Motor Learning - Back to the Basics
Introduction[edit | edit source]
There is increasing evidence that motor learning principles can have a positive effect on skill acquisition.[1][2] However, while there is a general acknowledgement in research that motor learning is a valuable addition to physiotherapy interventions, it has been found to have only a limited impact in actual clinical practice.[3]
Learning has been defined as: “A change in the capability of a person to perform a skill that must be inferred from a relatively permanent improvement in performance as a result of practice."[2]
Motor learning has been defined as the process of the acquisition and / or modification of skilled action. In essence, it is the process of learning how to do something well.[1]
Learning is a dynamic process, which takes place over time and in different environments.[1] There are various factors associated with motor learning that are well recognised, such as the amount of practice, types of practice and style of feedback and practice schedules.[4] However, the best method to enable learning to occur in a physiotherapy setting will depend upon clinical context.[1]
Learning vs Performance[edit | edit source]
When considering learning, it is important to be able to distinguish between performance and learning. Performance tends to improve after an individual practices a skill. These improvements often occur quickly and can be quite significant. However, they also tend to be temporary and may be affected by factors such as fatigue, anxiety, mood and motivation.[1] When practice continues over time, true learning occurs - i.e. the individual retains the skill. She or he can remember what to do and is able to do it effectively. These changes are sustainable over time.[1]
The three key phases or motor performance and learning are:[5]
- Acquisition
- Retention
- Transfer
When applying learning theory into clinical practice, the aim of a physiotherapy intervention is to ensure that a patient moves from skill acquisition to retention. Ultimately, the goal of therapy will be for patients to continue to practice and reach the transfer stage, so that they can apply the acquired skill in other situations, environments and tasks.[1]
Types of Learning[edit | edit source]
Learning is typically divided into ‘explicit learning’ and ‘implicit learning’ although terminology for these terms has not always been clearly defined in the literature.[6]
Explicit Learning[edit | edit source]
Explicit learning has been defined as “learning which generates verbal knowledge of movement performance (e.g., facts and rules), involves cognitive stages within the learning process and is dependent on working memory involvement”.[6] It is usually associated declarative knowledge, where the learner is able to state, or say out loud, what the technicalities of the movement are (i.e. they can list the steps of a specific task like tying a shoelace). Thus, it is more cognitive and verbal than implicit learning.[1] Over time, the learner tends to progress and the performance becomes more automatic (i.e. she / he is able to perform the task without having to think about each step).[1]
Implicit Learning[edit | edit source]
Implicit learning is procedural learning. It has been defined as a type of learning which “progresses with no or minimal increase in verbal knowledge of movement performance (e.g., facts and rules) and without awareness. Implicitly learned skills are (unconsciously) retrieved from implicit memory.”[6] Thus, with implicit learning it is not easy to verbalise or declare the specific steps of a task, but the skill is learned more inherently. Implicit learning can often lead to greater automaticity than explicit learning.[1][7] This means that the individual can do a task naturally without having to think about it slightly faster than with explicit learning.[1]
While there is debate in the literature about which type of learning may be better, mastering many tasks often requires elements of both.[1]
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 Bissen T. Motor Learning - Back to Basics Course. Physioplus. 2020.
- ↑ 2.0 2.1 Sattelmayer M, Elsig S, Hilfiker R, Baer G. A systematic review and meta-analysis of selected motor learning principles in physiotherapy and medical education. BMC Med Educ. 2016; 16(15).
- ↑ Kafri M, Atun-Einy O. From Motor Learning Theory to Practice: A Scoping Review of Conceptual Frameworks for Applying Knowledge in Motor Learning to Physical Therapist Practice. Phys Ther. 2019 Dec 16;99(12):1628-1643.
- ↑ Kwon YH, Kwon JW, Lee MH. Effectiveness of motor sequential learning according to practice schedules in healthy adults; distributed practice versus massed practice. J Phys Ther Sci. 2015;27(3):769-772.
- ↑ Piccoli A, Rossettini G, Cecchetto S, Viceconti A, Ristori D, Turolla A et al. Effect of Attentional Focus Instructions on Motor Learning and Performance of Patients with Central Nervous System and Musculoskeletal Disorders: a Systematic Review. J. Funct. Morphol. Kinesiol. 2018; 3(40): 1-20.
- ↑ 6.0 6.1 6.2 Kleynen M, Braun SM, Bleijlevens MH, Lexis MA, Rasquin SM, Halfens J, et al. Using a Delphi Technique to Seek Consensus Regarding Definitions, Descriptions and Classification of Terms Related to Implicit and Explicit Forms of Motor Learning. PLoS ONE. 2014; 9(6): e100227.
- ↑ Kal E, Prosée R, Winters M, van der Kamp J. Does implicit motor learning lead to greater automatization of motor skills compared to explicit motor learning? A systematic review. PLoS One. 2018;13(9):e0203591.
