Occupational Therapy Task Oriented Approach.

Want to become a member of this facebook group? It offers interesting research, this blog, and open discussion.

https://www.facebook.com/groups/279873255759689

Last week someone asked me, what the difference was between task specific training and occupational therapy task oriented approach. Today we will talk about the difference.

Task specific training is a specific intervention used in stroke rehabilitation. It has many names, including repetitive task specific training and task oriented training. It involves repeatedly performing a task over and over to improve the function of the arm. The task can be broken down into several steps so the component movements of the task are practiced over and over again. When performing task specific practice, it is important to grade the task and gradually make it more difficult or easier, depending how the client is doing.

The Occupational Therapy Task Oriented Approach is a comprehensive model. It has suggestions for what evaluations to use. It clarifies basic scientific assumptions that can be empirically tested.  It shares scientific research on where the model came from in the first place, and it also gives treatment principles that can be used in occupational therapy.

There are several very helpful treatment principles used in the occupational therapy task oriented approach.

Looking for quality continuing education in the convenience of your own home? http://bit.ly/2rWhcbO

Patients learn to adjust to role and task performance limitations. For example, let’s say that a client had a stroke and one of his proudest roles was to be a grandparent to his grandson. Every Sunday afternoon, they would get together and throw the baseball around.  Now since this client had a stroke and is in a wheelchair, primarily as his main mode of mobility, he has lost his ability to participate in this activity. One suggestion, besides using a restorative approach, would be to learn to propel his wheelchair safely in the back deck so he can play a board game on the table. That way he can continue to connect with his grandchild.

Create a rehab environment that uses the common challenges of every day activities. I think most rehab units are going to this structure. From early morning ADL routines to laundry rooms to kitchens and even real life environments like Easy Street. Many therapy rehab units have remodeled their clinics to help simulate environments in which clients interact.

Practice task or close functional simulations to find effective strategies for performance. I think this is very important. Especially when the client has enough movement for this to be realistic, and it’s been shown in research that the kinematics of movement are much different when one performs a real task instead of a simple exercise, even a meta analytic review provided some evidence that suggested that engagement in purposeful activity produces better quality movement than concentration on exercise alone.

Provide practice time outside of therapy. 90 minutes of occupational therapy is not going to cut it. So every opportunity then the client has to practice their new skills is essential. So it is imperative that you train the nurses and the nursing assistant, the physical therapist, the speech therapists on specific activities of daily living or movement strategies that you desire.

The use of contemporary motor learning training. This means using random, variable practice within natural environments. It is also essential to provide decreasing amounts of physical guidance and verbal feedback as the client improves as well as teaching the patient how to analyze their own tasks and problem solve through new situations as they become better with their basic living tasks.

Developing effective and efficient movement patterns for occupational performance. This includes restoring a client factor if the impairment is one of the underlying areas that is making occupational performance difficult. This certainly could include limited strength & coordination of the arm. Task specific training or task oriented training is a prime example of this. In fact, research demonstrates strong evidence that this is an effective technique to improve impairments. However, new research is suggesting that although it most likely will help on the impairment level, it may not generalize to ADL performance or real life participation. So task specific training should not be used alone when the goal is to improve upon the occupational therapy outcome. And then of course adapting the environment, modifying the task, using assisted technology or techniques to reduce the effects of gravity is a great way to improve upon new movement patterns.

Almhdawi, K. A., Mathiowetz, V. G., White, M., & delMas, R. C. (2016). Efficacy of Occupational Therapy Task‐oriented Approach in Upper Extremity Post‐stroke Rehabilitation. Occupational Therapy International, 23(4), 444-456.