Client Perceptions of Task-Oriented Training at Home: "I Forgot I Was Sick".

Area of Science:

• Neuroscience
• Rehabilitation Science
• Occupational Therapy

Background:

• Task-oriented training (TOT) integrates behavioral neuroscience and motor learning principles.
• The theory of occupational adaptation provides a framework for understanding adaptation.
• Upper extremity hemiparesis is a common impairment following stroke.

Purpose of the Study:

• To explore participant perceptions of task-oriented training at home (TOTE Home) for upper extremity hemiparesis.
• To understand the lived experiences of individuals undergoing TOTE Home.
• To identify key themes influencing the adaptation process in home-based stroke rehabilitation.

Main Methods:

• A directed content analysis was employed.
• Field notes from TOTE Home sessions were analyzed.
• Four participants with upper extremity hemiparesis post-stroke were included.

Main Results:

• Three emergent themes: salience of activity in context, desire for mastery through 'just right challenge,' and adapted self-perception.
• Motor learning principles guided practice and feedback.
• Motivation for meaningful activities was a primary driver of adaptation.

Conclusions:

• Meaningful activity engagement is central to the adaptive process in TOTE Home.
• The combination of motor learning and occupational adaptation principles enhances rehabilitation.
• Participant-driven motivation is key for successful home-based stroke recovery.