Role of the PTA

A PTA must consider each patient's functional level, motivation, endurance, treatment goals (including discharge plan), and environment when planning an intervention for improving function. PTAs are trained in functional task analysis. In short, PTAs make observations and comparisons and apply their knowledge of body movements, posture, balance, safety, cognition, and endurance to specific task requirements for the patient. PTAs select interventions within the plan of care to improve performance and retention of safe and effective movement strategies. In order for a PTA to be an effective patient educator, a PTA must apply motor learning principles and strategies during the treatment session and in planning treatment progressions.

Remember, patients need to have the opportunity to be successful, so they can internalize their performance and truly learn. Some basic considerations are:

• closed environments are easier than open.
• changing the set up or conditions between skill attempts makes the task more functional, but more difficult
• practicing activities where the body can be still is easier than practicing while asking your patient to move from one place/position to another
• quiet environments are less distracting (e.g., less "open") than noisy, active environments
• anything that requires fine motor control (e.g., use of hands to manipulate objects) will be more challenging than those which do not
• patient rapport influences motor learning

Tests Measures Used To Assess Motor Performance and Learning

PTAs use tests and measures to document the result of exercise instruction and functional mobility training. Motor performance and motor learning are assessed as the patient demonstrates the selected activity. For home exercise planning and assessment, PTAs should include some information which provides evidence that the patient understands (or does not understand) instructions and/or precautions for exercise. Parameters used to quantify and document progress with task-performance and motor learning include:

• amount: number of sets/reps of an exercise, increase or decrease in substitute or compensatory movement patterns
• duration: includes reaction time, time to initiate, or amount of sustained activity
• speed/rate: how fast/slow to start/end a task
• accuracy: includes number and type of errors (e.g., loss of balance) or external cues needed
• functional level of assist: includes patient ability to execute the skill with or without help; ranges from Dependent to Independent
• trials: number of attempts to complete or number of training sessions to reach outcome
• retention: ability to recall (e.g., repeat back the instructions, remembering to reference home exercise instructions, etc.) and repeat (demonstrate) skill independently
• Standardized outcome measures - task-specific standardized tests for gait, balance, function, etc. can be used to document varying levels of patient autonomy in activities of daily living

toc | return to top | previous page