Applying principles of motor learning and control to upper extremity rehabilitation.

The purpose of this article is to provide a brief review of the principles of motor control and learning. Different models of motor control from historical to contemporary are presented with emphasis on the Systems model. Concepts of motor learning including skill acquisition, measurement of learning, and methods to promote skill acquisition by examining the many facets of practice scheduling and use of feedback are provided. A fictional client case is introduced and threaded throughout the article to facilitate understanding of these concepts and how they can be applied to clinical practice.

[1]  C. Weiller,et al.  Association of Activity Changes in the Primary Sensory Cortex With Successful Motor Rehabilitation of the Hand Following Stroke , 2012, Neurorehabilitation and neural repair.

[2]  R. Schmidt Motor Schema Theory after 27 Years: Reflections and Implications for a New Theory , 2003, Research quarterly for exercise and sport.

[3]  N. A. Bernshteĭn The co-ordination and regulation of movements , 1967 .

[4]  R. Shadmehr,et al.  Neural correlates of motor memory consolidation. , 1997, Science.

[5]  J. Liepert,et al.  Motor cortex plasticity during constraint-induced movement therapy in stroke patients , 1998, Neuroscience Letters.

[6]  R. Shepherd,et al.  Task-related training improves performance of seated reaching tasks after stroke. A randomized controlled trial. , 1997, Stroke.

[7]  J. Liepert,et al.  Treatment-induced cortical reorganization after stroke in humans. , 2000, Stroke.

[8]  M. Carter Movement Science Foundations for Physical Therapy in Rehabilitation, 2nd ed , 2002 .

[9]  M. Hallett,et al.  Modulation of muscle responses evoked by transcranial magnetic stimulation during the acquisition of new fine motor skills. , 1995, Journal of neurophysiology.

[10]  A. M. Gentile,et al.  Movement Science: Implicit and Explicit Processes during Acquisition of Functional Skills , 1998 .

[11]  S. Wolf,et al.  Forced use of hemiplegic upper extremities to reverse the effect of learned nonuse among chronic stroke and head-injured patients , 1989, Experimental Neurology.

[12]  K. Kerr Movement Science: Foundations for Physical Therapy in Rehabilitation , 1990 .

[13]  Timothy D. Lee,et al.  Motor Control and Learning: A Behavioral Emphasis , 1982 .

[14]  I. Treger,et al.  Constraint-Induced Movement Therapy Alters Cerebral Blood Flow in Subacute Post-Stroke Patients , 2012, American journal of physical medicine & rehabilitation.

[15]  P. Roland,et al.  Supplementary motor area and other cortical areas in organization of voluntary movements in man. , 1980, Journal of neurophysiology.

[16]  M. MacKay-Lyons,et al.  Forced use of the upper extremity in cerebral palsy: a single-case design. , 1997, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[17]  R. Schmidt,et al.  Contextual Interference in Motor Learning: Dissociated Effects Due to the Nature of Task Variations , 1992 .

[18]  Karl M. Newell,et al.  Constraints on the Development of Coordination , 1986 .

[19]  A. Karni,et al.  The time course of learning a visual skill , 1993, Nature.

[20]  J Zuckerman,et al.  Modeling effects on motor performance. , 1976, Research quarterly.

[21]  C. Hofsten,et al.  Structuring of early reaching movements: a longitudinal study. , 1991 .

[22]  C. Winstein,et al.  Effects of physical guidance and knowledge of results on motor learning: support for the guidance hypothesis. , 1994, Research quarterly for exercise and sport.

[23]  R. Magill Motor learning and control : concepts and applications , 2004 .

[24]  D. Wade,et al.  The effects of mental practice in stroke rehabilitation: a systematic review. , 2006, Archives of physical medicine and rehabilitation.

[25]  J. Shea,et al.  Contextual interference effects on the acquisition, retention, and transfer of a motor skill. , 1979 .

[26]  B. Sidaway,et al.  Interaction of Feedback Frequency and Task Difficulty in Children's Motor Skill Learning , 2012, Physical Therapy.

[27]  M. Levin,et al.  The development of coordination for reach-to-grasp movements in children , 2002, Experimental Brain Research.

[28]  B. Knowlton,et al.  Contextual interference effects in sequence learning for young and older adults. , 2010, Psychology and aging.

[29]  J. Lebeer,et al.  How much brain does a mind need? Scientific, clinical, and educational implications of ecological plasticity , 1998, Developmental medicine and child neurology.

[30]  Viktor K. Jirsa,et al.  Human trajectory formation: Taxonomy of movement based on phase flow topology , 2008 .

[31]  C. Richards,et al.  Mental Practice for Relearning Locomotor Skills , 2010, Physical Therapy.

[32]  B. Sidaway,et al.  A Comparison of Manual Guidance and Knowledge of Results in the Learning of a Weight-bearing Skill , 2008, Journal of neurologic physical therapy : JNPT.

[33]  N. Hogan,et al.  On rhythmic and discrete movements: reflections, definitions and implications for motor control , 2007, Experimental Brain Research.

[34]  E. Thelen,et al.  Hidden skills: a dynamic systems analysis of treadmill stepping during the first year. , 1991, Monographs of the Society for Research in Child Development.

[35]  T. Kuhn,et al.  The Structure of Scientific Revolutions. , 1964 .

[36]  K. Newell Motor skill acquisition. , 1991, Annual review of psychology.

[37]  C. Heriza,et al.  Implications of a dynamical systems approach to understanding infant kicking behavior. , 1991, Physical therapy.

[38]  M. Jeannerod The timing of natural prehension movements. , 1984, Journal of motor behavior.

[39]  M. Weiss,et al.  Modeling Considerations in Motor Skill Acquisition and Performance: An Integrated, Approach , 1989, Exercise and sport sciences reviews.

[40]  R. Magill,et al.  Variability of Practice and Contextual Interference in Motor Skill Learning. , 1995, Journal of motor behavior.

[41]  A. Gentile,et al.  Skill acquisition : Action, movement, and neuromotor processes , 1987 .

[42]  A. Gentile A Working Model of Skill Acquisition with Application to Teaching , 1972 .

[43]  A. Gordon,et al.  Effects of Constraint‐Induced Therapy on Hand Function in Children with Hemiplegic Cerebral Palsy , 2001, Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association.

[44]  E. Turiel,et al.  Judging social issues: difficulties, inconsistencies, and consistencies. , 1991, Monographs of the Society for Research in Child Development.

[45]  Leslie G. Ungerleider,et al.  Functional MRI evidence for adult motor cortex plasticity during motor skill learning , 1995, Nature.

[46]  N. Miller,et al.  Technique to improve chronic motor deficit after stroke. , 1993, Archives of physical medicine and rehabilitation.

[47]  P. McCullagh,et al.  Model Similarity Effects on Motor Performance , 1987 .

[48]  M. Jeannerod,et al.  Possible involvement of primary motor cortex in mentally simulated movement: a functional magnetic resonance imaging study. , 1996, Neuroreport.

[49]  M. Jeannerod,et al.  Is the organisation of goal-directed action modality specific? A common temporal structure , 2000, Neuropsychologia.

[50]  G. M,et al.  Motor Development in Children : Aspects of Coordination and Control , 2011 .

[51]  L. Kruisselbrink,et al.  Task Characteristics and the Contextual Interference Effect , 2011, Perceptual and motor skills.

[52]  A. Sanabria,et al.  Randomized controlled trial. , 2005, World journal of surgery.

[53]  Will F W Wu,et al.  Contextual interference and augmented feedback: is there an additive effect for motor learning? , 2011, Human movement science.

[54]  R. Dickstein,et al.  Motor Imagery in Physical Therapist Practice , 2007, Physical Therapy.

[55]  C. Winstein,et al.  Contextual Interference Effect: Elaborative Processing or Forgetting—Reconstruction? A Post Hoc Analysis of Transcranial Magnetic Stimulation—Induced Effects on Motor Learning , 2008, Journal of motor behavior.

[56]  John R. Anderson Cognitive Skills and Their Acquisition , 2013 .

[57]  Gabriele Wulf,et al.  Frequent External-Focus Feedback Enhances Motor Learning , 2010, Front. Psychology.

[58]  J P Scholz,et al.  Dynamic pattern theory--some implications for therapeutics. , 1990, Physical therapy.

[59]  S L Wolf,et al.  Effect of forced use of the upper extremity of a hemiplegic patient on changes in function. A single-case design. , 1981, Physical therapy.

[60]  R. Schmidt A schema theory of discrete motor skill learning. , 1975 .

[61]  E. Taub,et al.  Constraint Induced Movement Techniques To Facilitate Upper Extremity Use in Stroke Patients. , 1997, Topics in stroke rehabilitation.

[62]  John W Krakauer,et al.  Improvement After Constraint-Induced Movement Therapy , 2013, Neurorehabilitation and neural repair.

[63]  E. Reed The Ecological Approach to Visual Perception , 1989 .

[64]  C. Sherrington Flexion‐reflex of the limb, crossed extension‐reflex, and reflex stepping and standing , 1910, The Journal of physiology.

[65]  S. Wolf,et al.  An application of upper-extremity constraint-induced movement therapy in a patient with subacute stroke. , 1999, Physical therapy.

[66]  R Iansek,et al.  Current status of the motor program. , 1994, Physical therapy.

[67]  Steven W. Keele,et al.  Movement control in skilled motor performance. , 1968 .

[68]  M. Woollacott,et al.  Motor Control: Translating Research into Clinical Practice , 2006 .

[69]  Gitendra Uswatte,et al.  Constraint-induced movement therapy combined with conventional neurorehabilitation techniques in chronic stroke patients with plegic hands: a case series. , 2013, Archives of physical medicine and rehabilitation.

[70]  R. Hanlon Motor learning following unilateral stroke. , 1996, Archives of physical medicine and rehabilitation.

[71]  Allen and Rosenbloom Paul S. Newell,et al.  Mechanisms of Skill Acquisition and the Law of Practice , 1993 .