Motor Learning Lecture Notes PDF

Introduction to Motor Learning 1 Objectives § 3.1 Compare and contrast the stages in motor learning theory including Fitts and Posner’s three-stage theory, systems three-stage theory, and Bernstein’s 3 stage theory (CLO 1) § 3.2 Explain the stages and principles of motor le...

Introduction to Motor Learning 1 Objectives § 3.1 Compare and contrast the stages in motor learning theory including Fitts and Posner’s three-stage theory, systems three-stage theory, and Bernstein’s 3 stage theory (CLO 1) § 3.2 Explain the stages and principles of motor learning that drive plastic changes in the nervous system and across the lifespan. (CLO 1) o 3.2.1 Compare and contrast implicit and explicit forms of learning and give examples of each. (CLO 1) 2 1  Motor Performance vs Motor Learning1 Motor Performance Motor Learning - Temporary - Permanent - Same practice session - Transfers to other tasks/environments 3 Theories of Motor Learning1,2,3 § Closed-loop Theory—Reference of Correctness § Schema Theory—Recall and Recognition § Systems Theory—Whole Body § Ecological Theory—Environmental focus § OPTIMAL Theory—Motivation and Attention 4 2  Feedback and Feedforward Processes1,4 Environmental cues to adjust Intrinsic predictions to improve practice success 5 Motor Learning1,2,4 Processes of movement - Modified by practice 6 3  Extrinsic Attributes Constraints of Movement Acquisition1,3 Task Spatial/temporal aspects Intrinsic Attributes Speed Biomechanical Environment Muscle length tension Surfaces Joint mobility Mobility Objects Psychological Memory Cognition Neuromuscular Tone System processing 7 Practice using Explicit and Implicit Learning Explicit = step-by-Step Instructions Implicit = Unguided actions Photo credit: [Maria Lindsey]/[Spices on Bowl Near Knife on Chopping Photo credit: [Nubia Navarro]/[Woman and Man riding on Boad ]/[Pexels/CC license] bike]/[Pexels/CC license] 8 4  Summary Motor Learning Aspects of practice that allow for movement modification Constraints of Movement Acquisition Internal and External Intrinsic vs Extrinsic learning mechanisms 9 References 1. Shumway-Cook A, Woollacott MH, Rachwani J, Santamaria V. Motor Control: Translating Research into Clinical Practice. Sixth edition. Wolters Kluwer; 2022. ISBN – 978-1-975158-27-9 2. O'Sullivan S, Schmitz T, Fulk G. Physical Rehabilitation Assessment and Treatment, 7th ed. F.A. Davis Co; 2019. ISBN-13:9780803625792 3. Wulf G, Lewthwaite R. Optimizing performance through intrinsic motivation and attention for learning: the OPTIMAL theory of motor learning. Psychon Bull Rev. 2016;23:1382-1414. 4. Houglum PA, Bertoti DB. Brunnstrom’s Clinical Kinesiology, 6th Ed, F.A. Davis CO; 2012. ISBN 978-0-8036-2352-1 10 5  Motor Memory and Learning Styles 1 Objectives § 3.2 Explain the stages and principles of motor learning that drive plastic changes in the nervous system and across the lifespan (CLO 1) o Compare/contrast differences in the two forms of long-term memory o Recognize different learning styles 2 1  Declarative Facts Explicit Long-term Memory1,2 Non associative Learning Non-Declarative Associative Learning Implicit Procedural Learning 3 Declarative Facts Explicit Long-term Memory1,2 Non associative Learning Non-Declarative Associative Learning Implicit Procedural Learning 4 2  Example 1 Fable: The Boy who Cried Wolf What type of memory did the Villagers have in this story? 5 Example 2 Wrong Destination (Golf vs Work)? What type of memory was in control in this scenario? 6 3  Learning Styles Analytical/Objective Intuitive/Global VS 7 Summary Long Term Memory Declarative—Factual Non-Declarative—reflexive, subconscious, “autopilot” Learning Styles Analytical/Objective—lists, structure Intuitive/Global—real-world examples/experiences 8 4  References O'Sullivan S, Schmitz T, Fulk G. Physical Rehabilitation Assessment and Treatment, 7th ed. F.A. Davis Co; 2019. ISBN-13:9780803625792 Shumway-Cook A, Woollacott MH, Rachwani J, Santamaria V. Motor Control: Translating Research into Clinical Practice. Sixth edition. Wolters Kluwer; 2023. ISBN – 978-1-975158-27-9 9 5  Motor Skills Classification 1 Objectives § 3.2 Explain the stages and principles of motor learning that drive plastic changes in the nervous system and across the lifespan. (CLO 1) § Recognize classification of gross and fine motor skills § Recognize classification of open and closed motor skills § Classify difficulty of motor skills based on degrees of freedom and Gentile’s taxonomy 2 1  Gross Motor Skills § Large muscle groups § Global movements/activities 3 Fine Motor Skills § Precise § Involved in ADLs 4 2  Closed Motor Skills § Unchanging § Quiet 5 Open Motor Skills § Unpredictable § Busy 6 3  Degrees of Freedom § # dimensions controlled by an individual § More increases difficulty 7 Action Body Stability Body Transport Gentiles Trial No Object Object No Object Object Taxonomy4 Variability Manipulation Manipulation Manipulation Manipulation Stationary Standing watching Standing and Walking looking at Walking on a level TV alone catching a ball items in an empty surface catching a EA store ball S IER Closed Mild Standing on an Standing on an Walking on an empty Walking on an empty shoreline of empty shoreline of shoreline of a beach empty shoreline a beach watching a beach catching a of a beach the ocean ball catching a ball Stationary Standing in a Standing in a Walking in a crowded Walking in a Table modified based on Gentile 2000. crowded store crowded store store crowded store watching people texting HA and texting RD Open walk by ER Mild Standing on a Standing on a Walking on a Walking on a crowded beach crowded beach crowded beach crowded beach watching the catching a ball catching a ball waves 8 4  Summary Gross vs Fine motor skills Closed vs Open motor skills Increased degrees of freedom increase complexity Challenge/regress interventions using Gentile’s Taxonomy 9 References O'Sullivan S, Schmitz T, Fulk G. Physical Rehabilitation Assessment and Treatment, 7th ed. F.A. Davis Co; 2019. ISBN-13:9780803625792 O’Sullivan S, Schmitz TJ. Improving Functional Outcomes in Physical Rehabilitation, 2nd ed. F. A. Davis Co; 2016. ISBN – 9780803646124. Shumway-Cook A, Woollacott MH, Rachwani J, Santamaria V. Motor Control: Translating Research into Clinical Practice. Sixth edition. Wolters Kluwer; 2023. ISBN – 978-1-975158-27-9 Gentile A. Skill acquisition: Action, movement, and neuromotor processes. In Carr J, and Shephard R (eds): Movement Science: Foundations for Physical Therapy in Rehabilitation, 2nd ed. Aspen Publication; 2000. ISBN-10: 0834217473. Image References 1. All Images by gettyimages.com. Accessed January 2, 2024. 10 5  Theories and Stages of Motor Learning 1 Objectives § 3.1 Compare and contrast the stages in motor learning theory including Fitts and Posner’s three-stage theory, systems three-stage theory, and Bernstein’s 3 stage theory (CLO 1) § Apply the stages of motor learning to simple case scenarios 2 1  Foundational Theories of Motor Learning Closed-loop Adam’s Reference of correctness Theory Motor Program Schema Recall vs Recognition Theory Perception -> Action Ecological Task and Environmental considerations Theory 3 Staged Theories of Motor Learning Bernstein’s 3 Stage Approach Degrees of Freedom Fitt’s and Posner 3 Stage Approach Cognitive Associative Autonomous 4 2  Bernstein’s 3 Stage Approach Stage 2: (Advanced) Stage 1: (Novice) Stage 3: (Expert) Release additional Reduced Degrees of Freedom Release all Degrees of Freedom Degrees of Freedom 5 Fitts and Posner’s 3 Stages of Motor Learning1,2,3 § Cognitive § Associative § Autonomous 6 3  Case 1 7 Case 2 8 4  Case 3 9 Summary Stages of Motor Learning Cognitive—Extreme processing needed; a LOT of external feedback required for success. Associative—Some processing still needed; external reminders needed on occasion, but individual can utilize intrinsic feedback also. Autonomous—Mostly subconscious activity with little to no processing required; Able to intrinsically correct errors without need for external feedback from another person. 10 5  References Fitts P, and Posner M. Human Performance. Brooks/Cole; 1969. O'Sullivan S, Schmitz T, Fulk G. Physical Rehabilitation Assessment and Treatment, 7th ed. F.A. Davis Co; 2019. ISBN-13:9780803625792 Shumway-Cook A, Woollacott MH, Rachwani J, Santamaria V. Motor Control: Translating Research into Clinical Practice. Sixth edition. Wolters Kluwer; 2023. ISBN – 978-1-975158-27-9 Image and Video References 1. All media by gettyimages.com. Accessed January 2, 2024 11 6  PHT5228C Science of Movement Practice Strategies to Improve Motor Function 1 Unit 3 Objectives § Recognize the components of practice. § Classify aspects of practice appropriate to facilitate motor performance and motor learning. 2 1  Reference of Correctness1 § Recognizing and responding to changing situations § Important for Motor Learning 3 Guided Movement1 § May be tactile, verbal, or environmental guiding § How it feels to move using appropriate biomechanics § Too little allows for frustration § Too much allows for dependence Photo credit: [Min An]/Couple holding hand]/[Pexel/CC license] 4 2  § Distributio § Variability § Order Practice1 Distribution § Strategies § Environme Variability Practice PRO Practice Order Practice Strategies Environment Structure 5 § Distributio § Variability § Order Practice1 Distribution § Strategies § Environme Variability Practice PRO Order Practice Perfect Practice Strategies Environment Structure 6 3  Practice Distribution: Massed vs Distributed Practice1 Massed Practice > Rest Practice Motor Performance Distributed Practice Motor Plan Use-dependent cortical reorganization 6 3  10/15/24 Choosing Interventions Based on Neural Plasticity Examination Evaluation Personal & Environmental Factors Social Comorbid Contra- Lifestyle Potential Determinan Precautions ts of Health Factors indications PT Diagnosis/Prognosis/Plan of Care Rehabilitation/Recovery Compensation 7 Summary Recovery § Reacquisition of previous motor patterns Compensation § Adjustments/adaptations to previous motor patterns Cortical Remapping/Plasticity § Neural adjustments to changes in behavior or environment 8 4  10/15/24 References 1. O'Sullivan S, Schmitz T, Fulk G. Physical Rehabilitation Assessment and Treatment, 7th ed. F.A. Davis Co; 2019. ISBN-13:9780803625792 2. Miura N, Tagomori K, Ikutomo H et al. Asymmetrical loading during sit-to-stand movement in patients 1 year after total hip arthroplasty. Clin Biomech. 2018;57;89-92. 3. Buonomano DV, Merzenich MM. Cortical Plasticity: From Synapses to Maps. Annu Rev Neurosci. 1998;21:149-186. Media 1. All media by gettyimages.com. Accessed January 22, 2024. 9 5  PHT5228C Science of Movement Principles of Neural Plasticity 1 Objectives § 3.3 Describe strategies to enhance neural plasticity, including Kleim’s Principles of Experience-dependent plasticity. (CLO1) 2 1  Ten Principles of Experience-Dependent Neuroplasticity1 1. Use it or Lose It 6. Time Matters 2. Use it and Improve It 7. Salience Matters 3. Specificity 8. Age Matters 4. Repetition Matters 9. Transference 5. Intensity Matters 10. Interference 3 Use it or Lose it 1,2 4 2  Use it and Improve it1,3 5 Specificity Activity that is practiced is similar to the intended goal 6 3  Repetition Matters 7 Intensity Matters4 Plasticity needs challenge!! 8 4  Time Matters5 § How soon is too soon? § When is not soon enough? 9 Salience Matters1 Plasticity increases when people find things enjoyable! 10 5  Age Matters1 11 Transference1 Plasticity carryover 12 6  Interference Maladaptive responses where other circuitry impedes intended movement acquisition. 13 Summary 10 Principles of Neural plasticity Guides plan of care Rooted in research Applicable to all diagnoses 14 7  References 1. Kleim JA, Jones TA. Principles of Experience-Dependent Neural Plasticity: Implications for Rehabilitation After Brain damage. J Speech Lang Hear Res. 2008;51:S225-S239. 2. Hubel DH, Wiesel TN. Binocular interaction in striate cortex of kittens reared with artificial squint. J Neurophysiol. 1965; 28:1041:1059. 3. Nudo RJ, Milliken GW. Reorganization of movement representations in primary motor cortex following focal ischemic infarcts in adult squirrel monkeys. J Neurophysiol. 1996;16:785-807. 4. Dankel SJ, Mattocks KT, Jessee MB, et al. Frequency: The Overlooked Resistance Training Variable for Inducing Muscle Hypertrophy? Sports med. 2017;47:799-805. 5. Biernaskie J, Cherneko G, Corbett D. Efficacy of rehabilitative experiences declines with time after focal ischemic brain injury. J Neurosci. 2004;24:1245-1254. Media 1. All media by gettyimages.com. Accessed February 22, 2024. 15 8 RISE: IMPACT OF NEUROPLASTICITY ON MOVEMENT Neuroplasticity Defined The human nervous system is an incredible organ that has vast capabilities to grow, develop, and adapt to change over time. This is known as neuroplasticity. It’s like reformatting or designing how the brain was previously working to allow new or different functions by adding or changing neural connections. It happens: ◦ Throughout the lifespan ◦ After injury ◦ When learning a new task (motor or cognitive) Positive and Negative Neuroplasticity As neuroplasticity occurs, it can be very effective and lead to great outcomes; however it may also be less effective and have negative or poorer outcomes. Factors affecting the success of neuroplasticity are many including: ◦ The nature/cause of the disease or injury ◦ Patient co-morbidities ◦ Environmental factors ◦ Quality of rehab Recovery ◦ Neuroplasticity at its finest! ◦ Patient regains lost skills or learns new ones effectively ◦ This is our (and our patient’s) highest goal/hope Compensation ◦ Neuroplasticity is incomplete ◦ Patient regains or learns some typical skills and function ◦ The goal/hope is for as much independence and function as possible, however compensations such as use of adaptive equipment or different movement patterns may be used Neurogenesis ◦ Occurs in the developing brain but also occurs in the adult brain in the hippocampus ◦ Primary function of the hippocampus is for learning and memory which is important for motor learning Axonal Sprouting and New synapses ◦ New and strengthened synapses may be created to help where damaged synapses are no longer working: Silent synapses are turned into active ones (LTP - long term potentiation) ◦ Weakened synapses may occur when active synapses are turned into silent ones (LTD - long term depression) ◦ LTP and LTD primarily happen in the hippocampus and cortex- areas of motor, somatosensory, visual, and auditory learning Axonal Regrowth (Sprouting) and New Synapses ◦ Occurs more in PNS than CNS ( due to (NGF) by Schwann cells ◦ 1 mm of growth per day, or about 1 inch of recovery per month  ◦ Exercise begun 5 days after a peripheral nerve lesion increases axonal regeneration and reinnervation of muscle Cortical Reorganization ◦ If damage is severe and nerve cells dies, the brain can re-organize itself so other areas of the brain take over the activity of the injured area ‣ Areas adjust their function ‣ Areas adjust their location ‣ Areas adjust their activity ◦ The brain will reorganize according to experience and stimulation (or lack of it) ‣ For instance, a skilled string instrument player will have a larger finger map on their dominant size due to years of practice ‣ Or: an individual with SCI will have leg organization switched to the hand are ‣ Similar reorganization can occur in brain injury, brain tumors, stroke Affect of injury If a nerve cell body dies, it cannot regenerate or grow/change synaptic abilities But: If injury is to the axon or at the synaptic level, axons can regenerate (more likely in the peripheral nervous system) and synaptic changes can occur