Motor teaching in rehabilitation practice
Motor teaching in rehabilitation practice
How do rehabilitation practitioners support their patients in (re)learning motor skills?
This PhD dissertation of Jorine Schoenmaker examines which teaching strategies practitioners use to promote motor learning in their patients. To analyze the use of teaching strategies, a new observation instrument (the OPTIMAL Strategies Observational Tool; OSOT) has been developed based on the OPTIMAL theory. This theory focuses on three factors: autonomy, expectancies and attentional focus (internal – inside the body, or external – to the environment). Throughout the dissertation’s studies. the OSOT has been employed to map in detail which motor teaching strategies physiotherapists and dance teachers use for three rehabilitation populations: children with Developmental Coordination Disorder (DCD), people with Parkinson's disease and people after a stroke.
In all three populations, practitioners appear to mainly use autonomy-supporting and expectancies -enhancing strategies (as opposed to therapist-controlled and expectancies-lowering strategies) and both external and internal attention focus. At the level of specific strategies, however, population-specific differences appear. Furthermore, tailoring appears to be a vital component of motor teaching in practice; practitioners adjust their teaching strategies to the characteristics and needs of the individual patient. Notably, therapists often seem to make these choices based on experience, without always being consciously aware of doing so.
In order to further advance rehabilitation practice, it is essential to formally articulate the actions and underlying choices and reasoning of practitioners, so that effective motor teaching elements from their daily practice, as well as opportunities for further improvement, can be identified.