Task-Oriented Training-Lower Extremity/Mobility
Authors: Elissa Sitcoff, BSc., B.A., Camille Costa PTU3, Nicol Korner-Bitensky, PhD OT
Task-Oriented Training takes a typical task that we do in daily life, such as drinking from a glass, and breaks that task into smaller parts required to complete it successfully. An individual undergoing Task-Oriented Training will learn small components of the movement needed to do the task, such as straightening out their elbow, and will practice this movement over and over again. Usually this treatment is done with guidance from a therapist. The goal is to work on regaining some of the movements that were lost after the stroke.
A stroke often leaves a person with problems using their arms and legs. Task-Oriented Training is a treatment in which you repeat a series of specific movements over and over again. The goal is to improve functional use of your arms and legs.
Task-Oriented Training exercises are categorized as either blocked practice or random practice.
Blocked Practice = The same movement is repeated over and over - for example, always using the same movement pattern to reach for a glass of water. Random Practice = Any movement necessary to achieve a goal, - for example, using any movements you can to try to reach for a glass of water.
Researchers have studied how Task-Oriented Training can help individuals who have had a stroke. We separate the information into training for arms and training for legs.
Arms: Research has shown that for a person who has had a stroke, Task-Oriented Training is effective in improving arm reaching and range of movement. Studies have shown that it is not effective in improving functional independence in everyday activities The results are not clear as to whether Repetitive Task Training can improve how quickly you respond to a stimulus when using your hand (like swatting at a mosquito) and we do not have strong scientific evidence that it improves hand use.
Legs: The research studies conflict as to whether Task-Oriented Training of the legs and trunk can improve walking and trunk stability following a stroke. Note: There is an ongoing debate about the intensity and frequency of the treatment sessions required to show a positive effect of this treatment. There is also controversy regarding whether it is better to use random practice or blocked practice.
The occupational therapist or physical therapist providing the treatment will do exercises with you and may also give you exercises to do on your own or with a family member or friend.
There is little risk related to Task-Oriented Training. Side effects could include sore muscles just like after beginning any new exercise program. At one point, you will probably begin practicing Task-Oriented Training exercises with your family or friends. Before you do this, your therapist should show them safe ways of working with you.
Task-Oriented Training can improve a person's arm function and may improve leg function following a stroke. Scientific evidence shows that it works to improve range of motion and reaching ability. There is conflicting scientific evidence as to whether it can improve how quickly you respond to stimulus, how well your hand functions and how stable you are when standing and how well you walk. It is a therapy with minimal risks, and people who have had a stroke have found it very helpful.