Motor Learning

• Normal motor learning occurs through schemas and patterns.
• Normal motor learning requires spatial, temporal, and hierarchical organization in the CNS.
• After a neuro injury, there is a depression of brain activity, and then a cascade of events that disrupt nerve function in the area of the injury.
• After neuro injury, the brain attempts to fix itself, known as spontaneous recovery.
• After changes to the brain, it will try to compensate through nerve growth, synaptic changes, and collateral sprouting.
• Cortical remapping is driven by changes in behavioral, sensory, and cognitive experiences.
• After a neuro event, overall, the efficiency and flexibility of motor patterns is significantly reduced.
• The first stage of learning is the cognitive stage. This stage is a basic understanding of the skill. The patient will make frequent errors, and still has to think about learning.
• The second stage of learning is the associative phase. The technique becomes automatic, and the patient begins to recognize their own errors. No major errors occur.
• The third stage of learning is the autonomous stage. Movements are automatic, and the patient no longer thinks about technique. Any improper form is now difficult to correct.
• Increased practice will lead to increased learning.
• Patients will make the most amount of improvements early. This is independent of practice.
• Massed practice is fewer, longer training sessions.
• Distributed practice is spaced. it is broken up into multiple shorter sessions over a longer period of time.
• Distributed practice is best in the neuro setting.
• Blocked practice is performing one task repeatedly.
• Randomized practice is switching between tasks frequently.
• Random practice is superior for long term effects.
• Blocked order occurs when the skill is performed in a certain order. This is best for early improvements.
• Random order is practicing skills in a random order. This is better for long term retention.
• Part practice is practicing a complicated skill in a simplified form.
• Whole practice is practicing an entire skill at once.
• Whole practice is better in neuro rehab.
• A closed environment is stable and predictable. It is best when first learning a skill.
• An open environment is variable and more like the real-world. it is better for retention
• In mental practice, the task is visualized or imagined without physical practice.
• Mental practice will activate similar areas in the brain to those that are active when the movement of that area is occurring. It facilitates the acquisition of motor skills.
• Mental practice is best for patients who fatigue easily that do not have profound cognitive or perceptual deficits.
• Intrinsic feedback occurs naturally as a result of the movement.
• Extrinsic feedback comes from outside the body.
• Task-specific training is challenging and meaningful practice with appropriate feedback in a supportive environment.
• Guidance is directing the learner through cues to achieve a task.
• Discovery occurs when the learner figures it out on their own.
• If the patient is successful with a task seven or more times out of ten, the patient has mastered the skill. You must increase the difficulty.
• If a patient can perform 5 to 6 reps of an exercise well, that is the sweet spot.
• If the patient is failing a majority of the reps, you need to make the activity slightly easier.
• As the patient acquires more skill, the difficulty of the task must also increase so the patient continues to make mistakes.