Task-oriented approach Flashcards
History
Traditional practice models developed empirically (NDT, Rood, PNF, Brunnstrom)
Contemporary practice models based on current motor control and learning theory and then developed methods (task oriented approach)
Paradigm
How something is viewed.
Shifts occur when it doesn’t fit the current knowledge or when the approach is inadequate
Traditional Neurophysiological approaches
Control of movement is reflex based and is organized
- Normal movement facilitated by providing specific patterns of sensory input
- Sequelae of stroke can be understood through neurophysiological explanation.
Recovery:
- can be facilitated by providing specific patterns and/or using reflexes to facilitate/inhibit motor activity
- Follows a predictable sequence that mimics normal development.
Task oriented approach
occupation based, client centered, focuses on enabling client to obtain motor recovery thru occupational performance using real objects, environments, and meaningful occupations. (authentic learning is the aim of this approach)
real objects from environment produces better functional movement.
Environmental context plays role in transfer of motor skill acquisition.
Contemporary task-oriented approach
Movement emerges from the interaction of many systems (person, task, environment)
abnormal motor control results from impairment in one or more systems and their interaction processes.
Movement should be used as a preferred means of achieving a goal.
Task oriented approaches
- Motor relearning approach
- OT Task oriented approach or contemporary task oriented approach
- Task oriented
- Constraint-induced therapy
activity analysis
analyze activity and grade activity according to analysis so client feels they are making progress towards goals.
Motor learning will take place if client has multiple practice opportunities in multiple environments and client able to cognitively reflect.
Coordinative structure
Group of muscles spanning several joints that are constrained to act as a single functional unit (when you reach behind your head, both your shoulder and elbow flex)
Open tasks
patient needs to make adaptive decisions about unpredictable events. (trying to cross the road may be different depending on location and time of the day.
Closed tasks
stable and predictable and methods have to be consistent over time. (brushing teeth, same way each time.)
Evaluation process
Top down approach- focuses on activity and participation level, not impairment.
Evaluation process
1) Assess role performance
2) Assess occupational performance (COPM)
3) Select and analyze tasks the client has identified as important and difficult.
4) Perform specific assessments of personal and/or environmental factors that are critical control parameters (what is most important to that individual).
CIMT
a form of massed practice designed to improve function in persons with hemiplegia (neuroplasticity) develop new pathways.
Intervention Process
- Select/practice functional tasks related to role and that are important and meaningful
- Create/select practice conditions appropriate to task and using motor learning principles
- Create environments that provide typical challenges. Treat in natural environments if possible
- Provide opportunities for practice outside therapy time.
- Minimize ineffective and inefficient movement patterns.
Levels of usage
Nonassistive= unable to use limb in functional activities because of pain, ROM limitation, apraxia, and neglect
Minimal stabilizing assist= use of limb passively to hold objects such as stabilizing paper while writing
Minimal active assist= use shoulder and elbow to actively place limb on lap or through sleeves of shirt or to stabilize trunk when upright. No active hand use occurs. (encourage to use shoulder and elbow as much as they can).
-Maximal active assist= use the limb actively with the shoulder, elbow, gross grasp, and release. fine motor function not present
-Incorporation into bilateral activities= Use impaired hand and arm in bilateral activities associated with daily activities and mobility.
