Journal
OCCUPATIONAL THERAPY INTERNATIONAL
Volume 16, Issue 3-4, Pages 175-189Publisher
WILEY-HINDAWI
DOI: 10.1002/oti.275
Keywords
motor rehabilitation; stroke; task specific training
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There is mounting evidence of the value of task-specific training as a neuromotor intervention in neurological rehabilitation. The evidence is founded in the psychology of motor skill learning and in the neuroscience of experience-dependent and learning-dependent neural plastic changes in the brain in animals and humans. Further, there is growing empirical evidence for the effectiveness of task-specific training in rehabilitation and for neural plastic changes following task-oriented training. In this paper, we position the evidence for task-specific training in the context of rehabilitation; review its relevance for occupation-based neurological rehabilitation, particularly in relation to upper limb function and everyday activities; and recommend evidence-driven strategies for its application. We recommend that task-specific training be routinely applied by occupational therapists as a component of their neuromotor interventions, particularly in management related to post-stroke upper limb recovery. Specifically, we propose five implementation strategies based on review of the evidence. These are: task-specific training should be relevant to the patient/client and to the context; be randomly assigned; be repetitive and involve massed practice; aim towards reconstruction of the whole task; and be reinforced with positive and timely feedback. Copyright (C) 2009 John Wiley & Sons, Ltd.
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