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

Abstract

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.

Enhancing functional improvement in reablement – a qualitative study

“…The user's actual participation in the decision-making process can therefore be questioned. A systematic review [6], identified clear value to consider shared decision making within rehabilitation settings, which also corresponds with the motor learning principle of meaningfulness [20,38]. A lack of meaningfulness can weaken important elements of learning such as emotions and motivation.…”

“…Larin [40] argues that purposeful tasks are more appropriate than passive behaviours to promote motor learning. Based on behavioural neuroscience and contemporary models of motor learning, meaningful activities targeting the user's goals are described as essential to recover function [30,36,38,41]. Thorough insights into the user's individual motivation and integration of the user's goals in treatment have been reported to increase success compared with constrained movements selected by the instructor [40].…”

“…Scholars support the use of a task-oriented approach in rehabilitation to enhance functional ability [44][45][46][47]. Task-oriented training is a contemporary intervention based on behavioural neuroscience and recent models of motor learning, which emphasise meaningful activities, consistency, flexibility and efficiency, and constraints to body function and structure [38,48]. Task-oriented training emphasises both quantitative and qualitative aspects of movement, as well as participation in roles, routines and habits [38], in line with our observations of the combined reablement approach.…”

Occupational adaptation – analyzing the maturity and understanding of the concept through concept analysis

“…A range of papers elaborated on the adaptive response sub-processes outlined by Schultz and Schkade [80,52,54,[81][82][83][84][85][86][87]. Other internal processes were also identified.…”

“…Wells [88] highlighted the occupational adaptation of a group of Mexican-American patients on renal dialysis involved conscious awareness, self-reflection, and choice. Rowe and Neville [85] described that problem-solving was an integral internal process of occupational adaptation.…”