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Cognitive Orientation to Daily Occupational Performance (CO-OP) in Parkinson's: Randomized Trial Findings
Journal article   Open access   Peer reviewed

Cognitive Orientation to Daily Occupational Performance (CO-OP) in Parkinson's: Randomized Trial Findings

Sarah Davies, Emmah Doig, Matthew Gullo and Hannah Gullo
Canadian Journal of Occupational Therapy, Vol.93(1), pp.34-48
2026
PMID: 40134279
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davies-et-al-2025-cognitive-orientation-to-daily-occupational-performance-(co-op)-in-parkinson-s-randomized-trial891.08 kBDownloadView
Published Version (Advanced Access)CC BY-NC V4.0 Open Access

Abstract

Occupational therapy Metacognitive strategy training Neurorehabilitation
Background. People with Parkinson's disease (PwPD) experience increasing disability due to progressive motor and non-motor symptoms. Comprehensive rehabilitation approaches are needed to maximize their daily functioning. CO-OP targets daily functioning and has established efficacy in populations with similar symptom profiles. Purpose. To explore the potential of CO-OP for PwPD, a feasibility randomized controlled trial (RCT) was conducted. Methods. Consenting PwPD (n = 20) were recruited to a parallel group, assessor masked RCT. Following baseline assessment, participants were randomized to CO-OP (20 sessions:10-weeks) or a waitlist control (WLC; 0 sessions: 10 weeks). Goal attainment, functional and cognitive status, quality of life, self-efficacy, transfer, and maintenance were measured. Data were analyzed using descriptive statistics and multiple regression analysis. Results. Effort (M = 3.02/5) and enjoyment (M = 3.15/5) ratings; homework completion (M = 91%) and protocol adherence (M = 82%) indicate that CO-OP is feasible. CO-OP was superior to the WLC on Canadian Occupational Performance Measure (COPM) performance (p=<.001), COPM satisfaction (p=<.001), and Performance Quality Rating Scale (PQRS; p=<.001) but not the Goal Attainment Scale (GAS; p = .123). Conclusions. Addressing a critical gap in Parkinson's disease management, findings suggest that CO-OP is implementable, feasible, and potentially beneficial for PwPD. Further research is warranted to further establish efficacy.

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