NBCOT Registered Occupational Therapists (OTR) Quiz: Motor Reeducation
20 questions · exam conditions
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Motor ReeducationQuestion 1 of 20

A client with chronic right hemiparesis (>2 years post-CVA) has reached a plateau in outpatient therapy. They have active wrist extension against gravity (MMT 3/5) but lack fractionated finger movement, using a mass grasp pattern for all activities. The OTR wants to implement an evidence-based approach to promote further recovery.

Which motor reeducation intervention is the MOST appropriate choice to specifically address the client's goal of improving individuated finger movements?

A high-intensity, repetitive task practice program focused on gross grasp and release of various-sized objects.
Neuromuscular electrical stimulation (NMES) applied to the finger extensors, synchronized with attempts to open the hand.
A home program consisting of passive range of motion to all finger joints and tendon gliding exercises.
Mirror therapy where the client watches their unaffected hand perform individuated finger movements while trying to mimic them.
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NBCOT Registered Occupational Therapists (OTR) Quiz

NBCOT Registered Occupational Therapists (OTR) Quiz: Motor Reeducation

Practice Motor Reeducation in NBCOT Registered Occupational Therapists (OTR) with focused quiz questions that help you check what you know, review explanations, and build confidence with test-style prompts.

What this quiz covers

This quiz focuses on Motor Reeducation, giving you a quick way to practice the rules, question types, and explanations that matter most for NBCOT Registered Occupational Therapists (OTR).

How to use this quiz

Try each quiz question before looking at the correct answer. Use the explanations to review missed ideas, then come back to similar questions until the pattern feels familiar.

All questions

Question 1

A client with chronic right hemiparesis (>2 years post-CVA) has reached a plateau in outpatient therapy. They have active wrist extension against gravity (MMT 3/5) but lack fractionated finger movement, using a mass grasp pattern for all activities. The OTR wants to implement an evidence-based approach to promote further recovery.

Which motor reeducation intervention is the MOST appropriate choice to specifically address the client's goal of improving individuated finger movements?

  1. A high-intensity, repetitive task practice program focused on gross grasp and release of various-sized objects.
  2. Neuromuscular electrical stimulation (NMES) applied to the finger extensors, synchronized with attempts to open the hand.
  3. A home program consisting of passive range of motion to all finger joints and tendon gliding exercises.
  4. Mirror therapy where the client watches their unaffected hand perform individuated finger movements while trying to mimic them. (correct answer)
Explanation: Mirror therapy is a powerful tool for promoting neuroplasticity, particularly for distal, fractionated movements of the hand. By providing congruent visual feedback of a successfully moving hand, it can help activate mirror neurons and remap cortical pathways associated with the paretic limb, which is ideal for breaking synergistic patterns and encouraging individuated movement. A is incorrect because it reinforces the existing mass grasp pattern rather than promoting fractionation. B is helpful for improving activation and strength of extensors but does not directly facilitate the complex control needed for individuated finger flexion/extension. C is a preparatory technique for maintaining tissue length but is not a motor reeducation technique for active control.

Question 2

An OTR is treating a client with functional movement disorder (FMD) who presents with a non-neurogenic tremor and weakness in her dominant hand. The symptoms worsen when her attention is drawn to them. The client's diagnostic workup has ruled out all neurological causes.

What is the MOST appropriate motor reeducation strategy for the OTR to use with this client?

  1. Engaging the client in a cognitively demanding dual-task activity that requires use of the affected hand for manipulation. (correct answer)
  2. Using EMG biofeedback to teach the client to consciously suppress the tremulous muscle activity.
  3. Applying mirror therapy to provide positive visual feedback of a non-tremoring hand to retrain the brain.
  4. Explaining the neurophysiology of the tremor in detail to help the client understand and gain control over it.
Explanation: When treating functional movement disorder (FMD), you need to understand that symptoms are real but not caused by structural neurological damage. The key principle is that FMD symptoms typically worsen with direct attention and improve when attention is diverted elsewhere. Answer A is correct because dual-task activities that engage cognitive resources while requiring use of the affected hand capitalize on this attention-diversion principle. When the client focuses on a demanding cognitive task, less conscious attention is available to monitor the tremor, often leading to symptom reduction. This approach helps retrain normal movement patterns without drawing attention to the dysfunction. Answer B is problematic because EMG biofeedback requires the client to consciously focus on and monitor their muscle activity - exactly what worsens FMD symptoms. This direct attention to the tremor would likely exacerbate rather than improve the condition. Answer C misapplies mirror therapy, which is designed for conditions like phantom limb pain or stroke rehabilitation where there's actual neurological damage. In FMD, the motor cortex and peripheral nerves are intact, so visual feedback manipulation isn't the appropriate mechanism for improvement. Answer D falls into the trap of over-explaining the condition. Detailed neurophysiological explanations can inadvertently increase the client's focus on their symptoms and may reinforce illness behavior, potentially worsening FMD symptoms. Remember: For FMD, therapeutic success often comes from shifting attention away from the problematic movement rather than toward it. Look for interventions that engage the affected body part in functional activities while the mind is occupied elsewhere.

Question 3

A client is 4 months post-stroke with significant proprioceptive loss in their left upper extremity but has fair (3/5) strength. During a cooking task, the client cannot modulate their grip force, often crushing soft items like a slice of bread or dropping heavier items like a can of soup.

Which motor reeducation technique would BEST help the client relearn to grade their grip force?

  1. Using a pressure biofeedback cuff, having the client grasp it and aim to reach and hold specific pressure targets. (correct answer)
  2. Providing repetitive squeezing exercises with therapy putty of various resistances to build strength.
  3. Applying PNF slow reversal-hold techniques to the finger flexors and extensors to improve co-contraction.
  4. Instructing the client to always watch their hand closely while gripping objects to compensate for sensory loss.
Explanation: Motor control after stroke involves relearning how to modulate force output, especially when proprioceptive feedback is impaired. When clients lose the ability to sense how much pressure they're applying, they need alternative feedback mechanisms to retrain motor control. The correct answer is A because pressure biofeedback provides the precise, quantifiable feedback this client needs to relearn grip force modulation. The biofeedback cuff gives real-time visual feedback about pressure levels, allowing the client to correlate their motor output with specific pressure targets. This external feedback substitutes for the lost proprioceptive input and helps retrain the motor system to produce graded, controlled grip forces. Option B is incorrect because therapy putty exercises primarily build strength, but this client already has fair strength (3/5). The problem isn't weakness—it's the inability to grade force output due to sensory loss. Strengthening exercises won't address the underlying motor control deficit. Option C misses the mark because PNF techniques focus on improving co-contraction patterns and muscle activation, but they don't specifically address force gradation. While co-contraction is important, it won't help the client learn to modulate grip pressure without sensory feedback. Option D represents a compensatory approach rather than true motor reeducation. Visual compensation can be helpful but doesn't retrain the motor system to automatically grade force. It's also impractical during functional activities where visual attention is divided. For NBCOT questions about motor control deficits, distinguish between strengthening, compensation, and true motor reeducation. When proprioception is lost, look for interventions that provide alternative feedback to retrain the motor system.

Question 4

An OTR is working with a client who sustained a severe TBI and has significant extensor tone in his lower extremities, making it difficult to position him safely in his wheelchair. The client tends to slide forward due to the strong extensor thrusting.

Utilizing principles from the Rood approach, which sensory input would be MOST effective as a preparatory technique to inhibit the client's lower extremity extensor tone before positioning?

  1. Maintained, firm pressure on the soles of the feet and slow, rhythmic rocking. (correct answer)
  2. Fast brushing over the quadriceps muscles followed by application of ice.
  3. Applying light, moving touch to the dorsal surfaces of the feet to stimulate a withdrawal reflex.
  4. Using a handheld vibrator on the hamstring tendon insertions for 30-60 seconds.
Explanation: When you encounter questions about managing abnormal tone following neurological injury, remember that the Rood approach emphasizes using specific sensory inputs to either facilitate or inhibit muscle responses. For inhibiting hypertonicity, you need techniques that provide calming, organizing sensory input. Answer A is correct because maintained, firm pressure (deep touch/pressure) and slow, rhythmic rocking both provide inhibitory sensory input according to Rood principles. Deep pressure receptors respond to sustained input and help normalize tone, while slow vestibular input (rocking) has a calming, organizing effect on the nervous system. These techniques work together to reduce the excessive extensor tone that's causing the client to thrust forward in his wheelchair. Answer B is wrong because fast brushing and ice application are facilitatory techniques in the Rood approach - they would increase muscle activity and tone, worsening the extensor thrusting. Answer C is incorrect because light, moving touch is facilitatory and stimulating a withdrawal reflex would likely increase overall lower extremity tone and extensor patterns. Answer D is problematic because vibration is typically facilitatory in Rood's framework, and applying it directly to muscle insertions could increase rather than decrease tone. For NBCOT questions about tone management, remember this key distinction: inhibitory techniques use sustained, deep pressure and slow movement, while facilitatory techniques use light touch, quick movements, and vibration. Always match your intervention goal (inhibit vs. facilitate) with the appropriate sensory input category from the treatment approach being referenced.

Question 5

An OTR is working with a client 3 months post-right CVA who presents with moderate left hemiparesis, learned non-use of the affected upper extremity, and newly diagnosed moderate cognitive deficits in executive function and new learning. The client meets the minimal active movement criteria for Constraint-Induced Movement Therapy (CIMT) but has a low frustration tolerance. The OTR plans to implement a modified CIMT protocol.

Which adaptation to the standard CIMT protocol is the MOST critical to implement first to maximize this client's potential for success?

  1. Prioritizing the transfer package component to ensure early generalization of skills to the client's home environment.
  2. Employing an errorless learning approach during shaping tasks with a blocked practice schedule for motor skill acquisition. (correct answer)
  3. Using a less restrictive restraint on the unaffected limb, such as a mitt instead of a sling, to decrease feelings of confinement and frustration.
  4. Focusing intervention on bimanual tasks rather than unimanual tasks to reduce the cognitive load of isolated movement.
Explanation: The client's primary barriers are cognitive deficits in new learning and low frustration tolerance. An errorless learning approach minimizes mistakes, reducing frustration and anxiety. A blocked practice schedule (practicing one task repeatedly) is most effective for initial skill acquisition in clients with cognitive impairments, as it reduces cognitive load and promotes procedural learning. This approach directly addresses the client's specific cognitive and emotional profile within the CIMT framework. A is incorrect because the transfer package is contingent on skills being learned first; the client's new learning deficit makes this a later priority. C is incorrect because reducing the constraint's effectiveness undermines the core principle of CIMT, which is to force use of the affected limb. D is incorrect as CIMT is fundamentally a unimanual approach; introducing bimanual tasks negates the protocol's purpose.

Question 6

An OTR is treating a client with Complex Regional Pain Syndrome (CRPS) Type I of the right hand. The client has completed the first phase of graded motor imagery (GMI), demonstrating 95% accuracy with left/right hand identification (laterality). They report increased anxiety and a slight increase in pain when attempting the second phase, imagined movements.

What is the therapist's BEST course of action in response to the client's report?

  1. Discontinue GMI and switch to a sensory desensitization protocol using fluidotherapy and textured materials.
  2. Proceed to the third phase, mirror therapy, as the visual input may override the painful sensation.
  3. Have the client imagine moving only the unaffected (left) hand while observing the paretic (right) hand at rest.
  4. Modify the imagined movements task by reducing duration, imagining smaller movements, or imagining moving in a different context (e.g., in water). (correct answer)
Explanation: The graded nature of GMI is critical. An increase in pain or anxiety indicates that the current step is too challenging and needs to be graded down. The appropriate response is to modify the current stage (imagined movements) to make it less threatening to the brain. This can be done by reducing the duration, complexity (smaller movements), or context of the imagery. This respects the 'graded' principle and allows for successful engagement without a pain flare-up. A is incorrect because desensitization may be too aggressive at this stage, and abandoning GMI is premature. B is incorrect because skipping a stage violates the protocol; proceeding to mirror therapy when imagined movements are painful will likely exacerbate symptoms. C is incorrect as the focus should be on gradually re-engaging the cortical representation of the affected hand, not avoiding it.

Question 7

A client is 6 months post-stroke with moderate left hemiparesis. They demonstrate active wrist extension of 20 degrees and gross finger extension against minimal gravity, but exhibit learned non-use. The client has good cognitive function and is motivated to improve the functional use of their left hand for stabilization during bilateral tasks.

Based on this client's presentation, which motor reeducation intervention is MOST appropriate to initiate?

  1. Passive range of motion exercises to maintain joint integrity.
  2. Fabrication of a resting hand splint to manage tone.
  3. Modified Constraint-Induced Movement Therapy (mCIMT). (correct answer)
  4. Mirror therapy with the non-affected hand.
Explanation: The correct answer is C. Modified Constraint-Induced Movement Therapy is indicated because the client meets the minimum movement criteria (e.g., some active wrist and finger extension), has good cognition, and is motivated. This intervention directly addresses learned non-use by forcing the use of the affected extremity in repetitive, task-specific training. A) Passive ROM is a preparatory technique but not the primary motor reeducation intervention for functional gains. B) A resting hand splint is for managing spasticity or preventing contractures, not for active motor reeducation. D) Mirror therapy is more appropriate for clients with severe paresis, no active movement, or significant pain, which is not the case here.

Question 8

A client is 3 weeks post-CVA with dense hemiplegia of the right upper extremity and no active movement. The client reports a painful, burning sensation in the affected hand and keeps it hidden under a blanket. The OTR observes the beginning signs of edema.

What is the MOST appropriate motor reeducation technique to introduce at this stage of recovery?

  1. Constraint-Induced Movement Therapy (CIMT).
  2. Mirror therapy. (correct answer)
  3. Electromyography (EMG) biofeedback.
  4. Active-assistive range of motion.
Explanation: The correct answer is B. Mirror therapy is an evidence-based intervention for clients with severe hemiparesis, pain, and neglect. It uses visual feedback from the moving, non-affected limb to stimulate cortical reorganization and can help reduce pain and initiate motor return without requiring any active movement from the affected limb. A) CIMT is contraindicated as the client has no active movement. C) EMG biofeedback requires at least trace muscle contraction to be effective. D) Active-assistive ROM is not possible as the client has no active movement.

Question 9

An OTR is working with a client with left hemiplegia who is dominated by a strong flexor synergy pattern in the upper extremity. The client is unable to actively extend their elbow, wrist, and fingers to reach for an object.

According to Neurodevelopmental Treatment (NDT) principles, what is the BEST initial approach to facilitate active reach?

  1. Repeatedly stretching the spastic biceps and finger flexors.
  2. Having the client engage in weight-bearing on the extended left arm. (correct answer)
  3. Strengthening the non-affected right arm to build confidence.
  4. Applying electrical stimulation to the extensor muscle groups.
Explanation: The correct answer is B. A core principle of NDT is to inhibit abnormal tone and facilitate normal movement patterns. Weight-bearing on an extended arm provides sustained proprioceptive input that helps to inhibit flexor spasticity and facilitates co-contraction around the shoulder and elbow joints, creating the proximal stability needed for distal movement like reaching. A) Quick stretching can increase tone; while prolonged stretch can be helpful, it's less active than weight-bearing. C) This is a compensatory approach and does not address the motor reeducation of the affected arm. D) E-stim can be a useful adjunct, but NDT emphasizes the use of handling and therapeutic activities first.

Question 10

A client with an incomplete spinal cord injury at the C6 level is working on developing a tenodesis grasp to pick up small objects. The client has active wrist extension against gravity (3/5) but no active finger flexion.

Which activity is MOST appropriate for motor reeducation to enhance the client's tenodesis grasp?

  1. Strengthening the wrist flexors using therapy putty.
  2. Repetitively picking up and releasing wooden blocks of varying sizes. (correct answer)
  3. Using a static splint to hold the fingers in a flexed position.
  4. Applying electrical stimulation to the finger extensor muscles.
Explanation: The correct answer is B. Repetitive, task-specific practice is a key principle of motor reeducation. Picking up and releasing objects directly uses the desired tenodesis action (wrist extension causes passive finger flexion; wrist flexion causes passive finger extension). Grading the size and weight of the blocks allows for progression. A) Strengthening wrist flexors would work against the goal of using wrist extension. C) A static splint is a passive intervention and does not promote active motor control. D) E-stim should be applied to finger flexors if used as an adjunct, but task practice is the core intervention.

Question 11

A client is status post-CVA with moderate hemiparesis. The client's goal is to participate in meal preparation, specifically tasks that require two hands such as stabilizing a bowl while mixing. The client can grossly grasp and release with the affected hand but has poor coordination.

Which intervention approach would be MOST beneficial for achieving this client's specific goal?

  1. Bilateral arm training with repetitive symmetric movements. (correct answer)
  2. Constraint-Induced Movement Therapy on the affected arm.
  3. Sensory reeducation using different textures.
  4. Passive stretching to the affected arm prior to the task.
Explanation: The correct answer is A. Bilateral arm training (BAT) involves practicing tasks that require both arms to work together. This approach is highly effective for improving coordination between the two limbs and directly translates to functional goals like stabilizing a bowl while mixing. It promotes cortical reorganization by activating both hemispheres. B) CIMT focuses on unilateral function and would not be the best choice for a goal that is inherently bimanual. C) Sensory reeducation is important but does not directly address the motor coordination aspect of the task. D) Stretching is a preparatory activity, not the core motor reeducation intervention.

Question 12

A child with spastic hemiplegic cerebral palsy demonstrates difficulty with in-hand manipulation skills. The OTR is planning an intervention to improve the child's ability to move a coin from their palm to their fingertips to place in a piggy bank.

Which motor reeducation activity is the MOST appropriate to address this specific skill?

  1. Practicing grasping and releasing large blocks.
  2. Squeezing a stress ball to increase overall hand strength.
  3. Repetitive practice of moving small beads from the palm to the fingertips. (correct answer)
  4. Weight-bearing through the affected hand on an open palm.
Explanation: The correct answer is C. This is an example of task-specific training. The skill deficit is palm-to-finger translation, a specific component of in-hand manipulation. The most direct and effective way to retrain this motor skill is to practice the exact movement pattern with objects of graded difficulty (e.g., starting with larger items and moving to smaller items like beads). A, B, and D are all valid therapeutic activities but do not specifically target the isolated motor skill of palm-to-finger translation.

Question 13

A client is re-learning to tie their shoes after a TBI. The task is complex, and the client becomes easily frustrated. The OTR decides to break the task down into smaller parts.

According to motor learning principles, which method is MOST appropriate for teaching this complex task?

  1. Whole practice, where the client attempts the entire sequence each time.
  2. Random practice, alternating between tying shoes and other dressing tasks.
  3. Part practice, mastering the first step (making the loops) before proceeding to the next. (correct answer)
  4. Blocked practice, repeating the same component multiple times before moving to the next.
Explanation: The correct answer is C. For complex, serial tasks like shoe tying, part practice is an effective strategy. It allows the learner to master each component of the sequence before chaining them together, which can reduce cognitive load and frustration, leading to more successful learning. A) Whole practice might be too overwhelming initially. B) Random practice is better for generalization once the basic skill is learned. D) Blocked practice involves repetition of the same task component, which may not facilitate the sequential learning needed for this complex motor task.

Question 14

A client with Multiple Sclerosis (MS) experiences intention tremors that interfere with their ability to apply makeup. The client wants to continue using their own makeup brushes and applicators. The OTR is considering strategies to improve motor control during this ADL.

Which motor reeducation strategy would be MOST effective for managing the tremors during this task?

  1. Promoting trunk and proximal limb stability during the activity. (correct answer)
  2. Practicing the task with rhythmic, fast movements.
  3. Using universal cuffs on all the makeup applicators.
  4. Completing the task in a gravity-eliminated plane.
Explanation: The correct answer is A. For individuals with intention tremors (common in MS and cerebellar disorders), improving proximal stability is a key strategy. By stabilizing the trunk, shoulder, and elbow (e.g., by leaning on a counter), the client creates a more stable base, which can reduce the amplitude of the tremor in the distal extremities (wrist and hand), allowing for more controlled movement. B) Fast movements would exacerbate the tremor. C) Universal cuffs assist with grasp, not tremor control. D) Changing the plane of movement may not be functional for this specific task and does not address the core issue of instability.

Question 15

A client is 2 months post-CVA and is transitioning from the associative to the autonomous stage of motor learning for wheelchair-to-bed transfers. The client can perform the transfer safely but it is slow and requires concentration.

To facilitate skill refinement and generalization, which type of practice schedule should the OTR now emphasize?

  1. Blocked practice, performing the same transfer repeatedly.
  2. Random practice, alternating between transfers and other tasks. (correct answer)
  3. Constant feedback, correcting every minor deviation from the ideal pattern.
  4. Part practice, breaking the transfer back down into its components.
Explanation: The correct answer is B. Random practice, where the learner performs different tasks in a random order, has been shown to be superior for long-term retention and generalization of skills. Now that the client has the basic motor pattern established, introducing variability (e.g., bed transfer, then toilet transfer, then a dressing task) will challenge their motor planning and problem-solving, leading to a more robust and adaptable skill. A, C, and D are all more appropriate for the initial (cognitive) stage of learning.

Question 16

An OTR is teaching a client with right hemiparesis to use Proprioceptive Neuromuscular Facilitation (PNF) patterns to improve their ability to perform self-care. The client's goal is to be able to comb the hair on the left side of their head using their right hand.

Which PNF pattern MOST closely mimics the movement required for this functional task?

  1. D1 Flexion (correct answer)
  2. D1 Extension
  3. D2 Flexion
  4. D2 Extension
Explanation: The correct answer is A. The D1 Flexion pattern involves shoulder flexion, adduction, and external rotation, which is the multi-joint movement used to bring the hand up and across the body toward the opposite ear, as in combing the hair on the contralateral side or bringing food to the mouth. D2 Flexion (shoulder flexion, abduction, external rotation) mimics combing hair on the same side. The extension patterns move the arm away from the body.

Question 17

A client recovering from a stroke is using a virtual reality (VR) system for upper extremity motor reeducation. The system provides engaging games that require reaching and grasping movements. The client enjoys the sessions but the OTR wants to ensure maximal therapeutic benefit.

To BEST promote transfer of skills from the VR environment to real-world tasks, what should the OTR do?

  1. Increase the difficulty of the game to the highest possible level.
  2. Ensure the client uses the VR system for the entire duration of every session.
  3. Follow the VR session with practice of real-world tasks that mimic the VR movements. (correct answer)
  4. Provide the client with summary feedback only at the end of the week.
Explanation: The correct answer is C. Virtual reality is a powerful tool for motor reeducation due to its ability to provide high-repetition, motivating practice. However, to ensure generalization and transfer of learning, it is crucial to bridge the gap between the virtual and physical worlds. Immediately practicing the same movement patterns with real objects in a functional context reinforces the motor learning and facilitates carryover. A) Excessively high difficulty may lead to frustration or compensatory movements. B) Sessions should be balanced with other therapies. D) Feedback should be more frequent to be effective.

Question 18

A client sustained a radial nerve injury resulting in wrist drop. After several weeks of therapy, the client can now actively extend their wrist against gravity. The OTR wants to incorporate this new movement into a functional activity.

Which activity BEST promotes the use of active wrist extension for motor reeducation?

  1. Squeezing therapy putty to improve grip strength.
  2. Wiping a table with the palm flat on the surface.
  3. Placing objects on a shelf at waist height. (correct answer)
  4. Carrying a shopping bag with the affected hand.
Explanation: The correct answer is C. Placing an object onto a shelf requires the client to lift an object and stabilize it with the wrist in an extended position against gravity, directly targeting the weakened wrist extensors in a functional, task-oriented way. A) Squeezing putty primarily works the finger flexors. B) Wiping a table does not require active wrist extension against gravity. D) Carrying a bag primarily involves isometric contraction of the finger flexors and does not challenge active wrist extension.

Question 19

An OTR is working with a client who has poor motor control and decreased proprioception in their right hand following a CVA. The goal is to improve the ability to button a shirt. The client is having difficulty orienting the button to the buttonhole.

Which intervention represents the BEST integration of sensory and motor reeducation for this task?

  1. Practicing the task with vision occluded to enhance proprioception.
  2. Using a buttonhook as an adaptive device.
  3. Locating and manipulating buttons of different sizes and textures hidden in a container of rice. (correct answer)
  4. Watching a video of the OTR demonstrating the task repeatedly.
Explanation: The correct answer is C. This activity combines sensory and motor reeducation by requiring the client to use tactile discrimination (sensory) to locate and orient the buttons, and then use in-hand manipulation skills (motor) to handle them. This addresses the underlying deficits in a graded way before attempting the full functional task. A) Occluding vision would be too difficult initially given the proprioceptive deficit. B) Using a buttonhook is a compensatory strategy, not a motor reeducation approach. D) This is a form of observation/motor imagery but lacks the critical sensory-motor component of active practice.

Question 20

An OTR is working with a client who sustained a severe traumatic brain injury (TBI) and presents with significant cerebellar ataxia. The client's primary goal is to be able to feed themself independently. During attempts to bring a spoon to their mouth, the client demonstrates marked intention tremors and dysmetria.

Which motor reeducation strategy is the BEST to use during a mealtime activity to address this client's goal?

  1. Using lightweight plastic utensils to reduce fatigue.
  2. Providing weighted utensils and a non-slip plate. (correct answer)
  3. Practicing PNF D1 flexion patterns without resistance.
  4. Encouraging the client to move as quickly as possible.
Explanation: The correct answer is B. Adding weight to the distal aspect of an extremity (in this case, via weighted utensils) can dampen tremors and provide increased proprioceptive feedback, which helps to improve motor control and reduce dysmetria in clients with ataxia. A non-slip plate provides stability. A) Lightweight utensils would likely worsen the effects of the ataxia. C) PNF patterns are a useful preparatory activity but do not directly address the functional task of eating in context. D) Moving quickly would increase the intention tremor and decrease accuracy.