Article

Objectives: Given (a) the importance of upper extremity skill performance in
persons with cervical spinal cord injury (C-SCI), (b) the limited number of
studies on arm hand functioning in C-SCI and (c) the discrepancy between the
importance of client centeredness and the lack of a theoretical framework and
practical guidelines on how to apply client centeredness into practice, the aim
of the present study is to (1) develop a training concept in which rehabilitation
of the upper extremity focuses on patient's needs and wishes and (2) to put this
concept into practice for tetraplegic persons.Methods: The training concept
contains two main components. The client-centered component includes both
extracting individual goals and defining and objectifying these goals. The
task-oriented component incorporates a task analysis and the composition of an
individual training program.Results: A task-oriented client-centered training
aimed at improving upper extremity skilled performance in tetraplegic persons is
described step by step. The Canadian Occupational Performance Measure is used to
identify patient's specific needs. The Goal Attainment Scale is applied to define
and objectify individual goals.
A task analysis is essential to map limiting and
facilitating factors of the person, the task and the environment and to identify
which aspects should be trained. An individual task-oriented training program is
composed, based on principles of motor learning and training physiology and the
use of assistive devices. Each step is explained and illustrated using a case example.

Langue : ANGLAIS