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Optimizing Outcomes in Rehabilitation: Motor Learning Principles and Beyond: Summary
How to Build Autonomy • Encourage patients to actively engage in their care decisions • Involve patients in setting therapy goals • Offer choices during therapy sessions, allowing patients to select the order or type of activities • Allow patients to decide when they want feedback or guidance • Collaborate with patients in the evaluation process, discussing their perspectives on their issues • Introduce meaningful and challenging tasks to increase patient engagement • Enhance self-efficacy by increasing anticipation of success through collaboration and autonomy support
• Encourage patients to focus on factors external to the body instead of getting too caught up in the intricate details of their movements The road to rehabilitation is multi-faceted. It calls for a thorough understanding of motor learning, neuroplasticity, patient autonomy, and evidence-based strategies. By customizing therapy to meet each patient’s unique needs, fine-tuning the intensity, delivering constructive feedback, and nurturing autonomy, providers have the power to positively influence their patients’ journey to recovery.
CASE STUDY: EXTERNAL FOCUS
Amy is a 30-year-old woman who experienced a traumatic brain injury when she was struck by a car while crossing a busy street. She was admitted as a patient in an inpatient rehabilitation center but had reached a plateau in her therapy. Despite the efforts of her therapists, Amy often displayed lethargy and a lack of enthusiasm during sessions. Amy’s team recognized the need to shift her focus from internal aspects of movement to external targets, promoting an external focus of attention. External focus means directing one’s attention to a specific target or goal, rather than getting overly absorbed in the internal mechanics of a movement. This approach aimed to enhance her performance and motivation.
In Amy’s case, instead of asking her to concentrate on internal elements like joint angles and muscle engagement, her therapists introduced external cues such as stepping on specific tiles or aiming for targets on the floor. This helped improve her engagement and performance, as it allowed her implicit motor system to take over without interference from her explicit system. Additionally, Amy’s therapists understood the significance of making therapy sessions goal-oriented, meaningful, and engaging.
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