motor learning (week 2)

What is motor learning?

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

 Stages of motor learning

•Cognitive stage

•Associative stage

•Autonomous stage

Cognitive

Lots of concentration and  a lot of errors occur

Patient has to figure out:

  1. What to do

  2. How to do it

  3. Relies heavily on visual feedback

  4. Requires frequent verbal feedback from therapist

 

Associative

The patient works on:

  1. Decreasing errors while doing the task

  2. Fine tuning the movements under varying   conditions

  3. Self correcting and problem solving occur

  4. Requiring less feedback from therapist

autonomous

The patient:

  1. Automatic movements

  2. Easily adapts to variations in the task

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

  4.   Requires little or no feedback from therapist

Types of Movement

•Discrete vs Continuous Task

•Closed vs Open Environment/Task

•Stability vs Mobility Tasks

Discrete task

•doing a specific task with a set beginning and an end; contracting a specific muscle group ( quad set, locking a wheelchair)

Continuous task

•involves repetitive, uninterrupted movement with no distinct beginning and ending (walking)

Serial task

•a series of discrete movements that are combined in a particular order (steps involved in wheelchair transfers)

Progression of motor tasks

Closed —→ Open Environment or Task

Stability —> Mobility

Absent —> Present variability

Absent —> Present Manipulation of Objects

Closed

(aka stable) objects around the patient and the surface that the task is performed does not move; everything stays the same each time the task is done

patient can focus on the task and is self-paced; works well in the cognitive stage 

(ex: practicing gt tr in the parallel bars with a new prosthesis)

Open

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 pt

patient has to predict the speed and direction of the object or adjust his own balance or posture as the support surface moves

(ex: maintaining standing balance while on a bus)

Stability Tasks

need a stable base of support

Mobility

some kind of movement is involved; transitional movt

Absent variability

environment that a task occurs is constant from one performance to another

Present variables

environment varies from one attempt to another; patient has to continuously change to new circumstances

Absent

doing a task without holding or manipulating an object

  (ex: Walking down a hallway)

Present

it is more difficult  to manipulate an object while doing a task

(ex: carrying a cup of hot coffee across an empty room on a tile floor)

Variables That Influence Motor Learning

•Pre-practice considerations

•Practice

•Practice schedules

•Practice types

•Feedback

Pre-Practice Considerations

•patient understanding

•attention

•willingness of patient

•demonstration

Practice Schedules

•Massed vs distributed

•Constant vs Variable

Massed

practice time is greater than rest time between sets

Distributed

practice time is less than rest time between sets

constant

doing the same skill in the same way each time

variable

doing a skill in various ways each time

Practice Types

•Part  vs  Whole

•Blocked  vs  Random

•Physical  vs  Mental

Part

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

whole

practicing the whole task

blocked

do a limited amount of a certain exercise or functional task

random

variables are introduced like varying support surface and doing a task

random/blocked

practice at least twice then vary the skill like adding weights or standing on an uneven surface; allows for self correction before trying the next variation

Physical vs Mental 

• physically doing the task

• mentally preparing to do the task

• if done together, faster learning of a task

What is Feedback?

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

Feedback

•Intrinsic – sensory input of learner

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

1. Results in either:

• Knowledge of performance

• Knowledge of results

• Timing and frequency of extrinsic feedback