (PMOT) and its four sub-scales (p < 0.05, based on repeated measures ANOVA). Moreover, the Goal Attainment Scale (GAS) T-scores were higher for both posttest and follow-up assessments in the CO-OP group compared to the bottom-up usual care group. Additionally, independent sample t-test results demonstrated a significant difference in the mean scores of the Canadian Occupational Performance Measure (COPM) between the two groups. The Cognitive Orientation to daily Occupational Performance (CO-OP) intervention successfully enhanced the motivation and facilitated the achievement of motor-based goals from the patient perspective in children with CP. The client-centered approach, focusing on meeting the basic psychological needs of the participants, contributed to improved therapy outcomes in terms of functional abilities, goal attainment, and engagement in daily activities. These findings highlight the potential of the CO-OP intervention as an effective approach for enhancing motivation and improving therapy outcomes in children with CP.
Acknowledgements
The authors would like to express gratitude to all families and participants who contributed to this study.
Disclosure Statement
No potential conflict of interest was reported by the author(s).
Key Findings
The CO-OP intervention effectively achieved self-identified performance-based goals in children with cerebral palsy.
Participants in the CO-OP group exhibited higher levels of motivation and engagement during therapy sessions compared to those in the bottom-up usual care group.
What the Study Has Added
This study significantly contributes to the relevant field by providing empirical evidence supporting the efficacy of the CO-OP approach in enhancing functional performance, goal attainment, and motivation among children with cerebral palsy. The findings underscore the importance of implementing child-centered and task-oriented interventions in pediatric occupational therapy to optimize outcomes and promote active participation in therapy sessions.