detailed note on the Task-Oriented Approach, based entirely on Annie Shumway-Cook's
"Motor Control: Translating Research into Clinical Practice" (especially 5th edition).
🧠 Task-Oriented Approach to Motor
Control
📘 Based on Shumway-Cook & Woollacott – Motor Control: Translating
Research into Clinical Practice
🔹 1. What is the Task-Oriented Approach?
The task-oriented approach is a motor control and rehabilitation strategy that emphasizes
practicing functional tasks in real-world contexts, rather than isolated muscle strengthening
or reflex-based training. It is grounded in systems theory, which views movement as an
interaction between the individual, the task, and the environment.
🔹 2. Theoretical Foundations
Based on Systems Theory of Motor Control:
o Movement arises from the interaction of multiple systems.
o Motor behavior is goal-directed and context-dependent.
Emphasizes neuroplasticity and the brain’s capacity to reorganize with practice.
🔹 3. Key Principles of Task-Oriented Approach
Principle Explanation
Movement is goal- Training should focus on real-life tasks (e.g., reaching, standing,
directed walking).
Active problem-solving Patients should figure out solutions, not just follow commands.
Functional relevance Practice must relate to tasks meaningful to the patient.
Skills are practiced in different environments, speeds, and
Variability of practice
contexts.
Sensory feedback Essential for error correction and learning.
Environmental
Context changes how a task is executed.
interaction
Use of patient’s strength Focus on what the patient can do and build from there.
🔹 4. Components of Movement: The Interaction Model
Individual: cognitive, sensory/perceptual, and motor systems
Task: mobility, stability, manipulation demands
Environment: regulatory (must conform to) and non-regulatory (may influence)
🔹 5. Clinical Application of Task-Oriented Training
✅ Step-by-step approach:
1. Identify functional goals (e.g., stand independently)
2. Analyze movement required for the task
3. Determine constraints in the patient (motor, sensory, cognitive)
4. Design practice sessions:
o High repetitions
o Progressive difficulty
o Real-life task simulation
5. Provide feedback (knowledge of performance and results)
6. Evaluate outcomes (objective and functional scales)
🔹 6. Examples of Task-Oriented Practice
Task Training Focus
Sit-to-stand Weight shifting, momentum generation, lower limb strength
Walking Gait initiation, step symmetry, obstacle negotiation
Reaching/grasping Shoulder/elbow control, object manipulation, hand opening
Dressing Bilateral coordination, trunk control, problem-solving
Transfers Trunk alignment, sequencing, anticipatory postural adjustments
🔹 7. Comparison with Traditional Approaches
Traditional NDT/Reflex-Based Task-Oriented Approach
Focus on normalizing tone Focus on functional goal achievement
Emphasizes passive handling Encourages active problem-solving
Task broken into components Task practiced as a whole
Therapist-directed Patient-driven exploration and repetition
🔹 8. Evidence-Based Outcomes
Improves functional recovery faster and more effectively.
Enhances patient motivation and participation.
Demonstrates neuroplastic changes on imaging and electrophysiology.
Used extensively in stroke, TBI, SCI, PD, and CP rehab.
🔹 9. Limitations
May not suit patients with severe cognitive impairment.
Requires therapist expertise in task analysis.
Needs time and varied equipment.
🔹 10. Conclusion
“Rehabilitation should be about retraining meaningful activities in meaningful environments
using strategies that mirror the complexity of real life.” – Shumway-Cook
The task-oriented approach empowers patients, promotes real-world skill transfer, and is
one of the most effective evidence-based methods for motor rehabilitation in neurological
conditions.
Would you like a flowchart of this approach, case application, or a comparison with
other motor learning theories (like NDT, Brunnstrom, Rood)?
