Background

Task-based motor control interventions are strategies that the occupational therapist (OT) uses for clients who are experiencing motor control deficits following a brain injury, stroke, or other diagnoses.

Many parts of the brain are involved in producing and fine-tuning movement. Some of these brain regions are the primary motor area, the primary somatosensory area, the premotor area, the supplementary motor area, the basal ganglia, and the cerebellum. Each of these brain areas play a unique role in motor control. Damage to any of these areas may result in functional deficits.

When an individual experiences motor control deficits, it is important to rebuild the brain-body connection to the affected limbs. Task-specific training is an intervention technique that the OT uses that draws upon neuroplasticity principles. Neuroplasticity is the brain’s ability to change itself in response to what we do, what we experience, and what we think. Neuroplasticity describes the way our brains rewire to rebuild connections when we repeat functional task components. Another intervention is called constraint-included movement therapy (CIMT), which describes another potential intervention that the OT implements to encourage a client to use a neglected limb.

No matter which area of the brain is affected, when the OT implements task-based motor control interventions, their client’s lost brain-body connections get rewired and repaired, which improves their functional performance. As the client’s brain is retrained, they are able to increase the affected limb’s use each day. This, in turn, increases the affected limb’s range of motion and muscle strength.

Implementing Task-Based Motor Control Interventions

This video explains principles of neuroplasticity, task-specific motor control interventions, and CIMT.

Video is licensed under CC BY 4.0.

Implementing Task-Based Motor Control Interventions Video Transcript

Principles of Neuroplasticity: Designing a Task Tips

• Make it meaningful and goal directed: The task should hold value for the client and demand the client’s attention.
• Make it intense: The task should be challenging enough that the client is successful in completing the task about 80 percent of the time.
  • If the client is successful more than 90 percent of the time, grade up.
  • If the client is successful less than 50 percent of the time, grade down.
• Make it repetitive: The tasks should be repeated as many times as possible—hundreds of times per session.

Task-Specific Training Tips

• Identify a goal-directed task: for example, playing the piano.
• Break the task down into subcomponents: for example, turning the music page.
• Have the client perform one of the task’s subcomponents with the affected limb for hundreds of repetitions.
• Repeat this step with the other task’s subcomponents.
• Grade the task up and down based on the client’s ability:
  • Strive for the 80 percent success rate.
  • Grade up if the client reports the following: being satisfied with their performance, the task is too easy, or they take less than three seconds to complete the repetitions.
  • Grade down if the client exhibits the following: extreme frustration, takes more than 30 seconds to repeat a repetition, or is unable to perform the necessary number or repetitions.

Resources

• Occupational Therapy and Neuroplasticity After Brain Injury by Shawn Phipps, PhD, MS, OTR/L, FAOTA
• Rehab With Real-World Objects for Improved Hand Use After Stroke, by Alison Scarpa, OTR/L, CSRS