Motor control, motor Learning
and recovery of function
E. Vermeulen
Learning objectives
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Define motor control and discuss its relevance to
clinical treatment of patients with movement
pathology
Define motor learning; discuss the similarities and
differences between learning, performance and
recovery of function.
Compare and contrast implicit and explicit forms of
learning and give an example of each
Learning objectives continued
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Discuss intrinsic versus extrinsic feedback; give
examples of each and discuss their importance in
teaching motor learning
Discuss factors that have an impact on the structure
of practice and describe their effect on performance
versus learning.
Define recovery of function, describe the
differences between recovery and compensation.
What is motor control?
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The study of the nature and cause of movement.
2 Aspects:
Stabilizing of the body in space (motor control as it
applies to postural and balance control).
Moving the body in space (motor control as it applies
to movement)
THUS: THE CONTROL OF MOVEMENT AND
POSTURE.
Case study
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Mrs Phoebe
R. hemiplegic, stroke
5/52 ago. stand walk and
feed herself
‘spontaneous recovery’/
therapy?
maintain after rehab?
Motor learning vs. motor control
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Motor Learning: The study of the
acquisition and or modification of
movement.
Motor control: focuses on understanding the
control of movement already acquired.
Motor learning: focuses on understanding
the acquisition and or modification of
movement.
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The definition of motor learning reflects four
concepts:
Learning is a process of acquiring the capability for
skilled action.
Learning results from experience or practice.
Learning cannot be measured directly – instead it is
inferred based on behavior.
Learning produces relatively permanent changes in
behavior; thus short term alterations are not
thought of as learning.
Motor learning continued
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Motor learning involves more than motor
processes; it involves learning new strategies
for sensing as well as moving.
Complex of perception-cognition-action
processes.
One cannot study motor learning or recovery
of function outside of the context of how
individuals are solving functional tasks in
specific environments.
Relating performance and learning
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Learning – defined as a relatively permanent
change, has been distinguished from
performance defined as a temporary
change in motor behavior seen during
practice sessions
Examples?
Variables may influence performance
Examples?
Practical applications of motor
learning research
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How often should my patient practice a particular
task? Is this type of feedback that I am giving my
patient concerning the quality of their movements
really effective? Could I give a different form of
feedback that might be better? Should I give
feedback with every trial that the patient makes, or
would it be better to withhold feedback occasionally
and make the patients try to discern for themselves if
their movement is accurate or efficient. What is the
best timing for feedback?
Practice levels
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Most important factor in retraining motor skill
Rate of improvement during any part of
practice is linearly related to the amount left
to improve.
Early in practice of new task – performance
improves rapidly, while after much practice, it
improves more slowly
Performance may improve for many years,
although the increments may be small.
Feedback
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Feedback is all the sensory information that
is available as the result of a movement that
a person has produced.
Important for motor learning.
Response/movement –produced feedback
Extrinsic or intrinsic
Intrinsic feedback
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Intrinsic feedback is feedback that comes to
the individual simply through the various
sensory systems as a result of the normal
production of the movement.
Visual information concerning whether a
movement was accurate as well as
somatosensory information concerning the
position of the limbs as one was moving.
Examples:
Extrinsic feedback
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Information that supplements intrinsic
feedback.
Example
Concurrently with the task or at the end of
the task.
Knowledge of results is an important form
of extrinsic feedback. Given at the end of the
task about the outcome of the movement in
terms of the movement’s goal.
Knowledge of results (KR)
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Research has shown that knowledge of results is an
important learning variable in learning motor tasks,
however there are some tasks for which intrinsic
feedback is sufficient.
Summary KR (KR for each trial at the end of an
entire block) is the best feedback. Why?
For adults quantitative KR appears to be best with
the more precice KR giving more accurate
performance, up to a point beyond which there is no
further improvement.
Practice condition
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Massed practice: amount of practice > amount of
rest between trials. Risks?
Distributed practice: amount of practice < or =
amount of rest between trials.
Variable practice may be most essential when
learning tasks that are likely to be performed in
variable conditions
Blocked (practicing one task for a block)or random
practice (different tasks in random order)?which
factors will you consider when deciding on blocked
or random technique?
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Whole versus part (breaking the task into
interim steps) training.
Part training: identify the components of the
skill or movement and then ordering them
into sequence.
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Transfer: (example : clinical environment to
home environment)
What determines how will a task learned in
one condition will transfer to another?
Mental practice – mentally practicing a skill in
one’s imagination. Mental practice will
enhance physical practice.
Guidance or discovery learning?
Recovery of function
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Recovery of function refers to the
reacquisition of movement skills lost through
injury.
Function: the complex activity of the whole
organism that is directed at performing a
behavioral task.
Recovery
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Achieving the functional goal in the same
way it was performed premorbidly, that is,
using the same processes used prior to the
injury.
Recovery vs. compensation
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Compensation is defined as behavioral
substitution, that is, alternative behavioral
strategies are adopted to complete a task.
Thus: Function returns, but not in its
identical premorbid form.
Should therapy be directed at recovery or
compensation?
Sparing of function
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When a function is not lost, despite an injury.
it is referred to as spared function.
Example?
Stages of recovery
Recovery
Spontaneous
Forced
Forced recovery: Recovery through intervention
designed to impact neural mechanisms.
Factors affecting recovery of
function
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Experiments show that several pre injury factors
including exercise, environmental enrichment and
nutrition, are neuro protective; that is, they minimize
the effects of neurodegenerative and traumatic brain
injury.
Post injury factors such as exercise and training can
have a positive effect on recovery of function, but the
optimal timing, frequency, and intensity of training
depends on the location of injury.
Summary
Motor learning, like motor control, emerges
from a complex set of processes including
perception, cognition and action.
 Motor learning results from an interaction of
the individual with the task and the
environment.
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Shumway-Cook, A. And Woollacott, M.J.
Motor Control: Translating Research into
clinical practice. 2007. Third Edition.
Lippincott Williams & Wilkins. United States
of America. Pensylvania.