Client Perceptions of Task-Oriented Training at Home: “I Forgot I Was Sick”

2018 ◽  
Vol 38 (3) ◽  
pp. 190-195 ◽  
Author(s):  
Veronica T. Rowe ◽  
Marsha Neville
Keyword(s):  
Motor Learning ◽  
Occupational Adaptation ◽  
Client Perceptions ◽  
Adaptive Process ◽  
Directed Content Analysis ◽  
Task Practice ◽  
Field Notes ◽  
Learning Principles ◽  
Task Oriented ◽  
At Home

Task-oriented training is a contemporary intervention based on behavioral neuroscience and recent models of motor learning. It can logically be guided by the theory of occupational adaptation. This report presents the perceptions of four participants who underwent task-oriented training at home (TOTE Home) for upper extremity hemiparesis following a stroke. Guided by principles of motor learning and the theory of occupational adaptation, a directed content analysis was used with field notes recorded during the TOTE Home. Three themes emerged: salience of the activity within context, desire for mastery by creating the just right challenge, and adapted self-perception of abilities. While motor learning principles informed the method of task practice and feedback, it was the person’s desire to perform meaningful, relevant activities that drove the adaptive process. This study provided insight in the perceptions and experiences of participants undergoing TOTE Home.

scholarly journals Motor learning-based activities may improve functional ability in adults with severe cerebral palsy: A controlled pilot study

2021 ◽  
pp. 1-11
Author(s):  
Helle Hüche Larsen ◽  
Rasmus Feld Frisk ◽  
Maria Willerslev-Olsen ◽  
Jens Bo Nielsen
Keyword(s):  
Cerebral Palsy ◽  
Motor Learning ◽  
Motor Function ◽  
Functional Ability ◽  
Active Group ◽  
Control Group ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Learning Principles

BACKGROUND: Cerebral palsy (CP) is a neurodevelopmental disturbance characterized by impaired control of movement. Function often decreases and 15% of adults are classified as severely affected (Gross Motor Function Classification Scale III-V). Little is known about interventions that aim to improve functional abilities in this population. OBJECTIVE: To evaluate a 12-week intervention based on motor learning principles on functional ability in adults with severe CP. METHODS: 16 adults (36±10 years, GMFCS III-V) were enrolled and divided into an intervention group (Active group) and a standard care group (Control group). Primary outcome measure was Gross Motor Function Measure (GMFM-88). Secondary measures were neurological status. The Active group were measured at baseline, after the intervention and at one-month follow-up. The Control group were measured at baseline and after one month. RESULTS: Analysis showed statistically significant improvement in GMFM-88 for the Active group from baseline to post assessment compared with the Control group (group difference: 5 points, SE 14.5, p = 0.008, CI: 1.2 to 8.7). Improvements were maintained at follow-up. Results from the neurological screening showed no clear tendencies. CONCLUSIONS: The study provides support that activities based on motor learning principles may improve gross motor function in adults with severe CP.

scholarly journals The Efficiency, Efficacy, and Retention of Task Practice in Chronic Stroke

2020 ◽  
Vol 34 (10) ◽  
pp. 881-890 ◽  
Author(s):  
Chunji Wang ◽  
Carolee Winstein ◽  
David Z. D’Argenio ◽  
Nicolas Schweighofer
Keyword(s):  
Controlled Trial ◽  
Practice Effect ◽  
Chronic Stroke ◽  
Skill Learning ◽  
Retention Rates ◽  
Lower Efficiency ◽  
Motor Practice ◽  
Negative Effect ◽  
Task Practice ◽  
Learning Principles

In motor skill learning, larger doses of practice lead to greater efficacy of practice, lower efficiency of practice, and better long-term retention. Whether such learning principles apply to motor practice after stroke is unclear. Here, we developed novel mixed-effects models of the change in the perceived quality of arm movements during and following task practice. The models were fitted to data from a recent randomized controlled trial of the effect of dose of task practice in chronic stroke. Analysis of the models’ learning and retention rates demonstrated an increase in efficacy of practice with greater doses, a decrease in efficiency of practice with both additional dosages and additional bouts of training, and fast initial decay following practice. Two additional effects modulated retention: a positive “self-practice” effect, and a negative effect of dose. Our results further suggest that for patients with sufficient arm use post-practice, self-practice will further improve use.

scholarly journals Integration of Motor Learning Principles Into Real-Time Ambulatory Voice Biofeedback and Example Implementation Via a Clinical Case Study With Vocal Fold Nodules

2017 ◽  
Vol 26 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Jarrad H. Van Stan ◽  
Daryush D. Mehta ◽  
Robert J. Petit ◽  
Dagmar Sternad ◽  
Jason Muise ◽  
...  
Keyword(s):  
Motor Learning ◽  
Relative Frequency ◽  
Vocal Fold ◽  
Clinical Case ◽  
Clinical Effectiveness ◽  
Vocal Behavior ◽  
Clinical Case Study ◽  
Learning Principles ◽  
Vocal Fold Nodules

Purpose Ambulatory voice biofeedback (AVB) has the potential to significantly improve voice therapy effectiveness by targeting one of the most challenging aspects of rehabilitation: carryover of desired behaviors outside of the therapy session. Although initial evidence indicates that AVB can alter vocal behavior in daily life, retention of the new behavior after biofeedback has not been demonstrated. Motor learning studies repeatedly have shown retention-related benefits when reducing feedback frequency or providing summary statistics. Therefore, novel AVB settings that are based on these concepts are developed and implemented. Method The underlying theoretical framework and resultant implementation of innovative AVB settings on a smartphone-based voice monitor are described. A clinical case study demonstrates the functionality of the new relative frequency feedback capabilities. Results With new technical capabilities, 2 aspects of feedback are directly modifiable for AVB: relative frequency and summary feedback. Although reduced-frequency AVB was associated with improved carryover of a therapeutic vocal behavior (i.e., reduced vocal intensity) in a patient post-excision of vocal fold nodules, causation cannot be assumed. Conclusions Timing and frequency of AVB schedules can be manipulated to empirically assess generalization of motor learning principles to vocal behavior modification and test the clinical effectiveness of AVB with various feedback schedules.

scholarly journals Revisiting Constraint-Induced Movement Therapy: Are We Too Smitten With the Mitten? Is All Nonuse “Learned”? and Other Quandaries

2007 ◽  
Vol 87 (9) ◽  
pp. 1212-1223 ◽  
Author(s):  
Steven L Wolf
Keyword(s):  
Upper Extremity ◽  
Movement Therapy ◽  
Detailed Model ◽  
Constraint Induced Movement Therapy ◽  
Scientific Exploration ◽  
Critical Issues ◽  
Valuable Treatment ◽  
Impaired Limb ◽  
Task Practice ◽  
Task Oriented

Constraint-induced movement therapy (CIMT) has gained considerable popularity as a valuable treatment for a hemiparetic upper extremity. This approach is compatible with the emerging notion that task-oriented or functionally oriented retraining of the impaired limb provides evidence to support its utility. This article first provides a historical perspective on the development of CIMT. An overview model of how learned nonuse of the hemiparetic limb occurs and can be overcome with CIMT is discussed, and then a more detailed model that incorporates critical issues requiring considerably more basic and applied scientific exploration is described. Among the issues considered are the extent to which hemiparetic limb nonuse and subsequent modes of delivery to overcome it are governed by structure-function deficits rather than being attributable primarily to behavioral phenomena; the relative importance of the intensity of training; the need to better balance unimanual and bimanual upper-extremity task practice; the role of psychosocial and cultural factors in fostering patient compliance; the optimization of modes of delivery; and the reevaluation of the constellation of components contributing to successful outcomes with this treatment. Finally, the strengths, uncertainties, and limitations associated with CIMT are examined.

Advantages of virtual reality in the rehabilitation of balance and gait

Neurology ◽  
2018 ◽  
Vol 90 (22) ◽  
pp. 1017-1025 ◽  
Author(s):  
Desiderio Cano Porras ◽  
Petra Siemonsma ◽  
Rivka Inzelberg ◽  
Gabriel Zeilig ◽  
Meir Plotnik
Keyword(s):  
Virtual Reality ◽  
Motor Learning ◽  
Cochrane Collaboration ◽  
Intervention Programs ◽  
Randomized Controlled ◽  
Methodologic Quality ◽  
Newcastle Ottawa Scale ◽  
Meta Analyses ◽  
Learning Principles ◽  
Ottawa Scale

BackgroundVirtual reality (VR) has emerged as a therapeutic tool facilitating motor learning for balance and gait rehabilitation. The evidence, however, has not yet resulted in standardized guidelines. The aim of this study was to systematically review the application of VR-based rehabilitation of balance and gait in 6 neurologic cohorts, describing methodologic quality, intervention programs, and reported efficacy.MethodsThis study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. VR-based treatments of Parkinson disease, multiple sclerosis, acute and chronic poststroke, traumatic brain injury, and cerebral palsy were researched in PubMed and Scopus, including earliest available records. Therapeutic validity (CONTENT scale) and risk of bias in randomized controlled trials (RCT) (Cochrane Collaboration tool) and non-RCT (Newcastle-Ottawa scale) were assessed.ResultsNinety-seven articles were included, 68 published in 2013 or later. VR improved balance and gait in all cohorts, especially when combined with conventional rehabilitation. Most studies presented poor methodologic quality, lacked a clear rationale for intervention programs, and did not utilize motor learning principles meticulously. RCTs with more robust methodologic designs were widely recommended.ConclusionOur results suggest that VR-based rehabilitation is developing rapidly, has the potential to improve balance and gait in neurologic patients, and brings additional benefits when combined with conventional rehabilitation. This systematic review provides detailed information for developing theory-driven protocols that may assist overcoming the observed lack of argued choices for intervention programs and motor learning implementation and serves as a reference for the design and planning of personalized VR-based treatments.RegistrationPROSPERO CRD42016042051.

Application of Motor Learning Principles with Stroke Survivors

2001 ◽  
Vol 13 (1) ◽  
pp. 23-44 ◽  
Author(s):  
Jodi Schreiber ◽  
Leslie Sober ◽  
Laura Banta ◽  
Lori Glassbrenner ◽  
Jennifer Haman ◽  
...  
Keyword(s):  
Motor Learning ◽  
Stroke Survivors ◽  
Learning Principles

scholarly journals Adaptive process in motor learning: the role of variability

2017 ◽  
pp. 55
Author(s):  
Go Tani
Keyword(s):  
Motor Learning ◽  
Adaptive Process

O objetivo desta apresentação é sintetizar alguns estudos experimentais realizados recentemente no Laboratório de Comportamento Motor (LACOM) para testar os principais pressupostos de um modelo teórico que trata da aquisição de habilidades motoras como um processo adaptativo. Segundo esse modelo teórico, a aquisição de habilidades motoras é um processo cíclico e dinâmico de estabilidade-instabilidadeestabilidade que resulta em crescente complexidade. Assim, considera-se não apenas a estabilização, mas também a adaptação como fases constituintes do mesmo processo. O problema central é considerar como consistência e variabilidade são conciliados numa mesma estrutura. Propõe-se, então, que através da prática é formado um programa de ação organizado hierarquicamente em dois níveis: a macro-estrutura que é expressa nos aspectos invariantes da habilidade motora estando assim relacionada à consistência, e a micro-estrutura expressa nos aspectos variantes da habilidade motora estando relacionada, portando, à desordem e à variabilidade. Dois estudos experimentais são descritos, um envolvendo uma tarefa de controle de força de preensão manual, e outro com uma tarefa de posicionamento linear com reversão. Os resultados foram, de uma forma geral, favoráveis às predições do modelo teórico proposto, porém, para que ele seja aperfeiçoado, é necessária a realização de novos estudos

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