Task-Oriented Training-Lower Extremity/Mobility
Task-oriented training involves practicing real-life tasks (such as walking or answering a telephone), with the intention of acquiring or reacquiring a skill (defined by consistency, flexibility and efficiency). The tasks should be challenging and progressively adapted and should involve active participation (Wolf & Winstein, 2009). It is important to note that it differs from repetitive training, where a task is usually divided into component parts and then reassembled into an overall task once each component is learned. Repetitive training is usually considered a bottom-up approach, and is missing the end-goal of acquiring a skill.
Task-oriented training can involve the use of a technological aid as long as the technology allows the patient to be actively involved. Task-oriented training is also sometimes called task-specific training, goal-directed training, and functional task practice.
This particular module focuses on task-oriented training intended specifically to improve lower extremity function and mobility.
NOTE: Studies were excluded if the intervention did not involve: 1) practicing a salient, real-life task, 2) progressively adapting the task to the patient's progress over time, or 3) active participation by the patient. As well, studies that mixed task-oriented training with other types of exercise (e.g. aerobic, strength), or that compared one type of task-oriented training to another type of task-oriented training (e.g. different types of feedback, or different types of gait training) without varying the intensity were excluded.
To date 8 high quality RCTs, 1 fair quality RCT and 1 quasi-experimental study that meet the above inclusion criteria have investigated this topic. Please note that the recent Cochrane Review by French et al. (2010) used different inclusion criteria and classification of outcomes, thus the findings differ somewhat from those reported on StrokEngine.
Authors*: Adam Kagan, B.Sc.; Dr. Nicol Korner-Bitensky PhD OT