2 - Motor Learning

Motor learning

A complex process that involves knowledge and retention of a skilled movement followed by a lot of practice

What is the difference between performance and learning a skill?

• You can know how to do something and perform poorly (due to outside factors)

• You can not know how to do something (a skill you haven’t learned) and be able to do it well (usually luck)

The cognitive motor learning stage

• A lot of concentration and repetition

• Many errors occur

• Patient is figuring out what to do and how to do it

• Relies heavily on visual feedback

• Needs decreased distractions

• Requires frequent verbal feedback from therapist

Associative motor learning stage

Patient works on:

• Error begin to decrease

• Focus on how the movement feels

• Fine tuning the movements under various conditions

• Self-correcting and problem solving

Requires less feedback from the therapist

Can have some distractions

Autonomous motor learning stage

The patient:

• Automatic movements

• easily adapts to variations in the task

• Can progress to more difficult activities by doing a task quicker or longer

• Requires little or no feedback from the therapist

• Able to do dual task

Discrete movement/task

• Doing a specific task with a set of beginning and end

• Ex. contracting a specific muscle group

Continuous movement/task

• Involves repetitive, uninterrupted movement with no distinct beginning and end

• Ex. walking, wheeling a wheelchair

Serial task

• A series of discrete movements that are combined in a particular order

• Ex. steps involved in wheelchair transfers

Closed environmental task

• Stable objects around the patient and the surface that the task is performed does not move; everything stats the same each time the task is done

• Pt is focused on task and is self-paced

• Ex. Practicing standing balance int he parallel bars with a new prosthesis

Open environmental task

• Object or patient is in motion or the support surface is unstable during the task

• Movement that happens in the environment is not under the control of the patient

• Pt has to predict the speed and direction of the object or adjust their own balance and posture as the supporting surface moves

• Ex. maintaining standing balance while on a bus

Stability task

Needs a stable BOS

Mobility task

Some kind of movement is involved

Ex. of progression of motor tasks

• Closed → Open environment or task

• Stability → mobility

• Absent → present variability

• Absent → Present manipulation of objects

Absent (variabilty)

• Doing a task without holding or manipulating an object; environment stays the same

• Ex. walking down a hallway

Present (variability)

• It is more difficult to manipulate an object while doing doing a task; varying environment

• Ex. carrying a cup of hot coffee across an empty room on a tile floor

Examples of progressing activities

• Sit to stand in a wooden chair with arms → sit to stand without using arms of the chair

• Standing on a flat surface → standing with eyes closed or standing on an uneven surface

Pre-practice considerations

• Pt understanding

• Attention

• Willingness of patient

• Demonstration

Massed practice

Practice time is greater than rest time between sets

Distributed practice

Practice time is less than rest time between sets

Constant practice

Doing the same skill in the same way each time

Variable practice

Doing a skill various ways each time

Part practice

Breaking down the task into component parts and practicing each part separately

Whole practice

Practicing the whole task

Blocked practice

Do a limited amount of a certain exercise or functional task

Random practice

Variables are introduce like varying the support surface and doing a task

Feedback

Sensory info that is received and processed by the learner during or after a task

Intrinsic (feedback)

Sensory input of the learner

Extrinsic (feedback)

Cues given by the therapist during or after the task; therapist determines the frequency, timing, and type of feedback