Implicit Memory
in Physiotherapy
w
Derby 2014
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andrew.clyne@nhs.net
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Avon and Wiltshire Mental Health Partnership NHS Trust
User Warning
A Person Centred Approach
will help you decide which
approaches to use.
Please keep this in mind:
This is not MSK Physiotherapy.
3 Approaches
1. Traditional Approach (Fitts & Posner)
2. Rosemary Oddy
http://www.alzheimers.org.uk/mobilitystrategies
3. Implicit Memory Approaches
.
Andrew Clyne - Agility Journal Summer 2013
Fitts and Posner Model 1967
Objectives
•
•
•
•
•
•
Implicit vs. Explicit Memory
Priming
Errorless learning
Repeated Constant Practice
Required Repetitions
Avoiding Multi-tasking
Implicit and Explicit Memory
.
Changing Lanes Macuga et al 2007
Implicit Memory and Mood
• .
Sabat 2006
Implicit Memory and
Communication
Priming
.
Henry Gustav Molaison - HM
Errorless Learning
Errorless Learning
Maxwell et al 2001
80 x 50 = 400 Reps
Error full Learning
Errorless Learning
Develop hypothesis
Correct Errors
Explicit Learning
Passive Learning
Little hypothesis
Implicit Learning
• More vulnerable to breakdown
under dual task
• Lower level of retention of skill
•
•
Less likely to breakdown under
dual task
Higher level of retention of skill
Constant Practice
(Dick et al 1996)
3
2.5
2
HC
AD
1.5
1
0.5
0
PreTest
PT1
PT2
PT3
Variable Practice
(Dick et al 1996)
3
2.5
2
HC
AD
1.5
1
0.5
0
PreTest
PT1
PT2
PT3
How Many Reps?
How Many Passes?
http://www.youtube.com/watch?v=Ahg6qcgoay4
Avoiding Multi-Tasking
Boyd and Winstein 2006
Case Study (Aug 2013)
Objectives
•
•
•
•
•
•
Implicit vs. Explicit Memory
Priming
Errorless learning
Repeated Constant Practice
Required Repetitions
Avoiding Multi-Tasking
Rehab Potential?
Motor learning may represent an island of
saved functioning in the midst of the
devastating cognitive losses associated with
(Alzheimer’s) dementia. (Dick et al 1996)
We should be fitting our approaches to the
patient not judging people’s ability to fit our
traditional approach.
“The session you
did for us has
stuck in my mind”
andrew.clyne@nhs.net