Task-specific training: evidence for and translation to clinical practice.
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.
Hubbard
Isobel J
IJ
Acute Stroke Unit, John Hunter Hospital, Hunter New England Area Health Service, Newcastle, and the University of Newcastle, Newcastle, Australia.
Parsons
Mark W
MW
Neilson
Cheryl
C
Carey
Leeanne M
LM
D000203:Activities of Daily Living; D000818:Animals; D006801:Humans; D009044:Motor Cortex / Q000503:physiopathology; D009048:Motor Skills / Q000502:physiology*; D009473:Neuronal Plasticity / Q000502:physiology; D009788:Occupational Therapy / Q000379:methods*; D011788:Quality of Life; D020127:Recovery of Function / Q000502:physiology; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013647:Task Performance and Analysis; D034941:Upper Extremity