Teaching New Techniques

Teaching New Techniques

 

When working with a client, as they progress from the basics to more complex activities, a close eye on their technique and motor skills is extremely important in order to maximize their "gains" while avoiding injury.  There are three stages of motor skill development.  The first stage, called the Cognitive Stage, provides constant external coaching by you, the instructor.  You introduce the new technique and then provide the visual, verbal and manual cues to your client in order for them to perform the activity properly.  You may have to place your hands on your client to correclty move them or cue them on stability at this time.  Body Awareness and proprioception are touched on here, but they are not the main focus yet. 

The second stage is the Motor Stage.  During this phase, your client is performing the technique efficiently and consistently.  They know when they make a mistake and can adjust appropriately.  Body Awareness for the skill and proprioceptive feedback become the prevalent form of feedback.  This is when I begin to reduce the use of mirrors and visual/manual feedback.  I stand back and only assist to prevent injury.  This is the "practicing stage."  To move onto the next stage, your client must practice the activity frequently. 

The third stage is the Automatic Stage.  Here, your client is able to perform the activity properly, efficiently and with minimal assistance by you.  Know which stage your client is in, because giving too much feedback can be just as bad as too little feedback.



Functional Training & Observation Skills

We have all heard of Functional Training.  Many of us think of High Intensity Training using Kettlebells, Sandbags, Suspension Training, but it does not stop there.  That may be beneficial for an athlete to maximize his/her performance.  However, what about clients in their 50s, 60s or older, who are looking to improve their quality of life, not their athletic performance?  How do we incorporate Functional Training into their life? 

Just like any of your other clients, find out what their goals are upon the initial evaluation.  For example, presently I have a patient who is recovering from a fractured femur.  She had corrective surgery and during her first session, she stated how happy she would be if she could get down into the bath tub again.  My first goal is to improve her 'quality of life' by helping her return to her prior functional level.  I need to get her to be able to take a bath again.  Initially, if she is having trouble with the basics, such as getting up and down from a chair or is unsteady when walking, I will need to give her a standard strength and balance program (for her legs especially).  I will also need to assess her bathroom, including the size of the tub and the direction of the faucet controls so that I can make the transfer as efficient as possible.

Now here is where the task observation comes into play.  In order for her to transfer safely into the tub I need to break the entire task down into its individual parts, and focus on each part prior to attempting the entire task.  First, she needs to be able to approach the tub, and lift each leg high enough to get into the tub.  Then she needs to be able to transfer into a lunge, then tall kneeling, side-sitting, and sitting with legs stretched in front of her.  To get out of the tub she will need to roll over into quadruped (on hands and knees), into tall kneeling, lunging, standing and finally lift each leg high enough to get out of the tub safely. 

Who would have thought it took so much work to get in and out of the bath tub?  Each session, I work on these individual components, and will eventually take her into her bathroom in order to practice the entire task. 

Your goal is to be observant of the task at hand.  Learn your client's strengths and weaknesses and customize the task to their abilities.  Break down the activity that your client is trying to relearn into its component parts, which will be easier for your client to initially learn and master.   Then, for proper carryover, you need to have your client perform as many of the individual components in proper order as soon as possible, so that it makes sense to your client why she is performing all these exercises/activities.  

Repetition of the task will establish motor patterns in the brain. And before you know it, your goal will be accomplished.   Remember, if you must break the task down into component parts, the trick is to 'bring it all together' as soon as safely possible for actual learning and retention to occur.