Effects of Cognitive Orientation to Daily Occupational Performance (CO-OP) Intervention on Executive Functioning for Activities of Daily Living in Patients With Stroke: A Randomized Controlled Trial

Abstract

Objective This study aimed to examine the effects of the Cognitive Orientation to Daily Occupational Performance (CO-OP) intervention on executive functioning to promote the performance of activities of daily living in patients with stroke using a randomized controlled trial. Methods Thirty-eight patients with stroke who met the inclusion criteria were randomly assigned to either an experimental (n = 19) or a control (n = 19) group using a computer-generated randomization program. The experimental group received the CO-OP intervention, whereas the control group received conventional occupational therapy. Both interventions were delivered over 12 sessions, 5 times per week, with each session lasting 60 min. The Executive Function Performance Test - Korean version, Canadian Occupational Performance Measure, Performance Quality Rating Scale, Korean version of the Modified Barthel index, and Korean version of the Instrumental Activities of Daily Living Scale were administered for pre- and post-intervention assessments. Results Both groups showed significant improvements in executive function, occupational performance, and activities of daily living following the interventions (p < .001). However, when comparing the magnitude of change between the two groups, the experimental group demonstrated significantly greater improvements across all measures (p < .05, p < .01, p < .001). These findings indicate that the CO-OP intervention led to statistically greater enhancement than conventional occupational therapy. Conclusion This study provides evidence that the CO-OP approach in occupational therapy can effectively improve executive function, occupational performance, and activities of daily living in patients with stroke. Therefore, the CO-OP intervention, as a client-centered and evidence-based approach, may be a valuable therapeutic method in future clinical practice.

The authors' abstract, as published at the source. Hong Kong Journal of Occupational Therapy, 2026 · DOI ↗