Optimizing Outcomes in Rehabilitation: Motor Learning Principles and Beyond: Summary 48
As individuals progress in their learning journey and adopt more effective strategies, they transition into the associative phase of motor learning. During this phase, movements become smoother and more controlled. However, unexpected challenges can still cause errors. For instance, a stroke patient might walk in a straight line smoothly but struggle when asked to turn around or deal with obstacles. During the associative phase, the brain will continue to refine and edit motor plans, making them more precise and efficient over time. These plans will be stored in the basal ganglia for future use. Additionally, the cerebellum will become more involved in fine-tuning movements, improving their speed, automation, and accuracy. This part of the brain is more adaptable to handling unexpected challenges because it processes sensory inputs rapidly. Once mastery is achieved, individuals enter the automatic phase of motor learning. While movements become smooth, consistent, and adaptable, there is still variability in performance. This variability is a normal part of mastering a skill, as the brain cares more about achieving the task’s goal than achieving perfection. Finally, in the automatic phase of learning, attention can be diverted to other tasks, allowing for dual-tasking (the ability to perform two or more tasks simultaneously), which can be motor, cognitive, or a combination of both. The key for successful dual-tasking is mastering each skill to the point where cognitive resources are no longer needed for its execution. As individuals age or experience cognitive decline, their ability to dual-task tends to decline. However, training can enhance automaticity, making patients more capable of managing multiple tasks and maintaining their performance under pressure.
LEARNING TIP! The Timed Up and Go test is an excellent way to measure the level of automaticity and the dual- tasking ability with a skill in geriatric settings. | HEALTHCARE CONSIDERATION Dual-tasking can be used in training to enhance motor learning and encourage automaticity as long as the second task challenges a similar area . In therapy, this means that tasks should be compatible, with similar cognitive characteristics, and can include combinations like two planning tasks or two execution tasks.
LEARNING TIP! Characteristics of a well-mastered motor skill: • Smooth and efficient execution • Consistent • Attention can be diverted to other tasks while performing the mastered skill • Minimal cognitive effort • Execution of a task that is adaptable to varied challenges
The nervous system uses two kinds of learning to fine-tune a motor plan and make it “stick”: Error-based learning and reward- based learning .
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