1
|
Olivier GN, Dibble LE, Paul SS, Lohse KR, Walter CS, Marker RJ, Hayes HA, Foreman KB, Duff K, Schaefer SY. Personalized practice dosages may improve motor learning in older adults compared to "standard of care" practice dosages: A randomized controlled trial. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:897997. [PMID: 36189036 PMCID: PMC9397834 DOI: 10.3389/fresc.2022.897997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/14/2022] [Indexed: 11/13/2022]
Abstract
Standard dosages of motor practice in clinical physical rehabilitation are insufficient to optimize motor learning, particularly for older patients who often learn at a slower rate than younger patients. Personalized practice dosing (i.e., practicing a task to or beyond one's plateau in performance) may provide a clinically feasible method for determining a dose of practice that is both standardized and individualized, and may improve motor learning. The purpose of this study was to investigate whether personalized practice dosages [practice to plateau (PtP) and overpractice (OVP)] improve retention and transfer of a motor task, compared to low dose [LD] practice that mimics standard clinical dosages. In this pilot randomized controlled trial (NCT02898701, ClinicalTrials.gov), community-dwelling older adults (n = 41, 25 female, mean age 68.9 years) with a range of balance ability performed a standing serial reaction time task in which they stepped to specific targets. Presented stimuli included random sequences and a blinded repeating sequence. Participants were randomly assigned to one of three groups: LD (n = 15, 6 practice trials equaling 144 steps), PtP (n = 14, practice until reaching an estimated personal plateau in performance), or OVP (n = 12, practice 100% more trials after reaching an estimated plateau in performance). Measures of task-specific learning (i.e., faster speed on retention tests) and transfer of learning were performed after 2-4 days of no practice. Learning of the random sequence was greater for the OVP group compared to the LD group (p = 0.020). The OVP (p = 0.004) and PtP (p = 0.010) groups learned the repeated sequence more than the LD group, although the number of practice trials across groups more strongly predicted learning (p = 0.020) than did group assignment (OVP vs. PtP, p = 0.270). No group effect was observed for transfer, although significant transfer was observed in this study as a whole (p < 0.001). Overall, high and personalized dosages of postural training were well-tolerated by older adults, suggesting that this approach is clinically feasible. Practicing well-beyond standard dosages also improved motor learning. Further research should determine the clinical benefit of this personalized approach, and if one of the personalized approaches (PtP vs. OVP) is more beneficial than the other for older patients.
Collapse
Affiliation(s)
- Geneviève N. Olivier
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
| | - Leland E. Dibble
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
- Center on Aging, University of Utah, Salt Lake City, UT, United States
| | - Serene S. Paul
- Discipline of Physiotherapy, Faculty of Medicine and Health, Sydney School of Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - Keith R. Lohse
- Center on Aging, University of Utah, Salt Lake City, UT, United States
- Department of Health-Kinesiology-Recreation, University of Utah, Salt Lake City, UT, United States
- Program in Physical Therapy and Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Christopher S. Walter
- Department of Physical Therapy, University of Arkansas for Medical Sciences, Fayetteville, AR, United States
| | - Ryan J. Marker
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Heather A. Hayes
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
- Center on Aging, University of Utah, Salt Lake City, UT, United States
| | - K. Bo Foreman
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
| | - Kevin Duff
- Center on Aging, University of Utah, Salt Lake City, UT, United States
- Department of Neurology, University of Utah, Salt Lake City, UT, United States
| | - Sydney Y. Schaefer
- Center on Aging, University of Utah, Salt Lake City, UT, United States
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States
| |
Collapse
|
2
|
Moore RT, Cluff T. Individual Differences in Sensorimotor Adaptation Are Conserved Over Time and Across Force-Field Tasks. Front Hum Neurosci 2021; 15:692181. [PMID: 34916916 PMCID: PMC8669441 DOI: 10.3389/fnhum.2021.692181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 11/02/2021] [Indexed: 11/23/2022] Open
Abstract
Sensorimotor adaptation enables the nervous system to modify actions for different conditions and environments. Many studies have investigated factors that influence adaptation at the group level. There is growing recognition that individuals vary in their ability to adapt motor skills and that a better understanding of individual differences in adaptation may inform how motor skills are taught and rehabilitated. Here we examined individual differences in the adaptation of upper-limb reaching movements. We quantified the extent to which participants adapted their movements to a velocity-dependent force field during an initial session, at 24 h, and again 1-week later. Participants (n = 28) displayed savings, which was expressed as greater initial adaptation when re-exposed to the force field. Individual differences in adaptation across various stages of the experiment displayed weak-strong reliability, such that individuals who adapted to a greater extent in the initial session tended to do so when re-exposed to the force field. Our second experiment investigated if individual differences in adaptation are also present when participants adapt to different force fields or a force field and visuomotor rotation. Separate groups of participants adapted to position- and velocity-dependent force fields (Experiment 2a; n = 20) or a velocity-dependent force field and visuomotor rotation in a single session (Experiment 2b; n = 20). Participants who adapted to a greater extent to velocity-dependent forces tended to show a greater extent of adaptation when exposed to position-dependent forces. In contrast, correlations were weak between various stages of adaptation to the force-field and visuomotor rotation. Collectively, our study reveals individual differences in adaptation that are reliable across repeated exposure to the same force field and present when adapting to different force fields.
Collapse
Affiliation(s)
- Robert T Moore
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Tyler Cluff
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.,Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
3
|
Shafti A, Haar S, Mio R, Guilleminot P, Faisal AA. Playing the piano with a robotic third thumb: assessing constraints of human augmentation. Sci Rep 2021; 11:21375. [PMID: 34725355 PMCID: PMC8560761 DOI: 10.1038/s41598-021-00376-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 10/05/2021] [Indexed: 11/16/2022] Open
Abstract
Contemporary robotics gives us mechatronic capabilities for augmenting human bodies with extra limbs. However, how our motor control capabilities pose limits on such augmentation is an open question. We developed a Supernumerary Robotic 3rd Thumbs (SR3T) with two degrees-of-freedom controlled by the user’s body to endow them with an extra contralateral thumb on the hand. We demonstrate that a pianist can learn to play the piano with 11 fingers within an hour. We then evaluate 6 naïve and 6 experienced piano players in their prior motor coordination and their capability in piano playing with the robotic augmentation. We show that individuals’ augmented performance with the SR3T could be explained by our new custom motor coordination assessment, the Human Augmentation Motor Coordination Assessment (HAMCA) performed pre-augmentation. Our work demonstrates how supernumerary robotics can augment humans in skilled tasks and that individual differences in their augmentation capability are explainable by their individual motor coordination abilities.
Collapse
Affiliation(s)
- Ali Shafti
- Brain and Behaviour Laboratory, Department of Bioengineering, Imperial College London, London, SW7 2AZ, UK.,Department of Computing, Imperial College London, London, SW7 2AZ, UK.,Behaviour Analytics Laboratory, Data Science Institute, London, SW7 2AZ, UK
| | - Shlomi Haar
- Brain and Behaviour Laboratory, Department of Bioengineering, Imperial College London, London, SW7 2AZ, UK.,Behaviour Analytics Laboratory, Data Science Institute, London, SW7 2AZ, UK.,Department of Brain Sciences and UK Dementia Research Institute - Care Research and Technology Centre, Imperial College London, London, W12 0BZ, UK
| | - Renato Mio
- Brain and Behaviour Laboratory, Department of Bioengineering, Imperial College London, London, SW7 2AZ, UK
| | - Pierre Guilleminot
- Brain and Behaviour Laboratory, Department of Bioengineering, Imperial College London, London, SW7 2AZ, UK
| | - A Aldo Faisal
- Brain and Behaviour Laboratory, Department of Bioengineering, Imperial College London, London, SW7 2AZ, UK. .,Department of Computing, Imperial College London, London, SW7 2AZ, UK. .,Behaviour Analytics Laboratory, Data Science Institute, London, SW7 2AZ, UK. .,UKRI CDT in AI for Healthcare, Imperial College London, London, SW7 2AZ, UK. .,MRC London Institute of Medical Sciences, London, W12 0NN, UK.
| |
Collapse
|
4
|
Chung YC, Fisher BE, Finley JM, Kim A, Petkus AJ, Schiehser DM, Jakowec MW, Petzinger GM. Cognition and motor learning in a Parkinson's disease cohort: importance of recall in episodic memory. Neuroreport 2021; 32:1153-1160. [PMID: 34334776 DOI: 10.1097/wnr.0000000000001707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Impaired motor learning in individuals with Parkinson's disease is often attributed to deficits in executive function, which serves as an important cognitive process supporting motor learning. However, less is known about the role of other cognitive domains and its association with motor learning in Parkinson's disease. The objective of this study was to investigate the associations between motor learning and multiple domains of cognitive performance in individuals with Parkinson's disease. Twenty-nine participants with Parkinson's disease received comprehensive neuropsychological testing, followed by practice of a bimanual finger sequence task. A retention test of the finger sequence task was completed 24 h later. Hierarchical linear regressions were used to examine the associations between motor learning (acquisition rate and retention) and cognitive performance in five specific cognitive domains, while controlling for age, sex, and years of Parkinson's disease diagnosis. We found that a higher acquisition rate was associated with better episodic memory, specifically better recall in visual episodic memory, in individuals with Parkinson's disease. No significant associations were observed between retention and cognitive performance in any domains. The association between motor acquisition and episodic memory indicates an increased dependency on episodic memory as a potential compensatory cognitive strategy used by individuals with Parkinson's disease during motor learning.
Collapse
Affiliation(s)
| | | | | | - Aram Kim
- Division of Biokinesiology and Physical Therapy
| | - Andrew J Petkus
- Department of Neurology, University of Southern California, Los Angeles
| | - Dawn M Schiehser
- Psychology and Research Services, Veterans Administration San Diego Healthcare System (VASDHS), San Diego, California, USA
| | - Michael W Jakowec
- Department of Neurology, University of Southern California, Los Angeles
| | | |
Collapse
|
5
|
How Common Is the Exponential Decay Pattern of Motor Skill Acquisition? A Brief Investigation. Motor Control 2021; 25:451-461. [PMID: 33992025 DOI: 10.1123/mc.2020-0043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 02/22/2021] [Accepted: 03/07/2021] [Indexed: 11/18/2022]
Abstract
Motor performance is classically described as improving nonlinearly with practice, demonstrating rapid improvements early in practice with stabilization later, which is commonly modeled by exponential decay functions. However, retrospective analyses of our previously collected data challenge this theoretical model of motor skill acquisition, suggesting that a majority of individual learners actually demonstrate patterns of motor improvement different from this classical model. A convenience sample of young adults, older adults, and people with Parkinson disease trained on the same functional upper-extremity task. When fitting three-parameter exponential decay functions to individual participant data, the authors found that only 13.3% of young adults, 40.9% of older adults, and 66.7% of adults with Parkinson disease demonstrated this "classical" skill acquisition pattern. Thus, the three-parameter exponential decay pattern may not well-represent individuals' skill acquisition of complex motor tasks; instead, more individualized analysis methods may be warranted for advancing a theoretical understanding of motor skill acquisition.
Collapse
|
6
|
Olivier GN, Paul SS, Walter CS, Hayes HA, Foreman KB, Duff K, Schaefer SY, Dibble LE. The feasibility and efficacy of a serial reaction time task that measures motor learning of anticipatory stepping. Gait Posture 2021; 86:346-353. [PMID: 33857800 PMCID: PMC8092847 DOI: 10.1016/j.gaitpost.2021.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 03/03/2021] [Accepted: 04/02/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Motor learning has been investigated using various paradigms, including serial reaction time tasks (SRTT) that examine upper extremity reaching and pointing while seated. Few studies have used a stepping SRTT, which could offer additional insights into motor learning involving postural demands. For a task to measure motor learning, naïve participants must demonstrate a) improved performance with task practice, and b) a dose-response relationship to learning the task. RESEARCH QUESTION Is a stepping SRTT feasible and efficacious for measuring motor learning? METHODS In this prospective study, 20 participants stood on an instrumented mat and were presented with stimuli on a computer screen. They stepped to the corresponding positions on the mat as quickly as possible. Presented stimuli included random sequences and a blinded imbedded repeating sequence. Three days after completing the randomly assigned practice dose [high dose group (n = 10) performed 4320 steps; low dose group (n = 10) performed 144 steps], a retention test of 72 steps was performed. Feasibility was measured as the proportion of participants who completed the assigned practice dose without adverse events. Efficacy was measured as within-group performance improvement on the random sequences and on the repeating sequence (paired t-tests), as well as a dose-response relationship to learning both types of sequences (independent t-tests). RESULTS All participants (mean age 26.8 years) completed all practice sessions without adverse events, indicating feasibility. High dose practice resulted in performance improvement while low dose did not; a dose-response relationship was found, with high dose practice resulting in greater learning of the task than low dose practice, indicating efficacy. SIGNIFICANCE This stepping SRTT is a feasible and efficacious way to measure motor learning, which could provide critical insights into anticipatory stepping, postural control, and fall risk. Future research is needed to determine feasibility, efficacy, and optimal practice dosages for older and impaired populations.
Collapse
Affiliation(s)
- Geneviève N Olivier
- Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, USA.
| | - Serene S Paul
- Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, USA
| | - Christopher S Walter
- Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, USA
| | - Heather A Hayes
- Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, USA
| | - K Bo Foreman
- Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, USA
| | - Kevin Duff
- Neurology, University of Utah, Salt Lake City, UT, USA
| | - Sydney Y Schaefer
- Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, USA
| | - Leland E Dibble
- Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
7
|
|