Motor learning is the understanding of acquisition and/or modification of movement.
As applied to patients, motor learning involves the reacquisition of previously learned movement skills that are lost due to pathology or sensory, motor, or cognitive impairments. This process is often referred to as recovery of function.
Understanding the various theories of motor control- reflex-hierarchal theory, ecological theory, dynamic systems theory and it's clinical application; also forming the basis of neurological rehabilitation techniques like Task-orient approach, Constraint induced movement therapy (CIMT), NDT (Neurodevelopmental Facilitation).
Retraining of motor control basing on understanding of normal movement & analysis of motor dysfunction.
Emphasis of MRP is on practice of specific activities, the training of cognitive control over muscles & movt. Components of activities & conscious elimination of unnecessary muscle activity.
In rehabilitation programme involve – real life activities included.
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Understanding the various theories of motor control- reflex-hierarchal theory, ecological theory, dynamic systems theory and it's clinical application; also forming the basis of neurological rehabilitation techniques like Task-orient approach, Constraint induced movement therapy (CIMT), NDT (Neurodevelopmental Facilitation).
Retraining of motor control basing on understanding of normal movement & analysis of motor dysfunction.
Emphasis of MRP is on practice of specific activities, the training of cognitive control over muscles & movt. Components of activities & conscious elimination of unnecessary muscle activity.
In rehabilitation programme involve – real life activities included.
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
The discipline of Motor Control is the study of human movement and the systems that control it under normal and pathological conditions.
Depends upon -
Environmental result of the movement (Outcome)
Movement pattern
Neuromotor processes underlying movement
NDT, BOBATH TECHNIQUE, BASIC IDEA OF BOBATH, CONCEPT OF BOBATH, NEUROPHYSIOLOGY OF NDT, ICF MODEL, PRINCIPLES OF TREATMENT OF NDT IN STROKE AND CP, AUTOMATIC AND EQUILIBRIUM REACTIONS, KEY POINTS OF CONTROL, FACILITATION, INHIBITION AND HANDLING IN NDT
This PPT share the principles used in exercise prescription and the parameters which should be kept in mind while prescribing and progressing the exercise regimen
Neurodynamics, mobilization of nervous system, neural mobilizationSaurab Sharma
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
It is a technique developed by Janet H Carr and Roberta B Shepherd which provides physiotherapists and occupational therapists with an approach to stroke rehabilitation that is clear, relevant, and effective, building on the research-based model created by the authors
Controlled use of sensory stimulus.
Specific Motor response
Normalization of muscle tone
Use of Developmental sequences.
Sensorimotor development = from lower to higher level.
Use of activity to demand a purposeful response.
Practice of sensory motor response is necessary for motor learning.
Aerobic means "with oxygen," and anaerobic means "without oxygen." Anaerobic exercise is the type where you get out of breath in just a few moments, like when you lift weights for improving strength, when you sprint, or when you climb a long flight of stairs.
The discipline of Motor Control is the study of human movement and the systems that control it under normal and pathological conditions.
Depends upon -
Environmental result of the movement (Outcome)
Movement pattern
Neuromotor processes underlying movement
NDT, BOBATH TECHNIQUE, BASIC IDEA OF BOBATH, CONCEPT OF BOBATH, NEUROPHYSIOLOGY OF NDT, ICF MODEL, PRINCIPLES OF TREATMENT OF NDT IN STROKE AND CP, AUTOMATIC AND EQUILIBRIUM REACTIONS, KEY POINTS OF CONTROL, FACILITATION, INHIBITION AND HANDLING IN NDT
This PPT share the principles used in exercise prescription and the parameters which should be kept in mind while prescribing and progressing the exercise regimen
Neurodynamics, mobilization of nervous system, neural mobilizationSaurab Sharma
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
It is a technique developed by Janet H Carr and Roberta B Shepherd which provides physiotherapists and occupational therapists with an approach to stroke rehabilitation that is clear, relevant, and effective, building on the research-based model created by the authors
Controlled use of sensory stimulus.
Specific Motor response
Normalization of muscle tone
Use of Developmental sequences.
Sensorimotor development = from lower to higher level.
Use of activity to demand a purposeful response.
Practice of sensory motor response is necessary for motor learning.
Aerobic means "with oxygen," and anaerobic means "without oxygen." Anaerobic exercise is the type where you get out of breath in just a few moments, like when you lift weights for improving strength, when you sprint, or when you climb a long flight of stairs.
Motor Learning is required for motor recovery after an injury to the motor system. This slides discussed the forms of motor learning and the theories of motor learning.
Learning is “a process that leads to change, which occurs as a result of experience and increases the potential for improved performance and future learning”. The change in the learner may happen at the level of knowledge, attitude or behavior.
\It is a condition of the lung characterized by permanent dilatation of the air spaces distal to the terminal bronchioles with destruction of the walls of these airways.
Chronic Bronchitis
It is a disease characterized by daily cough with sputum for at least 3 months of the year for at least 2 consecutive years and airway obstruction which is irreversible.
These are cardiac anomalies arising as a result of a defect in the structure or function of the heart and great vessels which is present at birth
These lesions either obstruct blood flow in the heart or vessels near it, or alter the pathway of blood circulating through the heart
Burn is coagulative necrosis of the skin’s tissues, usually caused by excessive heat
Excess heat causes rapid protein denaturation and cell damage
Wet heat (scald) travels more rapidly into tissue than dry heat (flame)
A surface temperature of over 60˚C produces immediate cell death as well as vessel thrombosis
The dead skin tissue is known as Eschar
Modified Sweat gland
Lies in the deep pectoral
fascia
Boundaries:
clavicle superiorly,
the lateral border of the latissimus muscle laterally,
the sternum medially
inframammary fold inferiorly
Pre- Operative Assessment
Detailed History (Obsteritic & Gynecological h/o)
Chest assessment
Lung function tests (PFT)
Stage of cancer, extent of the disease
Surgical plan should be documented -length & duration of surgery, type of incision & details of the flap used for reconstruction
Assess the involvement of lymph nodes, posture, mobility
Checking of the Exercise capacity considering the patient’s tolerance
AMPUTATION:
“Surgical removal of limb or part of the limb through a bone or multiple bones”
DISARTICULATION:
“Surgical removal of hole limb or part of the limb through a joint”
Establishing the need for a surgical intervention
Confirmation of relevant physical findings and review of the clinical history and laboratory investigations that support the need of surgical intervention
Type of approach- Benefits & Risks of surgical procedure
The incision site- ease of surgery as well as cosmetic considerations
Type of anesthesia
Pulmonary rehabilitation is a comprehensive intervention based on a thorough patient assessment followed by patient tailored therapies that include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviors”
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
3. Contents
04/11/18Motor learning3
Define motor learning and learning
Procedural learning
Declarative and associated learning
Adam’s theory
Schmidt’s theory
Ecological theory
Motor learning occurs in stages
Measuring learning outcomes
Transfer of learning
Feedback and giving augmented
feedback
Practice conditions
4. Definition
04/11/18Motor learning4
Motor learning is the understanding of
acquisition and/or modification of
movement.
As applied to patients, motor learning
involves the reacquisition of previously
learned movement skills that are lost due
to pathology or sensory, motor, or
cognitive impairments. This process is
often referred to as recovery of function.
5. Learning vs. Motor Learning
04/11/18Motor learning5
Learning is a process of acquiring
knowledge about the world.
Motor learning: a set of processes
associated with practice leading to a
relatively permanent change in the
capacity for skilled actions.
6. Concepts of Motor Learning
04/11/18Motor learning6
Learning is a process of acquiring the
capacity for skilled action
Learning results from experience or
practice
Learning cannot be measured or observed
directly; it is inferred from behavior
Learning produces relatively permanent
changes in behavior; short term change is
not learning)
7. Motor Performance ≠ Motor
Learning
04/11/18Motor learning7
Motor Performance is the temporary
change in motor behavior seen during a
practice session
e. g. A patient learns how to shift
more body weight over the weaker leg
at the end of the therapy session.
However, the patient still bears more
weight on the unaffected leg at the
next visit to PT. Learning has not
occurred.
8. Motor Performance ≠ Motor
Learning
04/11/18Motor learning8
Performance may be influenced by
many other variables, e.g. fatigue, level
of learning/skills, anxiety, motivation,
cues or manual guidance given to the
learner
Motor Learning is a relatively
permanent change in motor behaviors
that are measured after a retention
period and only result from practice.
11. Nondeclarative (Implicit)
Learning:
Non-Associative Learning
04/11/18Motor learning11
A single stimulus is given repeatedly and
the nervous system learns about the
characteristics of the stimulus
Habituation
↓ response to the stimulus, e.g.
exercises to treat dizziness in patients
Sensitization
↑ response to the stimulus, e.g. training
to enhance awareness of loss of balance
12. Nondeclarative (Implicit)
Learning: Associative Learning
04/11/18Motor learning12
Classical Conditioning
learn to predict relationships between
two stimuli
e.g. before learning: verbal cues +
manual guidance stand up; after
learning: verbal cue stand up
patients are more likely to learn if the
associations are relevant and meaningful
14. Nondeclarative (Implicit)
Learning: Associative Learning
04/11/18Motor learning14
Operant Conditioning
learn to associate a certain response,
from among many that we have, with a
consequence; trial and error learning
e.g. relearn stability limits after ankle
sprain; verbal praise from PT
behaviors that are beneficial and
rewarded tend to be repeated
16. Procedural Learning
04/11/18Motor learning16
Does NOT require attention,
awareness, or other higher cognitive
processes
One automatically learns the rules for
moving, i.e. movement schema
Learning requires repeating a
movement continuously under a variety
of situations
Patients with damage to cortex (e.g.
TBI, dementia, aphasia) can still ↑
17. Declarative (Explicit) Learning
04/11/18Motor learning17
Require attention, awareness, and
reflection
Results in knowledge or facts (e.g.
objects, places, events) that can be
consciously recalled and expressed in
declarative sentences, e.g. “1st
I move to
the edge of chair. 2nd
I lean forward and
stand up”; instruction from PT; mental
rehearsal; motor imagery
18. Declarative (Explicit) Learning
04/11/18Motor learning18
Practice can transform declarative into
procedural or nondeclarative knowledge
e.g. a patient first learns to stand up may
verbally repeat the instruction; after
repeated practice, the patient may be able
to stand up without instruction
Processes of declarative learning:
encoding consolidation storage
retrieval
20. Adams Closed-Loop Theory
04/11/18Motor learning20
In motor learning, sensory feedback
from the ongoing movements is
compared with the stored memory of the
intended movement
Memory trace selects and initiates a
movement
Perceptual trace, built-up over practice,
is the internal reference of correctness
22. Adams Closed-Loop Theory
04/11/18Motor learning22
Clinical Implications
Accuracy of a movement is
proportional to the strength of the
perceptual trace
Patient must practice the movement
repeatedly to ↑ the perceptual trace
Limitations
Cannot explain open loop movement.
23. Schmidt Schema Theory
04/11/18Motor learning23
Emphasizes open-loop control processes
and generalized motor program
“Schema” is a generalized set of rules for
producing movements that can be applied
to a variety of contexts
Equivalent to motor programming theory
of motor control
24. Schmidt Schema Theory
04/11/18Motor learning24
Information stored in short-term memory
after a movement is produced
1.Initial movement conditions, e.g. body
position, weight of an object, step height
2.Parameters of a generalized motor
program
3.Outcome of the movement, in terms of
knowledge of results
4.Intrinsic sensory feedback of the
movement
25. Schmidt Schema Theory
04/11/18Motor learning25
Information stored in short-term
memory is converted into two schemas
1.Recall schema selects a specific
response and contains rules for
producing a movement
2.Recognition schema evaluates the
response correctness and informs the
learner about the errors of a movement
27. Schmidt Schema Theory
04/11/18Motor learning27
Clinical Implication
Variability of practice↑ learning and
generalized motor program rules
Limitations
Vague; no consistent research finding in
support of variable practice
Cannot account for one-trial learning (In
the absence of a schema)
28. Ecological Theory
04/11/18Motor learning28
Learning involves the exploration the
perceptual and motor workspace
1.Identify critical perceptual variables, i.e.
regulatory cues
2.Explore the optimal or most efficient
movements for the task
3.Incorporate the relevant perceptual cues
and optimal movement strategies for a
specific task
30. Ecological Theory
04/11/18Motor learning30
Clinical Implications
Patients learn to identify relevant
perceptual cues that are important for
developing appropriate motor responses,
e.g. identify relevant perceptual cues for
reaching and lifting a heavy glass:
weight, size, or surface of the glass vs.
its color?
31. Theories of Motor Learning
continue…….
Dr. Maheshwari H
M.P.TH (Neurosciences)
32. Fitts and Posner Three Stage
Model: Cognitive stage
04/11/18Motor learning32
Learner activities
Learn what to do
Learn about the task and goals
Require high degree of attention
Select among alternative strategies
Performance may be more variable
Fast improvement in performance
Develop a motor program
33. Fitts and Posner Three Stage
Model: Associative Stage
04/11/18Motor learning33
Learner activities
Refine the skills
Refine a particular movement strategy
Performance is less variable and
more consistent
Cognitive monitoring decreases
Improve the organization of the motor
program
34. Fitts and Posner Three Stage
Model: Autonomous Stage
04/11/18Motor learning34
Learner activities
Become proficient, save energy
Attention demands are greatly
reduced
Movements and sensory analysis
begin to become automatic
Able to perform multiple tasks, scan
the environment
Ability to detect own errors improves
35. Implications for PT
04/11/18Motor learning35
Motor learning probably occurs in
stages
Activities of the patient are different in
the different stages
Activities of the therapist should be
different in the different stages
36. Systems Three-Stage Model
04/11/18Motor learning36
Learners initially restrict degrees of
freedom (DOF) and gradually release
the DOF as the task is learned and the
skills improve
Novice Stage
Simplify movement by constraining
joints and ↓DOF, e.g. muscles co-
contraction
Less energy efficient
37. Systems Three-Stage Model
04/11/18Motor learning37
Advanced Stage
Gradual release of additional DOF
More adaptive to different contexts
Expert Stage
All DOF released
Efficient and coordinated movements
Exploit the mechanical and inertial
properties of the limbs and the
environment
38. Gentile’s Two Stage Model
04/11/18Motor learning38
Early stage
Understand the task goals, develop
movement strategies, recognize
regulatory features of the environment
Late stage
Refine the movement, consistent and
efficient performance
Closed skills become fixation/consistent
Opened skills become diversification/
adaptive
40. Think-Pair-Share
04/11/18Motor learning40
A patient is learning to use a walker. What
would the patient be able to do at each stage of
learning?
Cognitive stage (early)-
Association stage (late)-
Automatic stage (late)-
42. How to Measure Learning?
04/11/18Motor learning42
To separate the relatively permanent
effects of learning from the transient effect
of practice, learning can be measured
using retention or transfer designs.
1.Test the subject after a retention interval,
typically >= 24 hr
2.Choose the same task (retention test) or a
variation of the task (transfer test)(e.g.
different speed or lighting conditions for
walking)
43. Practice Level: How Much?
PRACTICE, PRACTICE,
PRACTICE
04/11/18Motor learning43
Animal Studies
9,600 retrievals over 4 week period
(Nudo, 1996)
7,000 trials of food catching in 5
weeks (Pavlides, 1993)
44. Feedback (FB)
04/11/18Motor learning44
FB is all the sensory information that is
available as a results of a movement
Types by mode of delivery
Intrinsic (e.g. proprioception)
Extrinsic (e.g. instruction from PT)
Types of FB by information provided
Knowledge of results (KR)
Knowledge of performance (KP)
45. Knowledge of Performance
(KP)
04/11/18Motor learning45
Information about the movement
patterns
Usually intrinsic but can also be
extrinsic
Proprioception, Biofeedback, video
recording, verbal instruction (e.g. “Your
elbow was /is in flexed.”)
46. Knowledge of Results (KR)
04/11/18Motor learning46
Information about the result or outcome
of the movement in terms of the goal
Verbal instruction - proprioception (e.g.
feeling loss of balance during a fall)
47. Characteristics of Good
Feedback
04/11/18Motor learning47
Timing
Allow some time to reflect between trials
Summary FB
Summary FB after a few trials works
better than after every trial
Give more frequent summary feedback
(e.g. after every 5 trials) for complex
tasks than for simple tasks
48. Characteristics of Good
Feedback
04/11/18Motor learning48
Accuracy
Positively reinforce correct performance
Augmented (extrinsic) Feedback
Video/visual of movement patterns alone
does not help; need to provide error-
correcting cues as well
AVOID VERBAL BOMBARDMENT
Can be given concurrently or afterwards
49. Characteristics of Good
Feedback
04/11/18Motor learning49
Frequency and Fading Schedule
More impaired patients may require
more frequent FB.
Avoid giving FB every trial.
Decrease the amount of FB given
across learning stages so the patients
won’t become dependent on FB.
50. Practice Conditions
04/11/18Motor learning50
Massed vs. Distributed Practice Schedule
Distributed in early stage (e.g. 20 min X
3 days) to avoid fatigue and massed in
later stage (e.g. 60 min in one day)
Constant vs. Variable Practice
Usually variable practice (walk at
different speeds) results in better
learning outcomes than constant practice
(walk at the same speed) in health adults
51. Practice Conditions
04/11/18Motor learning51
Random vs. Blocked Practice
Random practice (practice multiple tasks
in 15 min) results in better learning than
blocked practice (practice one task in 15
min) in healthy adults but not necessarily
patients
52. Practice Conditions
04/11/18Motor learning52
Whole- vs. Part-Task Practice
Task specificity says the best practice
is the task itself
If utilizing a part technique, the part
(e.g. hip and knee flexion, extension)
must be a naturally occurring
component of the whole (e.g. walking)
53. Practice Conditions
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Transfer
Amount of transfer is determined by the
similarity between the two tasks or the
two environments
The more closely the practice
environment resemble those in the
performance environment, the better the
transfer
54. Practice Conditions
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Mental Practice
The same neural circuits producing
the movement are also active during
mental practice
Can produce large positive effects on
performance of the task (Rawlings
1972)
Physical + mental practice produces
the best learning outcome
55. Practice Conditions
04/11/18Motor learning55
Mental Practice
The same neural circuits producing
the movement are also active during
mental practice
Can produce large positive effects on
performance of the task (Rawlings
1972)
Physical + mental practice produces
the best learning outcome
Occurs when a single stimulus is given repeatedly and the nervous system learns about the characteristics of the stimulus.
Habituation is a decrease in responsiveness that occurs as a result of repeated exposure to a non-painful stimulus.
Sensitization: An enhanced response to many different stimuli after experiencing an intense or noxious one. For example, an animal responds more vigorously to a tone of lesser intensity once a painfully loud tone has been played. Here we say that the animal is sensitized.
Explore the world to identify the relationships between one’s body and the environment is a critical task for patients with movement problems.
Associating a weak, ineffective (unconditioned-U) stimulus with a strong, effective (conditioned-C) stimulus to produce a desired response (R)
e.g. Verbal cues (U) coupled with manual guidance (C) to help a patient make the movement (R)
Patients are more likely to learn if the associations are relevant and meaningful to them
Predict one’s behavior with the consequence
Therapists use positive feedback(“Good job!”) to reinforce the successful accomplishment of a task
Neural circuits involved in operant conditioning
Cerebellum for movements
Amygdala for emotions
Premotor areas for associating sensory events with a specific movement (“Mirror Neurons”)
e.g. some of the rules for performing a sit to stand
Shifting the weight over to a new base of support
Produce extensor force in the hips and legs against the body weight
Learning under a variety of contexts enables the successful performance of action in variable environments.
A patient who had a TBI and cannot verbalize the sequence of use of an assistive gait device may still be able to learn the movement sequence.Neural structure involved
cerebellum
striatum of the basal ganglia
With declarative learning, motor tasks can be practiced in a different way, e.g. athlet mental rehearsal before the competition
Neural circuits involved in declarative learning
Sensory association cortices
Medial temporal lobe
Hippocampus
Encoding requires attention: encoding is affected by motivation and attention to the information, and ability to associate it with stored memory.
Consolidation convert the memory into long term memory. It involves structural changes of neurons.
Storage involves the retention of long term memory.
Retrieval is the recall of information and different long term storage. It is subject to distortion since an individual reconstructs the memories from a combination of different sites. Retrieval is most accurate when the context is similar or the same to the context it is created.
Declarative memory is stored in the cortex (likely in temporal cortex), not hippocampus!
Recall schema
~similar to Adams memory trace
Recognition schema ~similar to Adams perceptual trace
Note that Shumway-Cook’s borrowed from Schmidt’s book on this section but she might have missed the point? It was not clear from what she stated in the book. I looked up Schmidt’s original text and this is what he stated.
Schmidt and Lee, 2005. Motor Control and Learning, 4th edition. Human Kinetics.
Note that Shumway-Cook’s borrowed from Schmidt’s book on this section but she might have missed the point? It was not clear from what she stated in the book. I looked up Schmidt’s original text and this is what he stated.
Schmidt and Lee, 2005. Motor Control and Learning, 4th edition. Human Kinetics.
Study of 4 TBI patients with memory deficits (Haring, 2002)
2 patients who received feedback on 75% of movement attempts were more successful in learning a 7-step supine stand transfer task than 2 patients who received feedback on 25% of movement attempts
Blocked Practice
Practice all of one movement at one time and then practice all of another movement
Better for performance, but less efficient for learning
Random Practice
Continuously change the task being practiced
Better for learning
Forces learner to reconstruct motor program with each movement (active learning process)
Movements requiring “whole” practice
Cyclic movements, e.g. gait
Multi-joint movements where timing of movement components is linked, e.g. reaching for a cup to pick up
Okay to practice “parts” if:
Task is easily broken down into parts
Muscle strengthening is desired outcome – be sure to link strengthening type exercise to ultimate task being learning (task specificity)
Practicing dorsiflexion while in sitting and expecting carry-over into gait does not work. Gait depends on central pattern generators and many postural synergies where muscles are activated together.
Picking up a cup involves the transport task of the arm and the grasp task of the hand. The timing of the grasp is such that the hand will open to prepare to grasp the cup before it reaches the cup
Thinking about how a movement is done can facilitate learning
Cognitively try out different strategies for achieving a motor task, e.g. floor WC transfers
SMA is active when doing mental practice of sequence movements
Thinking about how a movement is done can facilitate learning
Cognitively try out different strategies for achieving a motor task, e.g. floor WC transfers
SMA is active when doing mental practice of sequence movements