Motor Learning Stages

Cognitive Stage

learn what to do

gather information

extrinsic feedback > intrinsic feedback

knowledge of results before knowledge of performance

cognitive stage environment

closed environment

distributed, blocked practiced

trial and error

cognitive stage example

PT guides patient with hand over hand cues and demonstrate propulsion technique

associative stage

learn how to do it

put actions together

refinement of motor pattern is achieved through continued practice

intrinsic feedback

summed feedback at end of all trials

assosicative stage environment

serial practice, variable practice

open environment

no more guided movement

associative stage example

PT allows patient to problem solve when steering errors occur and does not provide feedback

autonomic stage

learn how to succeed

more time and practice

minimal level of attention needed

focus on secondary task

autonomic stage practice type

variable practice with consistent performance

change environment

add dual tasking

autonomic stage example

patient propels wheelchair with variable speed through an obstacle course

demonstration variables

motivation

attention

timing

critical component

no mistakes

novice

demonstration variables mnemonic

MAT-CNN

Feedback

allows motor responses to be adapted or modified according to the demands of the environment

feedforward

prepares the system in advance of movement

anticipatory or proactive responses

augmented feedback

externally provided feedback

augmented feedback - simple task

every 15 reps give feedback

augmented feedback - complex tasks

feedback every 5 reps

knowledge of performance

KP

specific details regarding movement characteristics

knowledge of performance example

you should bend your knees more as you walk

qualitative + prescriptive KP is used with

beginners

quantitative + descriptive KP used with

advanced learners

knowledge of results

outcome of movement

given first

knowledge of results example

yes or no

walked 10 feet today

passed your exam

knowledge of results feedback delay

no longer than 3 seconds

concurrent feedbac

feedback provided during the task

terminal feedback

provided at end of the task

summed feedback

after set number of trials

better of retention

fading feedback

decreasing amount of feedback

task intrinsic feedback

sensory information normally acquired during performance of a task

visual feedback

used during cognitive phase

easier for patient to understand this type of feedback

proprioceptive feedback

entails physical interaction with the environment which allows the patient to build sense of awareness for where the body is in space w/o use of vision

used during associative phase

constant variability

same environment, static motor skill

better for patients with cognitive deficits

variabile

different environments, required to make rapid modifications

allows for better retention

want to allow errors to occur to increase learning

regulatory conditions

characteristics in environment that directly influence the movement or task

nonregulatory conditions

characteristics in the environment that do not directly influence the movement or task

blocked practice

single motor skill repeated

used in beginning of learning with decreased cognitive ability

AAABBBCCC

random practice

group of motor skills in random or unpredictable order

better for retention

ABCBACCAB

random practice mnemonic

randon for retention

serial practice

group of motor skills in a serial or predictable order

ABBABBABB

variable practice

practice varied motor skills

required to make rapid modifications of skill in order to match task demands

mass practice

working time > rest break

preferred for discrete tasks

fatigue decreases performance so be aware

discrete task

taks with specific recognized start and end points

distributed practcied

rest break > work time

used if individuals have low endurance or fatigue or is mentally “checked out”

preferred most of the time

mental practice

cognitive rehersal of task without physical performance

good for beginners

whole transfer

simple training of the whole task

part transfer

complex task broken down into different substacks

part transfer example

wheelchair training — locking brakes, lifting foot pedals, moving forward in a chair, etc

fractionation

practicing individual limbs firest for an aysmmetrical coordinated task

segmentation

separating skill into parts and practicing them so the parts build on each other

simplification

reducing object manipulation, cognitive load or speed

add auditory cues

bilateral transfer

improving performance with one, untrained limb results from practice of similar movements with opposite trained limb

lead up tasks

presented to learning for more information on complex task

lead up task example

kneeling - half kneeling - plantigrade before standing

overlearning

process of rehearsing a motor skill even after there is no improvement in performance

constraint induced movement therapy

CIMT

less affected UE restrained using hand mitt which forces the patient to use affected UE

mobility

ability to initiate movement through function ROM

stability

ability to maintain position or posture through cocontraction and tonic holding around a joint

controlled mobility

ability to move within a weight bearing position or rotate around a long axis

emphasize weight shifting with trunk control or rotation

skill

ability to consistently perform functional tasks and manipulate the environment with normal postural reflex mechanism and balance reactions

motor development

evolution of changes in motor behavior occurs as a result of growth, maturation and experience