108 Optimizing Outcomes in Rehabilitation: Motor Learning Principles and Beyond: Summary
Considerations for Older Adults • Older adults may find it more challenging to consolidate learning • The dopaminergic system, which is crucial for neuroplasticity, slows down with age • Sleep quality significantly affects learning, especially during stage 2 sleep • Older adults may have difficulty with complex tasks and cognitive overload • Tailor instructions to match their cognitive capacity • Focus on simple, positive feedback and instruction
• The medial temporal lobe may compensate for implicit learning deficits in older adults So how do we design an optimal training setup for our patients to learn in the best possible way? Challenging and learning from midrange errors, intensity, and practice all play a role. Let's look at some case studies. Errorless learning is a method of minimizing errors to allow more successes during training, thereby improving self-efficiacy and enhancing learning. • Found to be less or as effective as error-based learning
CASE STUDY 1: ERROR AND CHALLENGE
Yerling is a 77-year-old man with Parkinson disease who recently had surgery for a hip fracture. He can walk fairly well with a walker but struggles with balance when turning, standing from a chair, or sitting down. He’s been doing physical therapy, but his progress has been slow, and he seems unenthusiastic about it, likely due to his condition. To help Yerling improve and stay motivated, it’s important to adjust his therapy.
One way to do this is by considering the challenge point theory, which suggests that people learn best when the challenge matches their skill level. In Yerling’s case, the therapy should be more tailored to his specific issues with balance and mobility. The therapist should increase the level of challenge as he gets better, making sure he learns from his mistakes. Motivation is critical in rehabilitation, so the therapist should strike a balance between making the therapy challenging enough to engage Yerling and allowing him to learn from errors. If Yerling’s errors are too small to notice or too big to handle, the therapist can increase the challenge or make the errors more obvious. This will help Yerling become more aware of his mistakes and encourage him to improve.
| HEALTHCARE CONSIDERATION One important thing to keep in mind is that motor learning is most effective when it is task specific. In practice, this means that when working on building strength in specific muscles, the ultimate objective is to ensure that those exercises directly translate to practical, real-world activities that patients perform on a daily basis.
Powered by FlippingBook