When is the best time for practice after CNS injury
Early practice (less than 5 days)
What type of training works best for new CNS injuries and why?
Very intense training (4-6hrs) b/c it promotes plastic changes in the brain d/t gene and protein expression
Plasticity and Practice
Skill acquisition causes structural changes in the brain
Experience based neural plasticity
Practice variability
Variety of movements and context characteristics a person experiences while practicing a skill;
Positive transfer is enhanced
Ways to introduce variety (3)
1. Practice contexts (walking gym floor vs sidewalk)
2. Practice condition for closed skills (golf shot)
3. Practice conditions for open skills (returning tennis serve)
True/False: Errors can benefit learning (explain)
True
Increasing amount of variability increases error, more error better for skill learning in initial phases
Who is the exception for benefits from performance errors in learning
Pts with cognitive impairment
What are the benefits of allowing error detection?
Necessary for practice and indicates active problem solving;
Serves as marker for progress
Two types of practice distribution
Massed Practice;
Distributed Practice
Massed practice schedule
The amount of rest between practice sessions/trials is very short; a lot at once
Ex. week long volleyball camp; pt comes in 3-4 days for a short amount of time
Distributed practice schedule
The amount of rest b/t practice sessions/trials is longer
Ex. two 2-hr volleyball clinics over 6 weeks; pt comes in 2x/wk for 3 months
Which is better for the learner and why: massed or distributed practice
Distributed practice
- less fatigue, increased cognitive engagement, improved LTM storage
Massed practice - positives
- Strength/endurance may improve
- overcome "learned disuse" to cause plastic changes in brain
Massed practice - negative
- Fatigue
- boring
- time intensive for treating PT
Distributed practice - positives
- minimize fatigue
- promote long-term learning
- more realistic clinically
Distributed practice - negatives
- inefficient in getting training effects
Two types of practice set-ups
Random practice; blocked practice
What is random practice?
Practice where there are no 2 trials in a row of the same skill; multiple skills ordered randomly
What is blocked practice?
Practice in which trials of same skills are performed together before moving to another skill
Blocked practice - positives
- Better w/ new skills at first
- May improve immediately
- For strength/endurance
- indicated more for cognitively impaired and new skills
Blocked practice - negatives
- May not facilitate long-term learning
- May be boring for client
Indicators for blocked practice
Cognitive impairment, frustration with new skill, trouble developing skill
Random practice - positives
- Better for long-term learning
- Encourage ability to carryover learning to new tasks
Random practice - negatives
- Inappropriate if learner does not understand task initially
- Poor initial performance
What are the three components of learning a skill? (train ugly)
Read --> Plan --> Do
Which practice set-up is better for learning retention and why: random or block practice
Random because it involves all elements (read, plan, do) while block mainly focuses on the "do" component
Two types of practice break up
Part-whole practice; whole practice
What is part-whole practice?
Breaking a task into steps and practicing each step individually (task analysis);
Eventually practice whole task together
What is whole practice?
Practice the whole task together; used for tasks that don't break into discreet steps
Part-whole practice - positives
- Useful if pt can't complete the whole task
- Helps PT and pt w/ problem solving of the task
Part-whole practice - negatives
Unknown if learning the parts of a task will improve function of the whole task
Whole practice - positives
Better learning is expected since the target task is being trained
Whole practice - negatives
Pt may not be able to complete the task d/t task difficulty (increase frustration, negative reinforcement)
What are the benefits of task scaling?
Learning a complex skill will be easier if the pt starts w/ less difficult version
Gentile's Taxonomy is opposite of ____________ practice because....
1. whole
2. Gentile's focuses on the breakdown of a movement/pattern
What are the benefits of self controlled practice?
1. control over order of practice tasks/duration/freq results in more effective learning
2. more active engagement
3. improve motivation
What is observational practice?
Having the pt observe the desired movement/pattern on another person to see their progression
What is another name for mental practice?
Motor imagery practice
What are benefits of mental practice?
1. increases excitability of motor cortex
2. improved task performance after mental practice
Two types of motor learning feedback
Task-intrinsic feedback; Augmented feedback
What is Task-intrinsic feedback?
Info received by performer as direct result of movement from PNS/CNS;
Learner getting info from their own body
What is Augmented feedback? (extrinsic feedback, augmented information)
Info not inherent in movement/task;
Provided by external force
Task-intrinsic feedback - problems in clinical practice
Intrinsic feedback may be missing or wrong
Consequences of impaired intrinsic feedback (3)
1. unable to know how to do task correctly
2. delay learning important to recovery
3. inefficient movement patterns
Why to use augmented feedback
Motivation, reinforcement, provide information, maintain safety
Augmented feedback and safety
Physical or verbal guidance may be needed to keep the pt and yourself safe
What are issues associated with task difficulty?
1. easy tasks don't facilitate learning
2. pt doesn't know how to correctly perform task
3. pt may become frustrated if they don't know what they did wrong or how to solve the problem
What is a better type of feedback content: ability/outcome praise or process praise?
Process praise
What are the two Types of augmented feedback?
Knowledge of performance; Knowledge of results
What is Knowledge of performance?
- Info regarding quality of movement a performer has produced
- "how it was accomplished
Knowledge of performance doesn't address....
If the goal was achieved
What is Knowledge of results?
- Info regarding whether task completion was successful
- "Was it accomplished
Knowledge of results doesn't provide....
Info specific to the performance
Verbal feedback should include...
1. verbally explain task
2. ask questions to promote problem solving
3. include learner talking (verbal or mental) while practicing
What is visual feedback?
Observational learning (modeling, level of skill of the model)
Visual feedback tools
Mirrors, video recordings, direct observation
Visual feedback - modeling expert vs. novice
- Experts: encourage imitation rather than true learning
- Novice: effective model may model closer to what the learner may achieve
When during practice is modeling most effective?
Before practice and when repeated at various intervals during practice
What is dyad practice?
Practicing in pairs
When are manual cues most effective in learning?
Early when the task is novel or unfamiliar; provides security
What can limit manual cues?
Depends on the nature of the task; not all tasks can receive effective manual guidance
Four types of timing of augmented feedback
1. Concurrent feedback
2. Delayed feedback
3. Immediate feedback
4. Summary feedback
What is Concurrent feedback?
As the action is being performed;
May be required for safety!
Concurrent feedback - negatives
May interfere w/ the learner's ability to process their own internal feedback
What is Delayed feedback?
Occurs after the task is completed - few seconds or more
Allows learner to think about what they did
Delayed feedback - negatives
- Too long: forget what they did
- Too short: not enough time to think about what they did
What is Immediate feedback?
Occurs right after the task is completed; provided each each TRIAL
Immediate feedback - negatives
May interfere w/ ability to process their own internal feedback
During what stage is immediate feedback the most effective?
Acquisition phase
What is Summary feedback?
Series of no feedback trials followed by summative feedback
During what phase is summary feedback the most effective?
Retention phase
Two types of augmented feedback frequency
Performance bandwidth feedback; faded feedback
What is Performance bandwidth feedback?
- Feedback provided based on the degree of error (minor error allowed)
- More feedback when errors are large (beginning) and less when errors minimize (later)
What is faded feedback?
Gradual reduction in amount of feedback provided; more effective than constant feedback
True/False: more feedback automatically improves learning
FALSE
- the right kind/timing improves learning