"Surgically created" excision of the back mimicking homicide: report of an unusual case.

BACKGROUND

Stroke is the third leading cause of permanent disability worldwide. It is associated with difficulties in occupational performance, an area targeted by the Cognitive Orientation to daily Occupational Performance (CO-OP).

OBJECTIVE

To investigate the evidence available for the effectiveness of the CO-OP in addressing adults' performance of activities of daily living.

DATA SOURCES: Randomized controlled trials (RCTs) or pilot RCTs of the CO-OP written in English and published through December 2021 were retrieved from PubMed, SCOPUS, ScienceDirect, OTseeker, and EBSCO.

STUDY SELECTION AND DATA COLLECTION: The studies' participants were adults with stroke, evaluated on occupational performance before and after CO-OP administration. The American Occupational Therapy Association Evidence-Based Practice Project methodology was followed. Quality appraisal was conducted using the Cochrane Collaboration's Risk of Bias 2 tool.

RESULTS

Four RCTs and 3 pilot RCTs met the inclusion criteria. Inconsistent results are presented for trained and untrained goals, with the last ones being scarcely investigated.

LIMITATIONS: The limited number of studies, combined with the methodological limitations observed, did not allow for definite conclusions to be reached.

CONCLUSIONS AND RELEVANCE: The CO-OP is a promising client-centered, occupation-based approach, but future adequately powered studies addressing the potential for generalization are needed. Plain-Language Summary: The Cognitive Orientation to daily Occupational Performance is a relatively new treatment method that uses cognitive techniques to guide patients into discovering ways to perform activities of daily living independently. This systematic review presents the available evidence regarding CO-OP's effectiveness when used with adults after stroke. The findings showed that CO-OP has a positive impact in this population, but further research is needed to reach more concrete conclusions. Stroke patients may benefit from CO-OP because it can be a cost-effective, short-duration, task-oriented treatment.