- Define neurofacilitation approach and task-oriented approach, and compare the biggest differences between these two approaches.
Neurofacilitation:
This approach suggests that normal movement results from a chain of reflexes organized hierarchically within the central nervous system (control of movement is going from the up to down). Normal movement requires that the cortex be in control of the brainstem and the spinal cord (2 lower centers) of the central nervous system. Here, emphasis is placed on the understanding that incoming sensory information stimulates and, thus, drive a normal pattern movement.
Thus, under this approach, abnormal movement patterns are considered to be a direct result of a lesion (not developed secondarily, in compensation to the lesion).
When considering restoration of function, to restore normal motor control higher centers of the central nervous system must regain control over the lower centers. There are 2 key assumptions:
-functional skills with automatically return once abnormal movement patterns are inhibited and normal movement patterns facilitated
-repetition of normal movement will automatically transfer to functional tasks
Task-oriented approach
This approach suggests that normal movement emerges as an interaction among different system which require independent practice. In addition, movement is organized around behavioral goals, constrained by the environment. With this approach, the therapist directs the patient’s focus of attention away from an internal body-oriented focus (the feet, upper body movement) to an external focus that is directed towards the goal (e.g. avoid obstacles on the floor). Moreover, adaptation to change in the environment context is a difficult part of the recovery function. In this context, patients are helped to learn different ways to solve the task goal rather than a single muscle activation pattern. Therefore, a goal in intervention may be improving the efficiency of compensatory strategies used to perform functional tasks.
Major differences:
The main difference between both approaches revolve around the assumptions. As a result, neurofacilitation promote a normal pattern movement in order to be able to do the functional task. However, a task-oriented task aims to provide patient’s abilities to solve functional tasks within the boundaries of the remaining system under varying environment.
Jehanne Crouzier 