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
