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Optimizing Outcomes in Rehabilitation: Motor Learning Principles and Beyond: Summary
CASE STUDY 2: INTENSITY
Russ, a 58-year-old diabetic, recently experienced a hemorrhagic stroke. Over the past few weeks, Russ has shown remarkable progress in his recovery. However, while he can now walk aided by a quad cane, he faces persistent challenges, particularly in lifting his left foot when stepping and in dealing with dynamic tasks such as altering his gait speed and direction.
Russ’s rehabilitation program starts with a 15-minute session on the step machine, aiming to achieve a target max heart rate of 50% to 60%, which significantly contributes to enhancing his cardiovascular health and overall physical endurance. Additionally, Russ engages in task practice, which accounts for about a third of recovery after a stroke; gait training; and balance exercises to enhance his stability and reduce the risk of falls . Finally, Russ participates in strength-training exercises aimed at bolstering his overall strength. One key challenge that needs to be addressed is the intensity of Russ’s training regimen. The existing program may not provide sufficient challenge in terms of strength training and aerobic exercise intensity, which play important roles in achieving substantial recovery following a stroke. However, it can be difficult to balance the benefits versus the deleterious effects of fatigue in learning. It’s essential to make adjustments to build up the training intensity, particularly by introducing high- intensity strength training and aerobic exercises to achieve better results and expedite Russ’s recovery.
CASE STUDY 3: PRACTICE
Jill is a 25-year-old former college athlete who suffered grade two hamstring strain while preparing for a half marathon. Her rehabilitation program has been built around the principles of motor learning, emphasizing the importance of repetitive and focused practice. To address her goals, her therapist incorporates elements such as task practice, repetitive exercises, blocked and variable practice sessions, strategic rest intervals, and maintaining consistency in her routine. This approach not only aids in the physical recovery of her hamstring but also plays a pivotal role in rebuilding her confidence and running abilities.
Feedback Feedback is another element that plays a crucial role in improving motor performance and learning. Effective feedback is contingent on:
Prescriptive feedback helps patients understand what they are doing wrong and offers guidance on how to make improvements. As learners progress to later stages of skill acquisition, descriptive feedback becomes more useful. This is because during the advanced stages, individuals have already developed a foundational understanding of the task and acquired the basic skills. Feedback can also be internal or external. Internal feedback is provided by a person’s own internal sensory systems and requires working sensory systems to process information quickly and accurately.
• What information is provided • How the information is provided • When the information is provided
Feedback can be either prescriptive (how to correct an error) or descriptive (whether or not an error occurred). During initial training, prescriptive feedback tends to be more effective because it provides specific instructions on how to correct errors made during a task.
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