explicit motor learning
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eNeuro ◽  
2021 ◽  
pp. ENEURO.0527-20.2021
Author(s):  
Guneet Bindra ◽  
Rylee Brower ◽  
Ryan North ◽  
Weiwei Zhou ◽  
Wilsaan M. Joiner

2021 ◽  
Vol 2 ◽  
Author(s):  
Paola Ortelli ◽  
Davide Ferrazzoli ◽  
Roberto Maestri ◽  
Leopold Saltuari ◽  
Markus Kofler ◽  
...  

Implicit and explicit motor learning processes work interactively in everyday life to promote the creation of highly automatized motor behaviors. The cerebellum is crucial for motor sequence learning and adaptation, as it contributes to the error correction and to sensorimotor integration of on-going actions. A non-invasive cerebellar stimulation has been demonstrated to modulate implicit motor learning and adaptation. The present study aimed to explore the potential role of cerebellar theta burst stimulation (TBS) in modulating explicit motor learning and adaptation, in healthy subjects. Cerebellar TBS will be applied immediately before the learning phase of a computerized task based on a modified Serial Reaction Time Task (SRTT) paradigm. Here, we present a study protocol aimed at evaluating the behavioral effects of continuous (cTBS), intermittent TBS (iTBS), or sham Theta Burst Stimulation (TBS) on four different conditions: learning, adaptation, delayed recall and re-adaptation of SRTT. We are confident to find modulation of SRTT performance induced by cerebellar TBS, in particular, processing acceleration and reduction of error in all the conditions induced by cerebellar iTBS, as already known for implicit processes. On the other hand, we expect that cerebellar cTBS could induce opposite effects. Results from this protocol are supposed to advance the knowledge about the role of non-invasive cerebellar modulation in neurorehabilitation, providing clinicians with useful data for further exploiting this technique in different clinical conditions.


2021 ◽  
Author(s):  
Li-Juan Jie ◽  
Melanie Kleynen ◽  
Kenneth Meijer ◽  
Anna Beurskens ◽  
Susy Braun

Abstract Objective Clinicians may use implicit or explicit motor learning approaches to facilitate motor learning of patients with stroke. Implicit motor learning approaches have shown promising results in healthy populations. The purpose of this study was to assess whether an implicit motor learning walking intervention is more effective compared to an explicit motor learning walking intervention delivered at home with regard to walking speed in people after stroke in the chronic phase of recovery. Methods This randomized controlled single-blind trial was conducted in the home environment. The 79 participants, who were in the chronic phase after stroke (age = 66.4 [SD = 11.0] years; time poststroke = 70.1 [SD = 64.3] months; walking speed = 0.7 [SD = 0.3] m/s; Berg Balance Scale score = 44.5 [SD = 9.5]), were randomly assigned to an implicit (n = 38) or explicit (n = 41) group. Analogy learning was used as the implicit motor learning walking intervention, whereas the explicit motor learning walking intervention consisted of detailed verbal instructions. Both groups received 9 training sessions (30 minutes each) targeted at improving quality of walking, for a period of 3 weeks. The primary outcome was walking speed measured by the 10-Meter Walk Test at a comfortable walking pace. Outcomes were assessed at baseline, immediately after intervention, and 1 month postintervention. Results No statistically or clinically relevant differences between groups were obtained postintervention (between-group difference was estimated at 0.02 m/s [95% CI -0.04 to 0.08] and at follow-up (between-group difference estimated at −0.02 m/s [95% CI -0.09 to 0.05]) Conclusions Implicit motor learning was not superior to explicit motor learning to improve walking speed in people after stroke in the chronic phase of recovery. Impact To our knowledge this is the first study to examine the effects of implicit compared to explicit motor learning on a functional task in people after stroke. Results indicate that physical therapists can use (tailored) implicit and explicit motor learning strategies to improve walking speed in people after stroke who are in the chronic phase of recovery.


2020 ◽  
Author(s):  
Li-Juan Jie ◽  
Melanie Kleynen ◽  
Kenneth Meijer ◽  
Anna Beurskens ◽  
Susy Braun

PurposeTo evaluate whether the implicit and explicit motor learning walking interventions for people after stroke delivered in a randomized controlled trial were performed as intended (fidelity) and to report the therapist and participant experiences with regard to feasibility.MethodsDose delivered and content of instructions were assessed by evaluating the therapist logs and audio recordings of the training sessions. The therapist and participant experiences were assessed by means of self-developed questionnaires.Results79 people were included of which seven people (9%) dropped out. The remaining participants all received the required minimum of seven sessions. Overall therapists adhered to the intervention guideline. On average 5.2 and 0.4 explicit rules were used within the explicit group and implicit group respectively. Therapists and participants were generally positive about the feasibility but frequent comments were made by the therapists regarding “therapy time restrictions” and “tendency of the participants to develop explicit rules”. A variety of changes were observed ranging from improvements in spatiotemporal parameters to cognitions and emotions.ConclusionThe delivery of the implicit and explicit motor learning walking interventions were successful in terms of fidelity. Therapists and participants were generally positive about the feasibility of the intervention.


2019 ◽  
Author(s):  
Li-Juan Jie ◽  
Melanie Kleynen ◽  
Kenneth Meijer ◽  
Anna Beurskens ◽  
Susy Braun

ABSTRACTBackgroundTherapists may use (more) implicit or (more) explicit motor learning approaches to facilitate motor skill learning of stroke patients. The use of implicit motor learning approaches has shown promising results in healthy populations.ObjectiveTo assess whether an implicit motor learning walking intervention is more effective compared to an explicit motor learning walking intervention delivered at home with regard to walking speed in people after stroke in the chronic phase of recovery.DesignRandomized controlled single blind trial.SettingHome environment.Patients79 people in the chronic phase after stroke (66.4 ± 11.0 years; 70.1 ± 64.3 months after stroke; walking speed 0.7 ± 0.3 m/s; Berg Balance Scale score 44.5 ± 9.5) were randomly assigned to an implicit (n=39) or explicit (n=41) group.InterventionAnalogy learning was used as the implicit motor learning walking intervention, whereas the explicit motor learning walking intervention consisted of detailed verbal instructions. Both groups received nine training sessions, 30 minutes each, for a period of three weeks.MeasurementsThe primary outcome was walking speed measured by the 10-Meter Walk Test. Outcome measures were assessed at baseline, immediate and 1-month post intervention.ResultsNo statistically or clinically relevant differences between groups were obtained post intervention (between-group difference estimated 0.02 m/s [95% CI −0.04 to 0.08] and at follow-up (between-group difference estimated −0.02 m/s [95% CI −0.09 to 0.05], p=0,563).LimitationsThe treatment effects may have been diluted by “noise” accompanied with research within real life settings, complex tasks and a representative sample.ConclusionsImplicit motor learning was not superior to the explicit motor learning to improve walking speed in people after stroke in the chronic phase of recovery.


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