Week 1-Motor Learning

Advantages of Instructive Motor learning

-Learning occurs quickly -High retention -Allows for practice of new motor programs *There is high cognitive load with this though!

What 4 aspects affect practice in use-dependent motor learning?

-Task specificity -Aerobic intensity -Fatigue errors -Perfect practice

What two things are key in motor learning?

1) A highly motivating task 2) MANY opportunities to practice

What aspects should be included in your interventions portion of documentation? (7)

1) Activity--what it is 2) Patient position 3) Assistance 4) Duration (sets, reps, minutes) 5) Cuing 6) Safety/Guarding 7) Rationale/purpose (1 sentence max)

Two types of Extrinsic Feedback

1) Knowledge of Results ("did you do it?"--successful or not) 2) Knowledge of Performance ("How well did you do it?"--how was movement organized, could it be done differently, etc.)

Use-dependent motor learning (repetition-based)

A change in motor behavior that occurs from repeated, task specific practice. Changes are made intentionally in order to solve a movement problem and achieve a goal. Involves the motor cortex and the spinal cord. E.g. sit-to-stands, a free throw, etc.

Task

A functional activity E.g.: getting dressed, walking, getting out of bed, etc.

ABCDE (F) goals

Actor, behavior, condition, degree, expected time, function

Reinforcement ML is in the ______ stage of motor learning

Associative

Use-dependent ML is in the ______ and ______ stages of motor learning

Associative and autonomous

When someone is in the ________ stage of motor learning, it is the hardest to change their strategies

Automatic stage

Sensorimotor ML is in the ______ stage of motor learning

Autonomous

Reinforcement ML primary neural substrate

Basal ganglia

Reinforcement Motor Learning requires what brain structure to function?

Basal ganglia (Dopamine reward system) Frontal and motor cortex reward systems

Practice Schedules

Blocked: work on practicing the same thing multiple times Random: Do original task a few times, do something else, then return to original task

Sensorimotor ML primary neural substrate

Cerebellum

Instructive Motor learning (strategy-based--explicit)

Change in motor behavior achieved through the use of an intentional movement strategy. Uses specific external feedback: Errors and performance knowledge.

Sensory Adaptation-based Motor Learning (recalibration--implicit)

Change in motor behavior that is driven by sensory prediction errors. Sensory feedback results in motor output changes. Automatic and implicit. *cerebellar function and all sensory input is needed for this

Which is the easiest type of task according to Gentile's Taxonomy?

Closed, Body Stability

Instructive ML is in the ______ stage of motor learning

Cognitive

Stages of motor learning (3)

Cognitive --> Associative --> Autonomous

What are the 4 cognitive processes (needed in instructive motor learning)?

Comprehension, Attentions, Prediction and Memory

Extrinsic feedback schedules (4 types)

Continuous: Consistently giving feedback. Faded: Start with a lot, then decrease as performance gets better. Summary: Overview at the end of the trials. Bandwidth: Set parameters to start, then only give feedback if the patient performs above or below those parameters.

Three types of tasks

Discrete, Serial, Continuous

Extrinsic feedback

External (from the PT). Most beneficial during the cognitive stages. *make sure to leave a slight delay so that the pt has time to have intrinsic feedback

T/F: Performance promotes motor learning

F: performance is helpful in the short-term, but not in the long-run *Performance is often promoted first in order to gain patient motivation for a task, then it is switched to motor learning strategies.

Which type of feedback schedule is optimal?

Faded

Instructive motor learning is difficult for patients with __________ lesions

Frontal lobe

Reinforcement Motor Learning (reward-based)

Improvement in motor behavior that is driven by binary, outcome-based feedback. Relies heavily on external feedback of outcome and not so much the process. Intentional strategies are put in place to achieve success. *Success vs. failure. **High cognitive load with this

Performance

Increased ability within a session. Normally not retained at the next session and does not transfer to other situations/environments easily

Motor learning mechanisms with highest cognitive load to the lowest

Instructive --> Reinforcement --> Use-dependent --> Sensorimotor adaptation

Which type of feedback is most effective?

Intrinsic

Automatic stage of motor learning

Learner does not require much thought to do the task. It can be performed in multiple contexts and concurrently with other tasks.

If a patient cannot practice a task on their own, what is another option?

Mental practice

Use-dependent ML primary neural substrate

Motor cortex, spinal cord

Cognitive stage of motor learning

Needs to think about what needs to be done. Requires a lot of cognitive attention.

Which is the hardest type of task according to Gentile's Taxonomy?

Open, Body Transport, Manipulation

Instructive ML primary neural substrate

Prefrontal cortex

Sensory Adaptation-based Motor Learning allows for _______ learning

Rapid *patient can also "unlearn" unneeded movements

The 4 components of motor learning

Task, Environment, Feedback, Practice

Discrete tasks

Tasks with a recognizable beginning and end E.g. Kick a ball, push a button

If you are going to use "WFL" in documenting, make sure to mention _________________

The function that was tested

Associative stage of motor learning

The learner knows WHAT needs to be done, but still has to learn to DO it. Less cognitive demand, variable performance, and more thought is required in challenging situations

Continuous tasks

There is no recognizable beginning and end. Tasks are performed until they are arbitrarily stopped. Often timing and momentum contribute to this task. E.g. Jogging, driving, swimming, etc.

T/F: Tasks should be things that the patient wants to do

True!

What types of tasks should be practiced as a whole? what about in components?

Whole: Continuous and discrete Components: serial tasks

Intrinsic feedback

Within the patient. Promotes opportunities to self-correct

Practice should be promoted ....

as much as possible!

Feedback should always be __________

delayed *to provide the pt time to process intrinsic feedback

For neuro patients, their goals are almost always _______ or _________ related

function or participation

Which portions of documentation should NOT be in past tense?

goals, prognosis and POC

Typically, what enhances performance impedes _____________

learning

Random practice schedule improves ___________ and hinders ____________

learning, performance

PT's should structure interventions to promote ______________ (performance or motor learning?)

motor learning

Tasks are NOT

movements or impairments

Blocked practice schedule improves ___________ and hinders ____________

performance, learning

Movement emerges through the interaction of the _________, __________, and ______________

person, task, environment

Assessment statements need to include language of ____________

possibility. NOT cause/effect! e.g. likely, possibly, suggests, indicates....

Motor learning

relatively permanent gains in motor skill capability associated with practice or experience. Involves retention and the ability to apply the "skill" to other situations/environments

Serial tasks

series of discrete movements that go together E.g. Getting into a car, unlocking a door, opening a door, etc.

Reinforcement Motor Learning has __________ learning but __________ retention

slower, longer *may benefit from combining this with Sensory Adaptation-based Motor Learning

Components of motor learning should match the __________ of learning the patient is in

stage

Neuroplasticity

the ability within the brain to constantly change both the structure and function of many cells in response to experience or trauma. This is driven by repeated practice of a new movement

Task Practice types

whole or part