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Optimizing Outcomes in Rehabilitation: Motor Learning Principles and Beyond: Summary
Error-Based Learning
Reward-Based Learning
• Learning from mistakes and making corrections • Well-functioning sensory system essential for recognizing and correcting mistakes • Cerebellum plays a crucial role in refining movements, making real-time small adjustments and corrections during learning • Corrections made promptly based on sensory feedback for more accurate movements • Focused on refining movements in the moment as actions are performed (known as online learning) • Errors recognized through sensory discrepancies between intended and actual movement | HEALTHCARE CONSIDERATION The hippocampus is the part of the brain that stores long-term memories. It is closely involved with explicit learning. Individuals with damage to the hippocampus, particularly those with hypoxic brain injury or tumors that put pressure on that part of the brain, have a hard time retrieving explicit instructions and strategies. Therefore, providers must find ways to compensate for this deficit and implement alternative strategies to support learning and motor skill development. Neuroplasticity , a fundamental aspect of learning, refers to the nervous system’s ability to adapt and change. But contrary to popular belief, neuroplasticity leads to not only adaptive and functional changes but also maladaptive ones. In other words, learning and reinforcing bad habits or incorrect techniques also represent forms of neuroplasticity.
• Learning what actions result in rewards • Sensory input helps determine which actions result in rewards • Cerebellum may also play a role in adapting actions to obtain rewards based on feedback • Adjustments made to actions that result in rewards to reinforce desired behaviors • Actions adjusted and refined based on immediate feedback to maximize rewards • Learners recognize when their actions result in rewards, thus reinforcing the behavior This carries critical implications for therapy: The longer an individual practices a skill incorrectly, the more challenging it becomes to modify and instill lasting changes. This highlights the importance of early intervention to prevent the ingraining of detrimental patterns and habits. Effective rehabilitation and relearning strategies must account for these nuances to facilitate successful skill correction. It is also important to recognize that even though the brain undergoes natural changes as it ages, it remains adaptable. This adaptability may involve a broader distribution of learning across different brain areas. In essence, while the overall capacity of a specific area might decline, older adults make up for it by engaging other regions of the brain.
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