Motor Learning Principles

what is motor learning

process associated with practice or experience leading to a relatively permanent change in the ability of producing skilled action

- founded on a closed loop concept of motor control

- sensory feedback is required for skilled movement

- memory trace used to initiate and select movement

- perceptual trace developed through practice

Adam's Closed Loop Theory rundown

when is memory trace used

to initiate and select movement (fast, novel, reflexive movements)

when is perceptual trace used

in practice (compares to memory trace) of "slower" movements

limitations to Adam's Closed Loop Theory

- animals and humans can still perform skilled movements without sensory feedback

- humans make accurate novel movements and transfer of one skill to another

- not enough memory to store every movement

clinical implications of Adam's Closed Loop Theory

patient must practice same exact movement repeatedly to develop an accurate perceptual trace

- emphasized more open loop control

- motor program does not contain specifics but more rather general strategies/schemas

- learning more general strategies allows you to adapt to various conditions

- slow movement is feedback based

- fast movement is program based

- feedback used to modify movement during the task

Schmidt's Schema Theory rundown

fast movement under Schmidt's Schema Theory is (FEEDBACK/PROGRAM) based

program

slow movement under Schmidt's Schema Theory is (FEEDBACK/PROGRAM) based

feedback

clinical implications of Schmidt's Schema Theory

when learning a new task, practice should be performed under a variety of conditions to develop a set of rules

- we are constantly searching for optimal strategies to perform a given task (solve a problem) in a given environment

- use perceptual information (sensory feedback, vision, etc.) combined with motor programs to achieve tasks within particular environmental constraints

Ecological Theory of Learning rundown

clinical implications of Ecological Theory of Learning

practicing under a variety of conditions helps patients to attend to and appreciate difference between regulatory and non-regulatory cues

Fitts and Posner stages of motor learning

cognitive, associate, autonomous

cognitive stage of motor learning

- understanding nature of task and developing strategies

- takes cognitive processing and attention

associative stage of motor learning

- refining of a skill

- less cognitive and slower improvement (weeks to months)

autonomous stage of motor learning

- automatic performance of a skill

- less attention needed which allows person to focus on other aspects of the skill

two types of learning

declarative and procedural

what is declarative learning

conscious knowledge (facts, events, etc.)

brain structures involved in declarative learning

prefrontal cortex, medial temporal lobes, hippocampus

what is procedural learning

motor learning (motor skills, sequences of movement)

brain structures involved in procedural learning

cerebellum, basal ganglia, motor cortex

factors that affect motor learning

- patient

- task selection

- formulation of motor plan

- feedback

- practice conditions

how does the patient affect motor learning

arousal, attention, motivation, memory

how does task selection affect motor learning

- must ultimately be that of the patient

- should be specific and challenging

strategies used to formulate a motor plan

verbal instruction, demonstrations, mental preparation

two types of feedback

intrinsic, extrinsic

intrinsic feedback

sensory information from the patient

extrinsic fedback

- also called augmented feedback

- feedback provided by the therapist

knowledge of results

whether or not the task was performed

knowledge of performance

quality of task performance

how extrinsic feedback should be given

- don't give after every trial (delay feedback a little bit)

- don't point out obvious

- differentiate between motivational and informational

- limit details initially

- help patient analyze errors

- video analysis

qualitative vs quantitative feedback

qualitative - words, descriptive, observational

quantitative - numbers, statistics, measurements

massed practice

- practice time in a trial greater than rest between trials

- lots of trial time with little rest

ex: walking

distributed practice

- rest time equal or greater to practice time

- more rest than activity

performance (INCREASED/DECREASED) with distributed practice

increased

is massed or distributed practice better

depends on the task and patient endurance

blocked practice is better during (ACQUISITION/RETENTION) phase

acquisition

random practice is better during (ACQUISITION/RETENTION) phase

retention

part practice

- practicing an individual component of a task

- task must be able to be broken down into discrete tasks (i.e. sliding board transfer)

whole practice

- practicing entire task as a whole

- used for continuous tasks (i.e. gait)

is mental or physical practice more beneficial

physical

what is transfer of training

the influence of a previously practiced skill on the learning of a new skill (unlikely unless tasks are practically identical)

guidance rundown

- hands on, physical feedback

- improves initial performance but decreases retention if performed too much

therapist's role in motor learning

- goal clarification

- selection of appropriate tasks

- structing environment

- give correct feedback

- assist patient in decision making

- MOTIVATION!

goal of therapy

facilitate patient's active problem solving skills so that the patient can solve the motor problems that they will meet in every day life

neuroplasticity

- ability of the nervous system to show modification or change

- any change in the nervous system that is not periodic and has a duration of more than a few seconds

10 principles of neuroplasticity

- use it or lose it

- use it and improve it

- specificity

- salience

- time matters

- intensity matters

- repetition matters

- transference

- interference

- age matters

habituation

- simple form of neuroplasticity

- decrease in EPSP (turn down sensory signals)

- short term changes in synaptic effectiveness

- long term structural changes

examples of habituation

vestibular rehab, tactile defensiveness

sensitization

- strengthening of a response

- more complex than habituation

- changes in potassium conductance mobilization of neurotransmitter

learning and memory

- most complex

- longer lasting changes in synaptic connections

- synthesis of new proteins and synaptic connections

- long term potentiation (LTP) -- storing of memories

primary neurologic injury

- direct insult to nervous system tissue (bullet, knife, shearing)

- infarction and hemorrhage occur

secondary neurologic injury

- metabolic effects that occur after the direct insult

- swelling occurs

diaschisis as an early transient event that depresses brain function

decreased function of one part of the brain due to its connection with another

edema as an early transient event that depresses brain function

compression of axons and blood flow

do injuries to axons cause cell death

may or may not

do injuries to cell bodies cause cell death

yes they always cause cell death

two types of sprouting axonal recovery

collateral, regenerative

collateral sprouting

the process by which axons of some healthy neurons adjacent to damaged cells grow new branches

regenerative sprouting

occurs when an axon and its target cell have been damaged and the injured axon sends out side sprouts to a new target

does axonal recovery occur most frequently in central or peripheral nervous system

peripheral

rate of peripheral axonal recovery

1 mm per day (1 inch per month)

synkinesis

a voluntary muscle movement causes other muscles to contract involuntarily, often affecting facial and extraocular muscles

sensory confusion

axon grows to different area of skin but still read by brain as being in its original position/area of skin

return of synaptic effectiveness

occurs when the swelling that caused a disruption in communication goes down and normal function is restored

deinervation hypersensitivity

- process of axonal shearing

- more receptors on one axon compared to another

- receptor sites upregulate in response to shearing in order to maintain the same level of excitability

synapse hypereffectiveness

- increase in neurotransmitters when there is a loss of axonal connections

functional reorganization

- cortical areas can change functional representation

- changes can occur within 4 weeks (mainly due to unmasking of silent synapses)

increased time spent in practice results in (INCREASED/DECREASED) improvement

increased