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LEARNING OBJECTIVES
Utilize a hybrid model for clinical decision-making that integrates current concepts of function and disability with key considerations for motor control and motor learning.
Link types of skilled movements to the motor control strategies that coordinate them.
Pair key motor learning factors to the respective neural networks that support them.
Apply principles of neuroplasticity to the design and implementation of effective, evidence-based treatment plans.
Categorize constraints on motor function as being associated with the individual, task, or environment and determine intervention strategies based on that assessment.
Identify individuals’ stage of motor learning based on descriptions of skill performance and incorporate appropriate instruction, practice, and feedback principles into therapeutic activities.
Analyze and interpret patient data, anticipate outcomes, formulate goals, and develop a plan of care that presents an integrated approach to treatment for individual cases.
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As physical therapists, we focus on our patients and their ability to produce functional, goal-directed movement. Our primary role is to teach people to move in new or better ways through effective instruction, practice, and feedback, and to develop meaningful and challenging, yet achievable, goals to benchmark progress and provide motivation. We must address the limitations and resources of each person and understand the demands of the tasks and the environmental context in which they will be performed. We also need to understand the processes involved in learning and producing movement, regardless of diagnosis.
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Section One in this textbook covers the examination of the body structures and functional systems in detail. This chapter will focus on key motor control features and motor learning principles involved in performing, acquiring, and improving movement skills. These considerations form the clinical decision-making framework for realistic goal-setting and effective treatment planning that broadly considers all movement factors, not just those associated with the performer.
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Foundational Concepts/Theoretical Models
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The World Health Organization's (WHO's) International Classification of Function, Disability and Health (ICF) Model,1 introduced in Chapter 1, Clinical Decision-Making, provides a framework for describing and organizing information on function and disability. It recognizes the role of environmental factors in the creation of disability, as well as the relevance of associated health conditions and their effects. These components align well with Newell's model of constraints that influence the learning and production of movement skills: the individual's capacity for movement, the requirements of the task or activity, and the environmental situations in which the activity is performed.2 Figure 10.1 represents a hybrid model incorporating the overlapping principles of these two concepts and provides the framework for the rest of this chapter.
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