Rowe Veronica T, Neville Marsha
1 University of Central Arkansas, Conway, USA.
2 Texas Woman's University, Dallas, USA.
OTJR (Thorofare N J). 2018 Jan;38(1):46-55. doi: 10.1177/1539449217727120. Epub 2017 Aug 31.
Principles of experience-dependent plasticity, motor learning theory, and the theory of Occupational Adaptation coalesce into a translational model for practice in neurorehabilitation. The objective of this study was to explore the effectiveness of a Task Oriented Training and Evaluation at Home (TOTE Home) program completed by people with subacute stroke, and whether effects persisted 1 month after this training. A single-subject design included a maximum of 30, 1hour sessions of training conducted in participants' homes. Repeated target measures of accelerometry and level of confidence were used to assess movement and confidence in weaker arm use through baseline, intervention, and follow-up phases of TOTE Home. Four participants completed TOTE Home and each demonstrated improvement in movement and confidence in function. The degree of improvement varied between participants, but a detectable change was evident in outcome measures. TOTE Home, using client-centered, salient tasks not only improved motor function but also facilitated an adaptive response demonstrated in continued improvement beyond the intervention.
经验依赖性可塑性原理、运动学习理论和职业适应理论融合成一种用于神经康复实践的转化模型。本研究的目的是探讨亚急性中风患者完成的家庭任务导向训练与评估（TOTE Home）计划的有效性，以及这种训练效果在训练后1个月是否持续存在。单受试者设计包括在参与者家中进行最多30次、每次1小时的训练课程 sessions。通过TOTE Home的基线、干预和随访阶段，使用加速度计的重复目标测量和信心水平来评估较弱手臂使用中的运动和信心。四名参与者完成了TOTE Home，每个人在运动和功能信心方面都有改善。参与者之间的改善程度各不相同，但在结果测量中明显有可检测到的变化。TOTE Home使用以客户为中心的突出任务，不仅改善了运动功能，还促进了一种适应性反应，表现为在干预后持续改善。
