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Infusing motor learning research into neurorehabilitation practice: a historical perspective with case exemplar from the accelerated skill acquisition program.

ABSTRACT: : This special interest article provides a historical framework with a contemporary case example that traces the infusion of the science of motor learning into neurorehabilitation practice. The revolution in neuroscience provided the first evidence for learning-dependent neuroplasticity and presaged the role of motor learning as critical for restorative therapies after stroke. The scientific underpinnings of motor learning have continued to evolve from a dominance of cognitive or information processing perspectives to a blend with neural science and contemporary social-cognitive psychological science. Furthermore, advances in the science of behavior change have contributed insights into influences on sustainable and generalizable gains in motor skills and associated behaviors, including physical activity and other recovery-promoting habits. For neurorehabilitation, these insights have tremendous relevance for the therapist-patient interactions and relationships. We describe a principle-based intervention for neurorehabilitation termed the Accelerated Skill Acquisition Program that we developed. This approach emphasizes integration from a broad set of scientific lines of inquiry including the contemporary fields of motor learning, neuroscience, and the psychological science of behavior change. Three overlapping essential elements-skill acquisition, impairment mitigation, and motivational enhancements-are integrated.(See Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A71) for more insights from the authors.

SUBMITTER: Winstein C

PROVIDER: S-EPMC5348298 | biostudies-literature | 2014 Jul

REPOSITORIES: biostudies-literature

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Infusing motor learning research into neurorehabilitation practice: a historical perspective with case exemplar from the accelerated skill acquisition program.

Winstein Carolee C Lewthwaite Rebecca R Blanton Sarah R SR Wolf Lois B LB Wishart Laurie L

Journal of neurologic physical therapy : JNPT 20140701 3

<h4>Unlabelled</h4>: This special interest article provides a historical framework with a contemporary case example that traces the infusion of the science of motor learning into neurorehabilitation practice. The revolution in neuroscience provided the first evidence for learning-dependent neuroplasticity and presaged the role of motor learning as critical for restorative therapies after stroke. The scientific underpinnings of motor learning have continued to evolve from a dominance of cognitive ...[more]

PMID: 24828523

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Project description:The plasticity of the human nervous system allows us to acquire an open-ended repository of sensorimotor skills in adulthood, such as the mastery of tools, musical instruments or sports. How novel sensorimotor skills are learned from scratch is yet largely unknown. In particular, the so-called inverse mapping from goal states to motor states is underdetermined because a goal can often be achieved by many different movements (motor redundancy). How humans learn to resolve motor redundancy and by which principles they explore high-dimensional motor spaces has hardly been investigated. To study this question, we trained human participants in an unfamiliar and redundant visually-guided manual control task. We qualitatively compare the experimental results with simulation results from a population of artificial agents that learned the same task by Goal Babbling, which is an inverse-model learning approach for robotics. In Goal Babbling, goal-related feedback guides motor exploration and thereby enables robots to learn an inverse model directly from scratch, without having to learn a forward model first. In the human experiment, we tested whether different initial conditions (starting positions of the hand) influence the acquisition of motor synergies, which we identified by Principal Component Analysis in the motor space. The results show that the human participants' solutions are spatially biased towards the different starting positions in motor space and are marked by a gradual co-learning of synergies and task success, similar to the dynamics of motor learning by Goal Babbling. However, there are also differences between human learning and the Goal Babbling simulations, as humans tend to predominantly use Degrees of Freedom that do not have a large effect on the hand position, whereas in Goal Babbling, Degrees of Freedom with a large effect on hand position are used predominantly. We conclude that humans use goal-related feedback to constrain motor exploration and resolve motor redundancy when learning a new sensorimotor mapping, but in a manner that differs from the current implementation of Goal Babbling due to different constraints on motor exploration.

Project description:Facilitating players' skill acquisition is a major challenge within sport coaches' work which should be supported by evidence-based recommendations outlining the most effective practice and coaching methods. This systematic review aimed at accumulating empirical knowledge on the influence of practice design and coaching behavior on perceptual-motor and perceptual-cognitive skill acquisition in soccer. A systematic search was carried out according to the PRISMA guidelines across the databases SPORTDiscus, PsycInfo, MEDLINE, and Web of Science to identify soccer-specific intervention studies conducted in applied experimental settings (search date: 22nd November 2020). The systematic search yielded 8,295 distinct hits which underwent an independent screening process. Finally, 34 eligible articles, comprising of 35 individual studies, were identified and reviewed regarding their theoretical frameworks, methodological approaches and quality, as well as the interventions' effectiveness. These studies were classified into the following two groups: Eighteen studies investigated the theory-driven instructional approaches Differential Learning, Teaching Games for Understanding, and Non-linear Pedagogy. Another seventeen studies, most of them not grounded within a theoretical framework, examined specific aspects of practice task design or coaches' instructions. The Downs and Black checklist and the Template for Intervention Description and Replication were applied to assess the quality in reporting, risk of bias, and the quality of interventions' description. Based on these assessments, the included research was of moderate quality, however, with large differences across individual studies. The quantitative synthesis of results revealed empirical support for the effectiveness of coaching methodologies aiming at encouraging players' self-exploration within representative scenarios to promote technical and tactical skills. Nevertheless, "traditional" repetition-based approaches also achieved improvements with respect to players' technical outcomes, yet, their impact on match-play performance remains widely unexplored. In the light of the large methodological heterogeneity of the included studies (e.g., outcomes or control groups' practice activities), the presented results need to be interpreted by taking the respective intervention characteristics into account. Overall, the current evidence needs to be extended by theory-driven, high-quality studies within controlled experimental designs to allow more consolidated and evidence-based recommendations for coaches' work.

Project description:Niemann-Pick type C1 (NPC1) disease is a lysosomal storage disorder caused by defective intracellular trafficking of exogenous cholesterol. Purkinje cell (PC) degeneration is the main sign of cerebellar dysfunction in both NPC1 patients and animal models. It has been recently shown that a significant decrease in Sonic hedgehog (Shh) expression reduces the proliferative potential of granule neuron precursors in the developing cerebellum of Npc1 (-/-) mice. Pursuing the hypothesis that this developmental defect translates into functional impairments, we have assayed Npc1-deficient pups belonging to the milder mutant mouse strain Npc1 (nmf164) for sensorimotor development from postnatal day (PN) 3 to PN21. Npc1 (nmf164) / Npc1 (nmf164) pups displayed a 2.5-day delay in the acquisition of complex motor abilities compared to wild-type (wt) littermates, in agreement with the significant disorganization of cerebellar cortex cytoarchitecture observed between PN11 and PN15. Compared to wt, Npc1 (nmf164) homozygous mice exhibited a poorer morphological differentiation of Bergmann glia (BG), as indicated by thicker radial shafts and less elaborate reticular pattern of lateral processes. Also BG functional development was defective, as indicated by the significant reduction in GLAST and Glutamine synthetase expression. A reduced VGluT2 and GAD65 expression also indicated an overall derangement of the glutamatergic/GABAergic stimulation that PCs receive by climbing/parallel fibers and basket/stellate cells, respectively. Lastly, Npc1-deficiency also affected oligodendrocyte differentiation as indicated by the strong reduction of myelin basic protein. Two sequential 2-hydroxypropyl-?-cyclodextrin administrations at PN4 and PN7 counteract these defects, partially preventing functional impairment of BG and fully restoring the normal patterns of glutamatergic/GABAergic stimulation to PCs.These findings indicate that in Npc1 (nmf164) homozygous mice the derangement of synaptic connectivity and dysmyelination during cerebellar morphogenesis largely anticipate motor deficits that are typically observed during adulthood.

Project description:Study objectivesSleep during the biological night facilitates memory consolidation. Here we determined the impact of sleep and wake on motor skill learning (acquisition) and subsequent off-line skill improvement (memory consolidation), independent of circadian phase, and compared this to the impact of the endogenous circadian system, independent of whether sleep occurred during the biological night or day.MethodsParticipants completed two 8-day sleep laboratory visits, adhering on one visit to a circadian aligned ("normal") sleep schedule for the full duration of the protocol, and on the other to a circadian misaligned (12-hour inverted) schedule, with alignment during the first 3 days, a 12-hour 'slam shift' on Day 4, followed by circadian misalignment during the last 4 days of the protocol. Participants were repeatedly trained and tested on different versions of the finger-tapping motor sequence task across each visit.ResultsSleep facilitated offline memory consolidation regardless of whether it occurred during the biological day or night, while circadian phase had no significant impact. These sleep-related benefits remained after accounting for general motor speed, measured in the absence of learning. In addition, motor skill acquisition was facilitated when the training session followed shortly after sleep, without significant impact of circadian phase (biological morning vs. evening). This effect was largely driven by heightened acquisition in participants who slept during the day and were trained shortly thereafter, that is, when acquisition occurred during the biological evening. These benefits were also retained after controlling for general motor speed.ConclusionsSleep benefits both the acquisition and consolidation of motor skill regardless of whether they occur during the biological day or night. After controlling for general motor speed, a critical adjustment that few studies perform, these sleep benefits remain intact. Our findings have clear implications for night shift workers who obtain their sleep during the day.

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Infusing motor learning research into neurorehabilitation practice: a historical perspective with case exemplar from the accelerated skill acquisition program.

Publications

Infusing motor learning research into neurorehabilitation practice: a historical perspective with case exemplar from the accelerated skill acquisition program.

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