Motor Learning Part 1 PDF Lecture Notes

PSTR 307 Lecture 3 MOTOR LEARNING GABRIEL KWAME FIENYA, PT, DPT, MSC, MCSP  Objectives University of Ghana | Dr Gabriel Kwame Fienya Objectives ž Define motor learning and understand its role in development, the acquisition of motor skills in adul...

PSTR 307 Lecture 3 MOTOR LEARNING GABRIEL KWAME FIENYA, PT, DPT, MSC, MCSP  Objectives University of Ghana | Dr Gabriel Kwame Fienya Objectives ž Define motor learning and understand its role in development, the acquisition of motor skills in adulthood and following lesions to the CNS ž Understand the role of the nature of the task, the stage of the learning and the structure of the environment in motor learning ž To understand theoretical models of motor learning including closed and open loop models University of Ghana | Dr Gabriel Kwame Fienya Objectives ž To understand the factors involved in the process of motor learning ž To understand the role of practice in motor learning ž To understand the role of information in motor learning ž To understand the role of motivational factors in motor learning University of Ghana | Dr Gabriel Kwame Fienya  Case University of Ghana | Dr Gabriel Kwame Fienya Case After her stroke, Mrs J received therapy for 5 weeks. She gradually regained the ability to stand, walk, and feed herself. v What is the course of her recovery? v How much is spontaneous? v How much is attributed to the therapy? v How many of her re-acquired skills will she be able to use when she gets home? University of Ghana | Dr Gabriel Kwame Fienya  Introduction University of Ghana | Dr Gabriel Kwame Fienya Introduction v Motor learning is a set of processes associated with practice or experience leading to relatively permanent changes in the capability for skilled. v It has also been described as the process by which we acquire/re-aquire motor skills v Every day motor activities such as walking, standing up and picking up an object are motor skills University of Ghana | Dr Gabriel Kwame Fienya Factors that Influence Motor Learning Impede Learning Promote Learning Low dose of practice Sleep Instructions Task specific training Poor organization of Brain stimulation (?) movement Altered force control University of Ghana | Dr Gabriel Kwame Fienya Motor learning occurs in development vStarts in early infancy where babies continuously practice movement sequences over and over. vIs the process by which the milestones are established vChildren develop new motor skills over time: hopping, jumping, throwing and catching. University of Ghana | Dr Gabriel Kwame Fienya Motor learning continues in adulthood vAdults continue to acquire new motor skills. vThe process by which adults learn to execute and control movement in voluntary and automatic manner is called motor learning. vSkills such as driving a car or typing are practiced and become part of the motor repertoire vSports related skills are also acquired through motor learning University of Ghana | Dr Gabriel Kwame Fienya Performance and learning vMrs J shows improved ability to stand symmetrically at the end of her daily physio sessions vWhen she returns to physio the next day, she stands again with all her weight on the uninvolved side vWhat does this mean? University of Ghana | Dr Gabriel Kwame Fienya Motor learning occurs after brain lesions vMotor re-learning needs to occur following lesions of the CNS as individuals 1. learn to move in spite of the deficits imposed by the lesion 2. At the same time that the patient is relearning how to move. Ongoing recovery processes University of Ghana | Dr Gabriel Kwame Fienya Motor Skill Loss vMotor skill is lost or impaired due to vDisordered voluntary muscle activation (can’t recruit muscles) vInability to control the pattern of muscle activation (cannot order muscle activation in a co- ordinated manner for performance of the task) University of Ghana | Dr Gabriel Kwame Fienya How Recovery Occurs vIn an acute brain lesion vSome recovery occurs spontaneously as a result of neural repair mechanisms vOver time individuals regain skills in spite of the residual deficits as a result of motor learning Neuroplastic processes underpin this learning University of Ghana | Dr Gabriel Kwame Fienya Why should PTs and Ots understand Motor Learning Understanding the processes involved in learning a motor skill enables the PT and OT to: §Design and deliver appropriate interventions §Conduct more effective practice and rehabilitation University of Ghana | Dr Gabriel Kwame Fienya  Processes Underlying Skill Acquisition University of Ghana | Dr Gabriel Kwame Fienya Motor Learning vThe processes underlying skill acquisition depend on: vthe stage of the learner, vthe nature of the task vthe structure of the environment University of Ghana | Dr Gabriel Kwame Fienya Motor Learning vThe processes underlying skill acquisition depend on: vthe stage of the learner, vthe nature of the task vthe structure of the environment University of Ghana | Dr Gabriel Kwame Fienya Motor Learning: Stage of the learner v Cognitive Phase v Associative Phase v Autonomous Phase University of Ghana | Dr Gabriel Kwame Fienya Motor Learning: Cognitive Phase v Cognitive Phase (what to do phase) v Goal: to obtain an overall idea of what the task is all about v May involve: v Sensory information v Verbal instruction v Visually guided movement University of Ghana | Dr Gabriel Kwame Fienya Motor Learning: Cognitive Phase v If there are cognitive deficits: vSkills acquired slower vDifficulty processing verbal instructions vPotential difficulties with attention and concentration v How will these affect the therapist’s approach to treatment? University of Ghana | Dr Gabriel Kwame Fienya Motor Learning: Associative Phase v Associative Phase (“how to do” phase) vPerson carries out the movement and assesses the outcome vErrors are detected and corrected with each new attempt. vLearning takes place with each new trial vAspects of the motor performance associated with success or failure University of Ghana | Dr Gabriel Kwame Fienya Motor Learning: Associative Phase vCharacteristics of this phase vlasts longer than the cognitive phase vSensory feedback is very important vCognitive aspect is still important vSuccess comes vWith practice and the ability to detect errors and correct them vWhen speed and efficiency improves vWith practice in various contexts University of Ghana | Dr Gabriel Kwame Fienya Motor Learning: Associative Phase vBrain damage (??): vdifficulty detecting and correcting errors because of sensory and/or motor deficits vPatients with low tolerance for failure may become frustrated in this phase. University of Ghana | Dr Gabriel Kwame Fienya Motor Learning: Autonomous Phase vAutonomous Phase (“how to succeed phase.” ) vOnce a task is mastered, vit can be carried out with little attention to details of the movement sequences involved eg. Tying your shoe laces vYou don’t forget it: eg. Riding a bike University of Ghana | Dr Gabriel Kwame Fienya Motor Learning: Autonomous Phase vThe autonomous phase is like an open-loop model of feedback in which the action, once started, is completed without conscious feedback. vIt is possible to make changes in performance at this stage vChanges now come more slowly because there is less attention to detail. vOnce this phase is reached, the learner can direct attention to other higher order cognitive activities e.g. your patient can now walk and hold a conversation University of Ghana | Dr Gabriel Kwame Fienya  Putting it together: stage of the learner: Paediatrics University of Ghana | Dr Gabriel Kwame Fienya Cognitive stage vProcess of learning how to walk begins before the child takes their first assisted or independent step v as they have been visually observing others around them walking and beginning to understand the purpose. vSo while they may look clumsy during this stage of learning, they are only just beginning to transition from understanding the skill to executing it. University of Ghana | Dr Gabriel Kwame Fienya Associative Stage vIn this stage, the child may start taking longer, more controlled steps, narrowing their base of support, and allowing their arms to relax at their sides. vThese behaviours indicate that the child has moved past the initial stage of learning and has progressed to a more refined movement. University of Ghana | Dr Gabriel Kwame Fienya Autonomous stage vThe child is now able to walk in a predictable environment such as home or an unpredictable environment such as a crowded birthday party at the park on grass without difficulty. University of Ghana | Dr Gabriel Kwame Fienya Motor Learning vThe processes underlying skill acquisition depend on: vthe stage of the learner, vthe nature of the task vthe structure of the environment University of Ghana | Dr Gabriel Kwame Fienya Motor Learning: Nature of the Task vGross Motor Skill or Fine Motor skills. vDiscreet or continuous or serial vStability of the environment University of Ghana | Dr Gabriel Kwame Fienya Motor Learning: Classification of skills: vGross Motor: Requires large muscles (total body or multi-limb) vFine Motor: Very little body movement, usually involves manipulation of tools or objects while (sitting down/being still) University of Ghana | Dr Gabriel Kwame Fienya Motor Learning: Classification of skills vDiscrete: Has a distinct beginning and ending, Involves a single execution to complete. Includes throwing, striking a match, and shifting gears while driving as examples vContinuous: No distinct beginning and ending, Repetition of movements. Examples include running, swimming, or steering a car. It is unclear whether therapists can successfully teach continuous tasks by "breaking them down" University of Ghana | Dr Gabriel Kwame Fienya Motor Learning: Classification of skills vSerial: Requires various steps. Series of movements in a sequence. Serial tasks are composed of a series of discrete tasks, and should be amenable to partitioning or part-task training. E.g.: starting a car, playing a piano composition University of Ghana | Dr Gabriel Kwame Fienya Motor Learning: Classification of skills vOpen: Done in environments that change over time, example: surfing, walking on different uneven surfaces (hiking), driving a car. Requires the mover to update constantly and pay attention to incoming information about the waves, support surface, movement in traffic etc. Involves more perceptual information vClosed: These are skills that have set parameters and stay the same such as walking on a carpet, holding an object, or reaching for a target. Closed skills pose fewer problems for the individual University of Ghana | Dr Gabriel Kwame Fienya Motor Learning vThe processes underlying skill acquisition depend on: vthe stage of the learner, vthe nature of the task vthe structure of the environment University of Ghana | Dr Gabriel Kwame Fienya Motor Learning: structure of the environment vIn the context of stroke, rehabilitation environment includes - Physical or built environment - Rehabilitation methods used - The staff, their knowledge and attitudes University of Ghana | Dr Gabriel Kwame Fienya Motor Learning: vStudies demonstrate vStroke patients spend more of their day in passive pursuits rather than physical activity vPatients noted to remain solitary and inactive for long periods vTherapy only occurs in a small percentage of the day University of Ghana | Dr Gabriel Kwame Fienya Question? Is the rehabilitation unit a suitable learning environment? University of Ghana | Dr Gabriel Kwame Fienya  Theories of Motor Learning University of Ghana | Dr Gabriel Kwame Fienya Theories of Motor Learning Theories guide clinicians thinking about what may be the reason that the patient has a problem moving and about what interventions may remediate this problem v Adams’s Closed Loop Theory (1971) v Schmidt’s Schema Theory (1975) University of Ghana | Dr Gabriel Kwame Fienya Adams’s Closed Loop Theory (1971) v Learn through feedback v Feedback triggers or modifies movement v Intrinsic and Extrinsic feedback is needed for motor control and motor learning. University of Ghana | Dr Gabriel Kwame Fienya Closed Loop Model of Feedback Figure 1: Closed Loop Model of Feedback: (Montgomery P, Connolly B, Motor Control and Physical Therapy: Theoretical Framework and Practical Application. Hixson, TN, Chattanooga Group Inc, 1991) University of Ghana | Dr Gabriel Kwame Fienya Adams’s Closed Loop Theory (1971) v Adams suggested that skilled movement was stored as v A memory trace v A perceptual trace v Memory Trace is used to select and initiate movement v Perceptual Trace which is built up over a period of practice and becomes the internal reference for correctness In learning, the more you practiced the skill, the stronger the perceptual trace would become University of Ghana | Dr Gabriel Kwame Fienya Adams’s Closed Loop Theory (1971) v Intrinsic feedback: (proprioceptive) v Comes from “the feel” of a movement v Present performance is compared to an internal references of correctness v Largely due to cerebellar involvement University of Ghana | Dr Gabriel Kwame Fienya Adams’s Closed Loop Theory (1971) v Extrinsic feedback: (therapist or environment) v Comes from external sources. Example: sound of a ball on a bat, seeing where the ball lands, hearing instruction from doubles partner. v External not only supply learner with information to correct performance but also assist learners to solve problems. University of Ghana | Dr Gabriel Kwame Fienya Schmidt’s Schema Theory v Based on Motor Programmes (MP) v Motor programmes contained generalised rules (schemas) rather than specifics of movement v A set of generalised rules can be applied in a number of different contexts University of Ghana | Dr Gabriel Kwame Fienya Schmidt’s Schema Theory v The rules and regulations for MP’s are stored in memory and can be called up with little cognitive involvement. v Feedback is not needed when an MP is performed unless the external or internal conditions related to the movement changes. University of Ghana | Dr Gabriel Kwame Fienya Open loop model of feedback Figure 2: Open Loop Model of Feedback (Montgomery P, Connolly B, Motor Control and Physical Therapy: Theoretical Framework and Practical Application. Hixson, TN, Chattanooga Group Inc, 1991) University of Ghana | Dr Gabriel Kwame Fienya Schmidt’s Schema Theory v Muscle commands are pre-programmed and once triggered, proceed to completion with no sensory interference (open loop feedback) v Three types of feedback may occur when movement takes place: v From muscles as they contract during movement v From the parts of the body as they move in space v From the environment in which the movement occurs University of Ghana | Dr Gabriel Kwame Fienya Schmidt’s Schema Theory v All the information is briefly stored when a person moves along with knowledge of results in the form of a schema. v Schemas are used to adjust and evaluate the performance of a motor program. University of Ghana | Dr Gabriel Kwame Fienya  Motor Learning Time Frame University of Ghana | Dr Gabriel Kwame Fienya