CO-OP has been applied with a number of populations. There is now sufficient research to warrant a systematic review of the research literature.

Muscle activity during the swing phase of walking is influenced by proprioceptive feedback pathways. Previous studies have shown that feedback and anticipatory motor commands contribute to locomotor adaptive strategies to prolonged exposure to a resistance against leg movements during walking. The purpose of this study was to determine whether people with motor-incomplete spinal cord injuries (SCI) modulate flexor muscle activity in response to different levels of resistance in a similar way as uninjured controls. A second purpose was to determine whether people with motor-incomplete SCI have the capacity to form anticipatory motor commands following exposure to resistance. Subjects walked on a treadmill with the Lokomat robotic gait orthosis. The Lokomat applied different levels of a velocity-dependent resistance, normalized to each subject's maximum voluntary contraction of the hip flexors. Each condition consisted of 20 steps against resistance followed by 20 steps without. Electromyography and kinematics of the lower limb were recorded. Although both groups responded to the resistance with an overall increase in rectus femoris activity during swing, the SCI group showed weak modulation of muscle activity to different levels of resistance. Following removal of the resistance, both groups showed aftereffects, but they were manifested differently. Controls responded to the removal of resistance with a high step, whereas the SCI subjects exhibited increased step length. The size of the aftereffect was related to the amount of added resistance. In addition, the SCI group showed a negative relationship between the size of the aftereffect and locomotor function.

Transferring learning from therapy to everyday life skills is a necessary step for successful therapy outcomes, yet rarely addressed and achieved. However, a cognitive approach to skill acquisition, and the Cognitive Orientation to daily Occupational Performance (CO-OP), explicitly identifies transfer as an objective and incorporates elements into the intervention to support transfer. A scoping review was undertaken to explore the nature and extent of the research regarding CO-OP and transfer. An online search of 10 databases was conducted to identify and examine research studies reporting on CO-OP and transfer. The search yielded 25 documents that addressed CO-OP and transfer. The studies used a variety of approaches to evaluate transfer; all reported transfer on at least one and, in many cases, multiple transfer outcome variables. The CO-OP literature addresses transfer across a variety of populations and settings using a variety of approaches. Further work is required to establish a common approach to examining transfer in the CO-OP literature and the literature in general.

This pilot study demonstrates that the combination of leg weights and treadmill training is a feasible approach, that is well tolerated by participants. This approach may have the potential to improve some aspects of functional ambulation and the performance of activities requiring hip and knee flexion.