MOVE FOR ADULTS PROGRAM MANUAL

The MOVE for Adults Program Manual is similar in format to the MOVE Curriculum. It is a top-down activity-based manual designed to teach adults basic, functional motor skills of sitting, standing, transitioning and walking. By combining natural body mechanices with instruction, learning occurs while adults are engaged in real life activities of daily living (ADLs). The MOVE for Adults Program manual provides six steps also for utilizing and teaching the MOVE Program: 1) MOVE Assessment, 2) Setting Goals, 3) Planning Activities, 4) Measuring Prompts, 5) Prompt Review, and 6) Teaching Skills.

Task Analysis of Activities included in the Manual

In the task analysis of activities, the manual outlines the physical skills required into the same 16 categories as in the MOVE Curriclum:

  1. Maintaining a sitting position
  2. Movement while sitting
  3. Standing
  4. Transition: Sitting to standing
  5. Transition: Standing to sitting
  6. Pivoting while standing
  7. Walking forward
  8. Transition: From standing to walking
  9. Transition: From walking to standing
10. Walking backward
11. Turning while walking
12. Walking up steps
13. Walking down steps
14. Walking on uneven ground
15. Walking up slopes
16. Walking down slopes 

Top-Down Down Model-Varying Levels of Success Outlined in the Manual

Also, as in the MOVE Curriculum for children, the physical skills are dividied into four levels of success. When adults enter the program, they are given a top-down test to determine motor skills. The test begins with the highest level of difficulty (GRAD LEVEL) and moves down a continuum of motor skills until the adult can demonstrate proficienty. This is considered a an adult's entry level. The adult then addresses the next highest skill on the continuum and disregards the skills below the entry level.

The majority of adult learners will have skills grouped closely together within the success levels. However, some learners may show wide fluctuations across several levels. Frequently learners have higher skills in sitting rather than in standing, transitioning and walking skills. Thenerally this is due to a lack of practie opportunities in standing, transitioning and walking activities. The
four levels of success are:

GRAD LEVEL-Completion of skills at this level assures learners of independent mobility at home and minimal assistance in the community. Learners at this level graduate from the program and can expand their motor skills through continuous use in daily activities.

LEVEL I-Completion of skills at this level assures that learners do not require an adaptive chair, and bear their weight during transitions in and out of walkers, chairs and onto toilets. Learners are able to walk independently with the use of a walker.

LEVEL II-Completion of skills at this level assures that learns can maintain an upright sittingposition with the use of prompts and can actively bear weight during transitions with assistance for body weight support. Leaners can walk short distances when supported in a front-leaning walker.

LEVEL III-Completion of skills at this level assures that learners have opportunities to be in upright postures to promjote greater participaton. Skill practice focuses on building strength and endurance and improving overall health.

Measuring Prompts (Support) and Reducing Prompts (Support) Needed

In the manual as in the MOVE Curriculum for children, there is a systematic approach to providing phsycial prompts to teaching people with phsycial disabilities to sit, stand and walk. The manual: 1)  categorizes and deines the prompts, 2) provides a system for reducing prompts and 3) provides a system for measuring progress.

Two categories of prompts are described in detail in the MOVE for Adults manual. One category describes the support an adult learner needs during sitting activities and the other category describes the support needed during standing or walking. (A third cateory for arm control may be added if arms and/or hands are needed to maintain a sitting, standing, or walking position.)

The manual explains how the MOVE team of therapists and other support providers must determine the degree of support needed and then must choose the prompts the adult learner needs while performing the activity. Because prompts are activity-specific, it is possible for an adult learner to have two different levels of prompts for two different sitting (or standing/walking) activities depending on the purpose of the activity, the learn's participatiion needs and the plans for motor skill practice during the activity. For example, an adult learner may require additional porompts to assist with head and trunk control during mealtime, but use fewer prompts during a leisure activity where practice bringing the head upright from a front-lagging
position can provide strengthening without interfering with participation in the active.

Prompts are given numerical values ranging from independent function (0) to the greatest degree of assistance (5). By using a simple chart in the manual, the instructor/support provider can see which areas require the greatest degree of assistance and then systematically reduce that assistance.

OVERVIEW OF THE MOVE ASSESSMENT & PROGRAM PROFILE FOR ADULTS (MAPP)

The MOVE Assessment and Program Profile for Adults (MAPP) is a workbook to be used in conjunction with the MOVE for Adults Program Manual. MAPP is used to record the results of the MOVE Assessment, develop plans for MOVE programming, and document progress over time.

A MAPP should be completed for each adult learner participating in the MOVE for Adults Program. Instructions and forms are provided in the profile to guide teams through the six step process of the MOVE for Adults Program. Upon completion of the profile, there is a detailed plan for teaching motor skills most critical to the adult learner.