Evaluation of a task-oriented client-centered upper extremity skilled performance training module in persons with tetraplegia

Spooren, Annemie; Janssen-Potten, Yvonne; Kerckhofs, Eric; Bongers, H M H; Seelen, Henk

doi:10.1038/sc.2011.54

Cited by 32 publications

(42 citation statements)

References 18 publications

(28 reference statements)

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“…However, it may be possible that combining a client-centred approach with components related to motor learning, like context specificity and exercise variety, and principle to grade and progress the client-centred training in which training parameters are well controlled, result in better outcome after training and at follow-up. The latter is supported by the studies of Spooren et al who applied a task-oriented client-centred training program (ToCUEST) in SCI [18,41] and Timmermans et al who applied a client-centred technology supported task-oriented training program (T-TOAT) in stroke [42]. Both programs combined the client-centred component with the explicit use of various training components, based on motor learning and training physiology, and demonstrated an improvement in upper extremity functioning [41,42].…”

Section: Discussionmentioning

confidence: 84%

Motor training programs of arm and hand in patients with MS according to different levels of the ICF: a systematic review

2012

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BackgroundThe upper extremity plays an important role in daily functioning of patients with Multiple Sclerosis (MS) and strongly influences their quality of life. However, an explicit overview of arm-hand training programs is lacking. The present review aims to investigate the training components and the outcome of motor training programs for arm and hand in MS.MethodsA computerized systematic literature search in 5 databases (PubMed, CINAHL, EMBASE, PEDro and Cochrane) was performed using the following Mesh terms: Multiple Sclerosis, Rehabilitation, Physical Education and Training, Exercise, Patient-Centered Care, Upper Extremity, Activities of Daily Living, Motor Skills, Motor Activity, Intervention Studies and Clinical Trial. The methodological quality of the selected articles was scored with the Van Tulder Checklist. A descriptive analyses was performed using the PICO principle, including scoring of training components with the calculation of Hedges’g effect sizes.ResultsEleven studies were eligible (mean Van Tulder-score = 10.82(SD2.96)). Most studies reported a specific improvement in arm hand performance at the ICF level that was trained at. The mean number of training components was 5.5(SD2.8) and a significant correlation (r = 0.67; p < 0.05) between the number of training components and effect sizes was found. The components ‘client-centered’ and ‘functional movement’ were most frequently used, whereas ‘distribution based practice’, ‘feedback’ and ‘random practice’ were never used. The component ‘exercise progression’ was only used in studies with single ICF body function training, with the exception of 1 study with activity level training. Studies including the component ‘client-centred’ demonstrated moderate to high effect sizes.ConclusionMotor training programs (both at the ICF body function and activity level) have shown to improve arm and hand performance in MS in which the value of the training specificity was emphasized. To optimize upper extremity training in MS the component ‘client-centred’ and ‘exercise progression’ may be important. Furthermore, given the importance attributed to the components ‘distribution based practice’, ‘feedback’ and ‘random practice’ in previous research in stroke patients, the use of these components in arm hand training should be explored in future research.

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Section: Discussionmentioning

confidence: 84%

Motor training programs of arm and hand in patients with MS according to different levels of the ICF: a systematic review

2012

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“…9,11 For each of these components, exercises were offered at increasing levels of difficulty with the feedback delivered according to the shaping principles. 12 Exercise progression was based on principles of training physiology 4 and motor learning. 5 Regarding training physiology, a goal-dependent functional and specific skill training was offered with training loads exceeding the patient's metabolic capacity (overload principle 4 ).…”

Section: Materials and Interventionmentioning

confidence: 99%

Robot-assisted task-oriented upper extremity skill training in cervical spinal cord injury: a feasibility study

et al. 2015

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Study design: Prospective multiple case study. Objectives: To test (1) the feasibility of haptic robot technology (Haptic Master (HM)) use to improve arm-hand function (AHF) and arm-hand skill performance (AHSP) in persons with a cervical spinal cord injury (C-SCI), (2) inventory participants' motivation and expectation to work with the robot technology used and (3) to descriptively report the results in individual cases. Setting: Rehabilitation Centre. Methods: Five C-SCI patients were trained for 6 weeks, 3 days per week, 60 min per day. Therapists filled out the Usefulness, Satisfaction and Ease-of-use questionnaire (USE). The Intrinsic Motivational Inventory (IMI) and credibility and expectancy questionnaire (CEQ) were filled out by participants. Performance at activity level was gauged using the Van Lieshout test for AHF in Tetraplegia and the Spinal Cord Independence Measure. Function level was gauged using muscle strength testing and the International Classification for Surgery of the Hand in Tetraplegia. Results: As to the feasibility of the application of haptic robot technology, the mean USE score was 65%. Mean IMI and CEQ results were 67% and 60%, respectively. Participants were motivated to train with the HM. All participants rated credibility higher than expectations regarding the improvement. In the current patients, little progress was demonstrated at the International Classification of Functioning, Disability and Health function and the activity level. Conclusion: It is feasible to train C-SCI persons with the HM. Therapists report that working with the HM is easy to learn and easy to perform. Usability of the HM may be improved. Further research is needed to assess in which group of C-SCI and at which stage of rehabilitation HM training may be most beneficial.

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“…In Spooren et al 21 the ToCUEST module will be evaluated with regard to the added value of combining the client-centered and taskoriented components into a training program to improve upper extremity skilled performance in persons with C-SCI.…”

Section: Discussionmentioning

confidence: 99%

ToCUEST: a task-oriented client-centered training module to improve upper extremity skilled performance in cervical spinal cord-injured persons

et al. 2011

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Objectives: Given (a) the importance of upper extremity skill performance in persons with cervical spinal cord injury (C-SCI), (b) the limited number of studies on arm hand functioning in C-SCI and (c) the discrepancy between the importance of client centeredness and the lack of a theoretical framework and practical guidelines on how to apply client centeredness into practice, the aim of the present study is to (1) develop a training concept in which rehabilitation of the upper extremity focuses on patient's needs and wishes and (2) to put this concept into practice for tetraplegic persons. Methods: The training concept contains two main components. The client-centered component includes both extracting individual goals and defining and objectifying these goals. The task-oriented component incorporates a task analysis and the composition of an individual training program. Results: A task-oriented client-centered training aimed at improving upper extremity skilled performance in tetraplegic persons is described step by step. The Canadian Occupational Performance Measure is used to identify patient's specific needs. The Goal Attainment Scale is applied to define and objectify individual goals. A task analysis is essential to map limiting and facilitating factors of the person, the task and the environment and to identify which aspects should be trained. An individual task-oriented training program is composed, based on principles of motor learning and training physiology and the use of assistive devices. Each step is explained and illustrated using a case example.

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Evaluation of a task-oriented client-centered upper extremity skilled performance training module in persons with tetraplegia

Cited by 32 publications

References 18 publications

Motor training programs of arm and hand in patients with MS according to different levels of the ICF: a systematic review

Motor training programs of arm and hand in patients with MS according to different levels of the ICF: a systematic review

Robot-assisted task-oriented upper extremity skill training in cervical spinal cord injury: a feasibility study

ToCUEST: a task-oriented client-centered training module to improve upper extremity skilled performance in cervical spinal cord-injured persons

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