Task-Oriented Training – upper extremity

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 upper extremity function.
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) were excluded. To date 10 high quality RCTs, 1 of fair quality and 1 pre-post single group design that meet the above inclusion criteria have investigated this topic.  Please note that the Cochrane Review by French et al. (2010) used different inclusion criteria and classification of outcomes, thus the findings differ somewhat from ours.

Authors*: Annabel McDermott, BOccThy; Adam Kagan, BSc BA; Carole Richards, Ph. D PT ; Nicol Korner-Bitensky, Ph. D OT

Evidence reviewed as of before 13-07-2014  

NOTE: *The authors have no direct financial interest in any tools, tests or interventions presented in StrokEngine.