Neuro Rehab motor learning theories & issues

motor learning

a set of processes associated with practice or experience leading to relatively permanent gains in the capability for skilled performance

🡆distributed throughout the nervous system, including the cerebellum, limbic system, premotor cortex, and sensory cortex

🡆focuses the issue of regaining motor skills on the rules for "skills practice" and "feedback" which may maximize learning.

retention

ability maintained over time when not practiced

generalization

applying a learned skill to similar tasks

adaptability

ability to perform a task under different conditions

motor performance

the execution of a motor task; it is what we immediately observe

🡆the result of a complex interaction among many variables, only one of which is learning

motor control

how the movement is executed; a process of manipulation of coordinative structures

nonassociative

___________ learning: a change in behavior that takes place after repeated exposure to a single stimulus (includes habituation & sensitization)

habituation

decreased responsiveness that occurs as a result of repeated exposure to a stimulus (aka desensitization)

sensitization

increased responsiveness to a stimulus

associative

__________ learning: making predictions - includes classical & operant conditioning

classical conditioning

pairing 2 stimuli such that an initially weak stimuli becomes highly effective in producing a response but it becomes becomes associated with another stronger response

🡆unconscious, automatic response

automatic

classical conditioning is a(n) automatic/purposeful response

purposeful

operant conditioning is a(n) automatic/purposeful response

operant conditioning

trial and error learning - we learn to associate a certain response from among many that we have made with a consequence

🡆law of effect

effect

law of _________: behaviors that are rewarded tend to be repeated at the cost of other behaviors

procedural

____________ learning/implicit knowledge:

🡆tasks that can be performed without attention or conscious thought = habit

🡆develops slowly through repetition over many trials

🡆practice in a wide variety of situations and contexts allows the individuals to learn the rules associated with that particular movement (schema)

🡆expressed through improved performance

implicit

procedural learning = _____________ knowledge

schema

rules associated with a particular movement in procedural learning

declarative

___________ learning/explicit knowledge:

🡆knowledge that can be consciously recalled - requires awareness, attention, reflection

🡆can be expressed verbally

🡆constant repetition can transform declarative knowledge into procedural

🡆can be practiced in other ways than it was learned

explicit

declarative learning = ____________ knowledge

closed loop

___________ _________ theory: feedback is necessary to guide each performance attempt during the early stages of learning

🡆feedback serves as an important source for the detection and correction of errors in performance

feedback

according to the closed loop theory, _____________ is necessary for learning

memory trace

in closed loop theory, the ______ __________ selects and initiates a given plan of action

perceptual trace

in closed loop theory, the _________ _________ is built up over time with practice, becoming the internal reference for correctness; detects error

perceptual trace

closed loop theory clinical implications: the more the individual practices the specific motion, the stronger the ____________ ____________ becomes

perceptual trace

closed loop theory clinical implications: the accuracy of the movement is directly proportional to the strength of the ____________ _____________ so you should have the person practice the same movement repeatedly to one accurate endpoint (perfect practice)

perfect

the closed loop theory supports perfect/variable practice

closed loop

problems with the ___________ ____________ theory:

🡆cannot account for our ability to perform movements in the absence of feedback

🡆cannot mentally store every movement in memory

🡆we can be fairly accurate with novel skills

🡆research has shown that variation in movement practice may actually improve motor learning

schema

the __________ theory emphasizes open loop control processes and the generalized motor program concept

schema

_____________/generalized motor program = contains the rules for creating the spatial and temporal patterns of muscle activity needed to carry out a given movement

generalized motor program/GMP

schema/____________ _________ __________: contains the rules for creating the spatial and temporal patterns of muscle activity needed to carry out a given movement

initial movement conditions

according to the schema theory, after performing a movement, 4 things are stored in memory:

1. __________ ___________ ____________

2. parameters used in the GMP

3. outcome of the movement

4. sensory consequences

parameters

according to the schema theory, after performing a movement, 4 things are stored in memory:

1. initial movement conditions

2. ____________ used in the GMP

3. outcome of the movement

4. sensory consequences

outcome

according to the schema theory, after performing a movement, 4 things are stored in memory:

1. initial movement conditions

2. parameters used in the GMP

3. ___________ of the movement

4. sensory consequences

sensory consequences

according to the schema theory, after performing a movement, 4 things are stored in memory:

1. initial movement conditions

2. parameters used in the GMP

3. outcome of the movement

4. _____________ ________________

recall

the ___________ schema (motor) selects the specific response

recognition

the __________ schema (sensory) evaluates the response

motor

the recall schema is motor/sensory

sensory

the recognition schema is motor/sensory

schema

clinical implications of the ____________ theory:

🡆optimal learning occurs if the task is practiced under variable conditions to allow the learning of the set of rules that apply to the task

🡆as understanding of these rules improves, the individual will be more capable of generating appropriate strategies

variable

the schema theory supports perfect/variable practice

schema

limitations of the ___________ theory:

🡆research results testing these hypotheses with adults has been mixed but has strongly supported the benefits of variable practice with children

🡆this theory lacks specificity - few recognizable mechanisms can be tested, so not clear how schema processing itself interacts with other systems during motor learning and how it aids in control of that movement.

🡆inability to account for the immediate acquisition of new types of coordination

ecological

_________________ theory of perception and action: learning is a process that increases the coordination between perception and action in a way that is consistent with the task and environmental constraints

🡆practice is a search for optimal strategies to solve the motor problem, given the task constraints - involves both appropriate motor response and most appropriate perceptual cues

🡆exploration of the perceptual-motor workspace requires exploring all possible perceptual cues to identify the most relevant to the task

regulatory

in the ecological theory, _____________ cues are those most relevant to the task

ecological

according to the ___________ theory, perceptual information has:

🡆a prescriptive role in understanding the task goal and movements to be learned

🡆a feedback role both during and upon completion of the movement

🡆is used to structure the search for the solution

ecological

clinical implications of the ____________ theory:

🡆help the learner understand the nature of the perceptual-motor workspace

🡆understand the natural search strategies used by performers when exploring space

🡆provide augmented information to facilitate the search

🡆transfer of motor skills will depend on the similarity of the optimal perceptual-motor strategies needed to perform the two tasks, rather than which muscles are used or the objects being manipulated

Fitts and Posner

_______________ ______ ____________'s model describes the cognitive, associative, and autonomous stage of motor learning

cognitive

the 3 stages in Fitts and Posner's model are ___________, associative, and autonomous

associative

the 3 stages in Fitts and Posner's model are cognitive, ___________, and autonomous

autonomous

the 3 stages in Fitts and Posner's model are cognitive, associative, and ______________

cognitive

in Fitts and Posner's model, the ____________ stage is the earliest stage, beginning learner of a motor skill - just trying to understand the nature of the task; learner is trying to figure out what to do, rather than how to do the task

🡆developing strategies that can be used to carry out the task and determining how to evaluate them

cognitive

the ___________ stage of Fitts and Posner's model requires a high degree of cognitive effort - need to concentrate and think in a focused fashion to perform the task

cognitive

errors are frequent in the ___________ stage of Fitts and Posner's model

visual

in the cognitive stage of Fitts and Posner's model, subject most dependent on __________ feedback to adjust movement accordingly

cognitive

during the _________ stage of Fitts and Posner's model, performance is deliberate and variable - experimenting with different strategies

associative

in the ____________ stage of Fitts and Posner's model, the task is better organized but still not automatic - has selected the best strategy for the task and is now beginning to refine the skill - learner is working less on what to do and more on how to do the task

🡆less cognitive requirements

🡆fewer errors and lesser degree of magnitude

🡆improvement less rapid

🡆less dependent on visual feedback, increasingly uses proprioception

proprioception

in the associative stage of Fitts and Posner's model, the learner is less dependent on visual feedback & increasingly uses _______________

autonomous

in the ____________ stage of Fitts & Posner's model, movement requires little cognition - subject can concentrate on things in the environment while still successfully completing the task

🡆motor programs that develop may be sophisticated, less dependence on visual and proprioceptive feedback

🡆errors are small and infrequent

🡆performance is good in varying environment

Fitts and Posner

clinical implications of ___________ _____ ___________'s model:

🡆this model helps outline the cognitive effort as well as the progression of motor performance we can expect an individual to go through as they learn a motor task

🡆it also provides guidance for how to structure practice sessions including type of feedback and how to structure the environment based on their stage of learning

systems

__________ model for motor learning includes novice, advanced, and expert categories

novice

the 3 stages in the systems model are ____________, advanced, and expert

advanced

the 3 stages in the systems model are novice, ___________, and expert

expert

the 3 stages in the systems model are novice, advanced, and _____________

novice

in the ______________ stage of the systems model

🡆learner simplifies the movement to reduce the degrees of freedom by constraining or fixing the angles of multiple joints together so they move in unison

🡆cost is reduced efficiency and flexibility

advanced

in the _____________ stage of the systems model

🡆learner begins to release additional degrees of freedom by allowing movements at more joints involved in the task

🡆joints can be controlled independently as necessary for task requirements

🡆co-contraction is reduced, synergies are used to create well-coordinated movement that is more adaptable

expert

in the _____________ stage of the systems model

🡆learner has released all the degrees of freedom needed to perform the task in the most efficient and best coordinated way

🡆have learned to take advantage of the mechanics of the musculoskeletal system and environment to optimize efficiency

systems

clinical implications of the ____________ model:

🡆explains co-contraction of muscles during early stages of acquiring a motor skill

🡆offers a new rationale for using developmental stages in rehab - motor development as a gradual releasing of degrees of freedom

🡆supports the importance of providing external support during early phases of learning motor skill in patients with coordination problems

Gentile's

___________'__ model: stages include getting the idea of the movement and fixation/diversification

goal

in gentile's model, getting the idea of the movement includes understanding the ________ of the task, developing movement strategies appropriate to achieving the goal, and understanding the relevant environmental features (regulatory vs. nonregulatory)

Gentile's

in the 2nd stage of ____________'__ model, goal is refinement of the movement.

🡆refers to developing the capability of adapting movement to changing task/environmental demands as well as consistent, efficient practice

🡆fixation is the goal for closed skills

🡆diversification is the goal for open skills

fixation

goal for closed skills according to Gentile's model

diversification

goal for open skills according to Gentile's model

intrinsic

this mode of feedback comes from the patient's body

extrinsic

this mode of feedback is supplemental, coming from outside of the patient

🡆ex: computer, beeper, metronome, mirror, verbal feedback

performance

feedback can include knowledge of _______________, which refers to the quality of movement or kinematics

results

feedback can include knowledge of ___________, which is the outcome (speed, safety, whether they met their goal)

delayed

generally, immediate/delayed feedback is better for learning

higher

frequency of feedback should be higher/lower for a new learner

intermittent

in general, 100%/intermittent feedback is better

faded

____________ feedback frequency describes giving a novice learner 100% feedback but gradually providing less feedback over time to increase learner independence

massed

_____________ practice: work>rest time

🡆better to get more repetitions

distributed

____________ practice: rest>work time

🡆benefit of rest for reflection on performance

constant

____________ practice: practicing the same every time

🡆if goal is fixation

variable

____________ practice: changing height, speed, environment each time

🡆if goal is diversification

random

______________ practice: when working on multiple skills in 1 session: CACBBABCAAC

blocked

_____________ practice: when working on multiple skills 1 session: AAAABBBBCCCC

random

blocked/random practice has better long-term outcomes

blocked

blocked/random practice has better within-session performance improvements but poorer carry-over

interference

with random practice, contextual ___________ explains why there is deeper thinking

🡆learners forget what happened in previous attempt & have to re-generate motor plan

whole

__________ task practice is better for continuous tasks - practicing entire skill

part

_________ task training is better for serial skills (isolated, standalone pieces of a task) - split up the parts before putting it together

physical guidance

this type of practice encourages perfect practice

discovery learning

this type of practice allows learner to make mistakes & learn from them

open

this type of task/environmental context is better for adaptability

closed

this type of task/environmental context is better for novice learners

OPTIMAL

___________ theory: optimizing performance through intrinsic motivation and attention for learning

🡆give choices (autonomy)

🡆set expectations for success

🡆focus on goal/outcome of movement

internal

__________ focus of attention: focusing on body movements may result in a more conscious control strategy & interfere with automatic control processing

🡆more co-activation including unnecessary motor units, limiting fluidity

🡆we focus on this 95% of the time

🡆verbal instructions can get very wordy & confusing when describing complex movement

external

___________ focus of attention: promotes unconscious motor processes - shortens first stage of learning by facilitating automaticity

🡆instructions should be simple and focus on the movement outcome

🡆set up the task to get the movement you want

internal

internal/external focus of attention limits automatic processing

external

internal/external focus of attention facilitates automaticity