can dace motor

8/3/2019 Can Dace Motor

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Lynne Dart

Carolyn Taylor

Candace Skinner


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Presentation Outline

Introduction

Classifying skills

Theories of motor learning

Goal setting

Motor learning v. motor performance Individual and performance characteristics of skill learning

Presenting and practicing a skill

Transfer of Learning

Feedback Stroke and Motor Learning

GAME!!!!


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Introduction

Motor skills are an important part of our existence ashuman beings. Therefore, the focus of ourpresentation is to look at how individuals developand perform motor skills by applying the principles of

motor learning.

Motor Learning is a set of cognitive processesassociated with practice, training, or experience that

results in relatively permanent changes in motorbehavior


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Classifying Skills

Skills Can Be Classified By Task

Discrete Skill: a skill that has a well

defined beginning and end.

Serial Skill:

Characterized by severaldiscrete skills connected in asequence, whereby order isoften crucial

Continuous Skill:

A skill that has noidentifiable beginning orend and can often berepetitive.

Skills Can Also Be Classified ByCognitive and Motor Elements

Motor Skill:

A skill determined by the quality

of a performers movements

Cognitive Skill:

A skill for which the primarydeterminant of success is thequality of the performersdecisions regarding what to do.


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Classifying Skills cont

Open Skill: A skill performed in an environment that is

unpredictable or in motion that requires

individuals to adapt their movements inresponse to dynamic properties of theenvironment.

Closed Skill: A skill performed in an environment that is

predictable or stationary and that allowsindividuals to plan their movements in advance.


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Theories of Motor Learning

Fitts and Posner (1967):

Cognitive Stage: Trial and error, directs attention

to movements

Associative: reduces amount of cognitive activity

involved, improvement in success and consistency

Autonomous: Skill is becoming automatic, little

cognitive attention


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Theories of Motor Learning

Gentiles Model

Initial Stage:

develop a movement coordination pattern for successful

performance,

learn to discriminate regulatory and non-regulatory conditions

Later Stages:

Adapt movement patterns to specific demands of any

performance situation

Perform skill with economy of effort

Closed skills require fixation and open skills require diversification


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Goal Setting

Individuals should have an input in the goal-setting

process.

Goal setting guides the progress of therapy.

Goals should be specific, measurable, attainable,realistic and time oriented.

Three types of goal should be set; performance

goals, process goals and outcome goals.


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Motor Learning Vs.Motor Performance

Motor Performance: Observable attempt voluntary action.

Level of performance is susceptible to

fluctuation in temporary factors such as

motivation, arousal, fatigue, and physicalcondition

Motor Learning:

Changes in internal processes that determine an

individuals capability of producing a motor task.

The level of motor learning improves with

practice and is often inferred by observing

relatively stable levels of motor performance.


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Individual Characteristics that Affect MotorLearning

Abilities

Attitudes

Motivational level Previous social experiences

Prior movement experiences


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Performance Characteristics of Skill

Learning

Improvement

Consistency

Stability

Persistence

Adaptability


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Presenting a Skill

Demonstration:

Very little research

Modeling: Use of demo to convey informationabout how to perform a skill, same as

observational learning

Beneficial when the skill being learned requiresthe acquisition of a new pattern of coordination

Demonstrator needs to perform skill correctly


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Demonstration Contd

Observing unskilled demonstrators can be

useful if learner is unaware they are unskilled

Useful only if model and demonstrator are

both beginners


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How frequently should youdemonstrate a skill?

Should be demonstrated before beginnerattempts skill

During early part of learning, skill should bedemonstrated as often as necessary

As skill progresses, learner should not need

demonstration as frequently


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Cognitive Mediation Theory

Explains benefit of a demonstration

Learner observes skilled model

Learner translates the observed movement

information into cognitive code

Learner stores cognitive codes in memory and

uses them when they perform the skill


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Verbal Instructions and Cues

Evidence supports this method of instruction

Must consider that learner has limited

attention capacity

Beginner may have difficulty paying attention

to more than 1 or 2 instructions at a time


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Verbal Instructions Contd

Direct learners focus to features of skill or

environment that will enhance performance

Performance of open skills requires direction of

attention to aspects of the environment that willhelp learner

Learners frequently attend to environmental cues

without conscious awareness


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Verbal Cues

Verbal instructions may be too short or too

long

They may provide too much or too little

information

May not provide learner with information

they need to perform the skill


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Verbal Cues

Short concise phrases

Direct attention to information relevant to

performing skills

Prompt key movement-pattern elements of

performing skills

Cues are effective in facilitating learning new

skills as well as performing well-learned skills


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When to give verbal instruction

Verbal cues can be given at the same time as a

demonstration

Can be given to help learners focus on critical

parts of skills

Learners can also use verbal cues themselves

when performing a skill


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How do you practice a skill?

Whole vs. part

Mass vs. Distributed practice

Speed/accuracy tradeoff

Transfer positive and negative


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Whole vs. Part

Low in complexity and high in organization

(i.e. whole practice)

Eg. Buttoning a button, throwing a dart

High in complexity and low in organization

(i.e. part practice)

Eg. Serving a tennis ball, reaching for, grasping and

drinking from a cup, driving a stick shift


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Practicing Parts of a Skill

Wightman and Lintern (1985) classified three

part-task strategies

Fractionization

Segmentation

Simplification


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Speed/Accuracy Trade-off

Characteristic of motor skill performance in

which the speed at which the skill is

performed is influenced by movement

accuracy demands

When the person emphasizes speed, accuracy

is reduced

When the person emphasizes accuracy, speed

is reduced

Motor Learning and Control Text


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Practice Mass vs Distributed

Massed practice a practice schedule in which the amount of rest

between practice sessions or trials is very short

Distributed practice

a practice schedule in which the amount of restbetween practice sessions or trials is relativelylong

Baddely and Longman (1978) Postal Workers on a mail-sorting machine

Shea et al. (2000) continuous dynamic balance tasks anddiscrete key-press timing


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Transfer of Learning

the influence of having previouslypracticed or performed a skill or skills on

the learning of a new skill

Positive transfer: beneficial effect of previousexperience on the learning or performing of anew skill, or on the performance of a skill in anew context

Negative transfer: negative effect of priorexperience on the performance of a skill so that

a person performs the skill less well than he orshe would have without prior experience

Bilateral transfer: transfer of learning thatoccurs between limbs


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Why does transfer occur?

Positive: 2 prominent hypotheses

Transfer occurs because the components of the skillsand/or the context is the same

Transfer occurs because of similarities between the

amounts and types of learning processes required Similarity of cognitive processes required


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Why does transfer occur?

Negative: an old stimulus requires a new butsimilar response

Environmental context characteristics of two

performance situations are similar but themovement characteristics are different

Change in spatial locations of a movement ie drive a cardifferent than your own

Change in the timing structure of the movement iedance


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Clinical Implications

Determine method based on skill complexity

ie whole vs part

Distribute therapy sessions, encourage practicesessions throughout the day and week, discouragemass practice before a therapy session

Demonstrate the skill several times before yourclient attempts


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Clinical Implications Contd

Verbal instructions should be short, and the skill

broken down

Use verbal cues that are short, direct attention and

prompt key components Encourage transfer of skills by mixing it up!

Practice with unimpaired limb during initial training

especially right after surgery


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Food For Thought

An occupational therapist is frustrated and confused.Her job is to oversee therapy for a number of strokepatients, who are trying to recover their functionalabilities. The therapist wants to provide as much

assistance as possible, but given the number ofpatients she must work with and working in an acutesetting, she is unable to provide a lot of feedback toany particular individual. As a result, the therapistspatients must spend most of the time practicing on

their own.


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Feedback

Questions We Need to Consider How and when should an occupational therapist provide feedback for

patients?

What kinds of information should be conveyed to them about their

performance?

Should the therapist attempt to provide feedback about more thenone aspect of a patients movement at a time?

When assisting a particular individual, should the therapist give

feedback after each performance attempt or wait until after theperson makes several attempts before providing feedback?


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Knowledge of Results

It is extrinsic, verbal information that tells learnersabout the success of their actions with respect to theintended goal.

This form of feedback is often a repetition of intrinsicfeedback.

Extrinsic feedback is essential when a persons

intrinsic feedback sources are diminished ordistorted, as in the case of some patients who sufferfrom neurological impairments.


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Knowledge of Performance

It provides performers with information about

the pattern of their movement.

It focuses on the quality of the produced

movement.

*Very important for every day tasks


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Benefits of Feedback

1. Provides Motivation for Clients

2. It provides reinforcement for an action

3. Information for learnersso that they may perform

an action more effectively.

*BUT.It can createdependency in the client.


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WHEN DO WE

PROVIDE FEEDBACK ?

Whether to provide feedback at all?

What information do we provide?

How much information is necessary?

How precise should that information be?

How often should we provide feedback?


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Whether to provide feedback at all?

Clients can pick up many forms of sensory information.

There is a hierarchy of intrinsic information that an individualmust be aware of to produce an effective movement,therefore it is important when providing instructionalfeedback that we ensure that the individual becomes in tunewith that information.

Also, important to look at what the individual must learnbefore they decide whether or not to provide feedback.


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What information do we provide?

Program feedback: This is error information about the fundamental movement pattern.

Parameter feedback-

This form of feedback provides a person with error information about theparameter values (e.g. amplitude, speed, force).

Visual feedback:

Videos can also be used to give a person visual feedback as opposed toverbal.

Descriptive feedback-

It describes the errors an individual makes during the performance of askill.

Prescriptive feedback-

This form of feedback describes errors made during the performance of askill and suggests something the learner might do to correct it.


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How much information is necessary?

Summary feedback:

It is given after a series of performance attempts that provides thelearner with information about each of the attempts in the series. Thenumber of performance attempts a practitioner should summarize in afeedback statement depends on the complexity of the task.

Average feedback: Feedback that is given after a series of practice attempts that provides

learners with information about their average performance in theseries.

*Both of these methods are a good way to block dependency on

feedback


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How precise should that information be?

Early in practice, errors are so large that precise information

about the size of the error does not matter, but with time

more precise feedback is better as the individual progresses in

treatment.

Bandwidth feedback:

The instructor will only provide feedback when an

individual

s movement falls outside an acceptable rangeof correctness or bandwidth.


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How often should we provide feedback?

Absolute feedback frequency: The total number of feedback presentations given for a series of performance

attempts

Relative feedback frequency:

The proportion of performance attempts for which feedback is given; equal to

absolute feedback frequency divided by the number of performance attemptsand multiplied by 100.

Faded feedback: An approach that uses a schedule for providing extrinsic feedback in which

relative frequency of feedback is high during initial performance attempts and

it diminishes during later learning. Feedback can be adjusted to theproficiency rate and improvement of each learner.


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Stroke and Motor Learning

Stroke is the most important single cause of

disability of people living in their homes

An important goal in management of stroke is

rehabilitation

Rehabilitation should start within 48 hours if

client is medically stable

What is effective rehabilitation?


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Stroke and Motor Learning

Need to teach clients how to perform tasks

using spared motor functions

Client will most likely have to learn how to

perform the task differently then they

performed it pre-stroke

Role of motor learning in stroke rehab has not

been extensively studied


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Stroke Literature Hanlon

Retention and transference varies as a

function of training style or practice schedule

If retention is goal, it is important to teach

distributed practice (Intersperse activity with

other tasks)


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Blocked v. Random Trials Hanlon

Blocked Practice: AAABBBCCC Low contextual interference

Random Practice: ABACCBACB High contextual interference

Random practice is more effective becauseof the effort required to distinguish betweenthe performance requirements of severaltasks during acquisition

Blocked practice allows client to use thesame solution on each trial without havingto generate it on each trial


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Sabari Motor Learning Intervention for Hemiplegia

Important to teach motor programs in meaningful

contexts so that transference is more likely

Clients need opportunity to practice skills in various

regulatory conditions so they can develop motorschema that versatile to meet daily situations

Differences in cognitive style require individualized

motor training to develop effective encoding

strategies


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Sabari Contd

Problems encountered in adults with hemiplegia:

Ineffective or absent motor programs

Impaired motor memory

Impaired feedback mechanisms Impaired feed-forward mechanisms

Goal of programs are to teach individuals to develop

problem solving strategies rather than develop

specific motor skills

J M t L i


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Jarus Motor Learning

and OT

Knowledge of effects of changing the order ofpresentation of different motor tasks can be used tofacilitate retention and transfer of motor skills

Important for planning OT treatment, we do notwant the most effective performance, we want tomaximize transference and retention

Need to increase the difficulty of learning context -most transferable to everyday situations


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Case: Mr. Taylor

50 year old male, right side dominant

Experienced left hemisphere stroke October2004

Affected: speech (expressive aphasia)

paralysis of right arm

memory number of other elements


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Questions

Aphasia affected his speech and also his

writing, however he initially started writing

again with his left handthis would help with

what concept discussed earlier?

As Gord regained movement of his right side,

how could we as OTs help him to re-learn to

write?


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References

Baddeley, A. D., & Longman, D. J. A. (1978). The influence oflength and frequency training session on the rate of learningto type. Ergonomics, 21, 627-635.

Magill, R. A. (2001). Motor Learning and Control: Concepts

and application, 7th

ed. Toronto, Ontario: McGraw and Hill. Shea, Lai, Black, & Park. (2000). Spacing practice sessions

across days benefit the learning of motor skills. Human MotorScience, 19, 737-760.

Wightman, D. C. & Lintern, G. (1985) Part-task training

strategies for tracking and manual control. Human Factors,27, 267-283.


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References

Carr, J. & Shepherd, R. (2003). Stroke rehabilitation: Guidelines for exercise andtraining to optimize motor skill. China: Butterworth Heinemann.

Hanlon, R. E. (1996). Motor learning following unilateral stroke. Archives ofPhysical Medicine and Rehabilitation, 77, 811-815

Jarus, T. (1994). Motor learning and occupational therapy: The organization ofpractice. The American Journal of Occupational Therapy, 48, 9, 810-815.

Marley, T. L., Ezekiel, H. J., Lehto, N. K., Wishart, L. R., & Lee, T. D. (2000).Application of motor learning principles: The physiotherapy client as a problem-solver. Physiotherapy Canada, 315-320.

Schmidt, R. A. & Wrisberg, C. A. (2000). Motor learning and performance: Aproblem-based learning approach. United States of America: Human Kinetics.

Shapero Sabari, J. (1991). Motor learning concepts applied to activity-basedintervention with adults with hemiplegia. The American Journal of Occupational

Therapy, 45, 6, 523-530.

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