Using Motor Learning Principles to Maximize Patient Function PDF Fall 2024

Using Motor Learning Principles to Maximize Patient Function DPT 452 Functional Neuroscience Fall 2024 Anne K. Galgon PT PhD NCS Rest of the course Today and Monday(11/18): motor learning/ neuroplasticity Next Wednesday (11/20): Neural mechanisms of Postural co...

Using Motor Learning Principles to Maximize Patient Function DPT 452 Functional Neuroscience Fall 2024 Anne K. Galgon PT PhD NCS Rest of the course Today and Monday(11/18): motor learning/ neuroplasticity Next Wednesday (11/20): Neural mechanisms of Postural control Quiz 3(Moto control and UE)( 11/20?) Thanksgiving Monday(12/1) after Thanksgiving 9:30-10:15 Motor learning lab (last assignment) 11:15-12:30 Neural mechanisms of locomotion Wednesday(12/4): Review class Quiz 4 ( motor learning )? Final Exam 12/11  Objectives Students will understand basic principles underlying Neuroplasticity related to motor learning. Students will identify motor learning principles and use them to assist a person with improving performance of a motor skill Students will learn and implement the components in optimizing motor learning during a treatment session Students will define recovery of function and understand how motor learning applies to this concept (Part II in week 13) Topics Physiologic Basis for Learning Neuroplasticity SC&W (pp 80-90) Motor Learning Definitions/Terms Implicit and Explicit process Theories Task oriented approach Stages of Learning Motor learning practice parameters (After the break) Neuroplasticity Leonard (1998) “Nervous system is not a static structure. Rather it is continuously being reshaped according to environmental needs and demands” Plasticity is present throughout life, but never equals changes seen in young animals  Plasticity Occurrences in Nervous System Neurodevelopment (Childhood) Learning (motor learning) (Adult) Recovery after injury (Brain injury or musculoskeletal injury) Definition Lundy- Ekman, 2002, 2007 “Ability of neurons to change their function, chemical profile, or structure that must be retain more than a few seconds” Examples of plasticity are seen in the following: Habituation and sensitization Learning and memory Cellular recovery after injury Neuroplastic Changes Parallel Behavior (SC&W; Fig 4-1)  Definition of Neuroplasticity Basso 1998 General term used to describe the ability for nervous system to adapt and change Occurs at different levels Changes in physiology Changes in nerve threshold, conduction velocity, synaptic efficiency Changes in anatomical morphology Changes in structure, connectivity Changes in behavior Learning or recovery of function  Rules of Synaptic Plasticity Hebb’s Hypotheses When presynaptic axon is active and at the same time the postsynaptic neuron is strongly activated under the influences of other inputs, than synapse for presynaptic axon is strengthened. Neurons that fire together wire together. When the presynaptic axon is active and at the same time the postsynaptic neuron is weakly activated by other inputs, then synapse is weakened. Neurons that fire out of sync lose their link. Neuroplastic Changes With Learning Activity-Dependent Synaptic plasticity Long-term potentiation (LTP) and Long Term depression (LTD) (SC&W, pp 86-87) ❖Changes in effectiveness of presynaptic and excitability of postsynaptic neurons ❖Growth of new connections (synaptogenesis)  Activity-Dependent Synaptic Rearrangement Synaptic segregation Synaptic stabilization- critical time period -with neurons firing together strengthen function Synaptic convergence Convergence of input – critical time period – visual environment influences development Synaptic competition Inputs compete for synaptic control of postsynaptic neuron Modulatory influences Individual must pay attention to cues (identification) Habituation and Sensitization Both processes results in either a increase or decrease a motor response through exposure to sensory information Repetition of stimulus Intensity of stimulus  Associative Learning Classical and Operant Condition Long-Term Synaptic Potentiation (LTP) Cooperative Presynaptic stimulation paired with post synaptic depolarization of other sources Associate Weak stimulus consistently paired with strong stimulus – weak stimulation strengthens Strength of the stimulation and reward Timing of the stimulation and reward  Procedural Learning More complex (Motor Cortex and Cerebellar) Trial and error learning Motor adaptation Gilbert and Thatch (1977) Monkey learning to return a lever to central position Unexpected change in load on the lever Other paradigms VOR and prism glasses Cerebellar control of Motor Adaptation Summary Motor Learning A set of internal processes associated with practice or experience leading to RELATIVELY PERMANENT CHANGE in the capability for skilled behavior (Schmidt, 1988) Changes in CNS may not be directly observable → rather are inferred from improvement in performance as result of practice or experience  https://www.youtube.com/watch?v=hQFP3npv6j8 (4:24)  https://www.youtube.com/watch?v=5-r7n6CFmQM Treatment Session Ask your self these questions: How can I best structure the session (practice) to ensure learning? How can I ensure that skills learned in one context transfer to others? Will simplifying a task result in more efficient learning? What is best to ensure retention? Or generalizability (transfer)? What is best way to promote neuroplasticity? Motor Learning Terms Performance: Temporary change in motor behavior seen during practice sessions Not a measure of absolute learning Retention: Measures learning Time Delay Required Transfer (generalization): Measures learning Able to perform in a new condition that was not practiced Performance and Learning Performance Learning Observable Behavior ― Internal mental process ― Observed through repeated Sensitive to “state” variables performances (Acquisition) (fatigue, anxiety, motivation, ― and under different etc) circumstances (Generalized) Variable ― Relatively permanent capacity (Retained) Performance and Learning Performance curves used to measure learning Early Late Performance Trials across weeks/months (Acquisition) Two Types of Learning and Memory Explicit learning Implicit learning Willingham (1999: Dual Mode learning?) Conscious Unconscious Memory Processes (Explicit learning)  4 types of processing  Encoding  → requires attention→ neural circuitry  Consolidation  →information stability in long-term memory  Structural changes in neurons  Storage – long term memory  Retrieval  → recall info from different LTM storage areas  Working or Short-term memory  attentional control & rehearsal systems  ENCODING AND RETRIEVAL Sensory processing Serial search- verbal Parallel processing Parallel search - movement Sensory Selective attention Encoding Memory consolidation stimuli Short term Long term Sensory memory memory memory Working Retrieval Attention memory Response selection and programming Response execution  Attention Assumption Attention is a limited resource We use part of our attention capacity when performing a function or focusing on a source of information Attention is compartmented by function (explicit information, procedural)  Memory and Learning Association cortex Procedural Prefrontal Sensory motor Limbic cortex Memory cortex cortex Explicit Memory Both Motor cortex amygdala hippocampus Basal dorsomedial ganglia Thalamus Anterior Cerebellum hypothalamus Sensory input This diagram represents what type of organizational theory? Willingham, 1999 Motor control vs. learning Explicit Learning AKA declarative learning Developing a memory of factual knowledge Revealed in tests of recognition and recall Used frequently when teaching a patient a skill What are the steps in the transfer? What are the features in the environment that need to be controlled? Implicit Learning AKA procedural learning Improved performance is assumed to reflect the acquisition of knowledge about a task Observed through changes in skilled movement relative to some baseline for example, more accurate or faster movements Acquiring skill through physical practice but without conscious awareness “Unintentional learning” Memory & Motor Learning Memory Structures fundamental to most theories of motor learning Compare and contrast Recall and recognition Schema (Schmidt: motor program theory) Ecological Theory (Newell) SC& W pp 26-28 Schmidt Schema Theory After a movement an individual stores short term memory of 1. The initial condition of the movement 2. The parameter of a generalized motor program (invariable features) 3. The outcome of the movement (Knowledge of results KR) 4. The sensory consequence of the movement. Schmidt Schema Theory If short term is stored long enough (practice) Create two schema’s Recall schema (motor) Recognition schema (sensory) Variable (different condition) practice improve learning of generalized motor program Ecological Theory (Newell) Motor learning increases the coordination between perception and action Practice with a perceptual work place Exploring the environment of the workplace The learner is….. Learning regulatory cues Developing motor solutions Ecological Theory (Newell) Perceptual information that may help learning The goal of the task and movement to be learned Help learner understand the nature of the workspace Help learner attaining search strategies for regulatory cues Knowledge of performance (KP)  Big Concepts: Individuals can use explicit and implicit systems for motor learning. Motor learning theories support use of both process Instruction, Knowledge of Results(KR) and Knowledge of Performance (KP) Practice to learning implicitly Variable Practice strength motor learning in both theories MONDAY How Are Motor Skills Learned? Learned through interaction and exploration of the environment Movement Proficiency Effectiveness Person = Individual Person Accuracy Efficiency Safety Task Task Environment