Summary of the motor learning lesson given by Prof. A. Timmermans of the subject of rehab technology. It is a summary of the powerpoint slides and additional items noted during the lesson. The slides were in English and my own notes are always in Dutch as much as possible. It is therefore a mix of ...
Rehab tech: MOTOR LEARNING IN THE CONTEXT OF TECHNOLOGY-SUPPORTED REHAB
TECHNOLOGY IN REHABILITATION – WHAT, WHY, HOW?
WHAT IS TECHNOLOGY?
Which of the applications underneath can be called “technology that supports motor learning
rehabilitation”? (multiple answers are possible)
A. Robot system
B. Sensor system
C. Virtual reality
D. Bicycle -> niet echt
E. Walking frame
F. All answers are correct
WHAT IS TECHNOLOGY IN REHABILITATION?
Assistive technology versus rehabilitation technology
Robot technologies for passive movements, eg “Continuous Passive Motion” systems after knee Surgery
Systems that facilitate and support active exercise therapy
- Nodig voor motor learning
- ROM zo ergonomisch mogelijk gebruiken
FB nodig voor leren
1. REVIEW – TIMMERMANS ET AL. 2009
Technology-assisted training of arm-hand skills in stroke: concepts on reacquisition of motor control and
therapist guidelines for rehabilitation technology design
- Analytical movement
Enkel indien groot verband met taak
- ↑uithouding;CR-fitheid
1.1. STATE-OF-THE-ART APPROACHES IN MOTOR LEARNING
Task-oriented training
Sensory-motor training is a total package
- Training of basic functions prerequisite to skill training
- Skill training
- Improvement of endurance on muscular and/or cardiovascular level
Principles of motor learning in rehabilitation
- Donald Hebbe (1904 – 1985) strengthening connections
- “ Fire together = Wire together”
- New post-synaptic dendrite spines appearing one hour after
stimulation – accompanying synaptic efficiency
- Veel hersenplasticiteit gebeurt volgens de manier dat we task
performance doen
we willen dat de P beter wordt in taak specifieke
bewegingen
- daarom is het belangrijk om bij een behandeling
hier de nadruk op te leggen
Schema
- enkel indien taak gerichte therapy
- CC-conections
Cortico-cortico conections
Beweging zo normaal mogelijk uitvoeren
Nala Melis Pagina 1
, Rehab tech: MOTOR LEARNING IN THE CONTEXT OF TECHNOLOGY-SUPPORTED REHAB
1.2. ACTIVE THERAPY APPROACHES
Task-oriented training approaches
- Learning by solving task-specific problems, anticipatory movements, locomotor adjustments,
cognitive processing, finding efficient goal-oriented movement strategies
Anticipatory movements: voorbereiding op beweging
Personally and goal tailored training load
Attention for bilateral (arm) training
Real life objects:
- Zeker voor BL
- met de aandacht dat er heel veel taken bilateraal zijn --> real life training!
- Sensorimotor integration is important (Pavlides 1993)
Sensorimotorische inegratie: connectie tussen sensorimotor cortex & primaire motor cortex
- fNIRS shows additional active brain area (prefrontal cortex) during real apple pealing vs mock apple
pealing
met echte objecten trainen is heel belangrijk om het beste effect te verkrijgen
er worden meer hersen regio's geactiveerd dit is niet bv bij een namaak appel en namaak mes
1.3. PERSONAL GOAL SETTING
self-selected, well-defined, individually meaningful goals within patient capability
- Important for patient motivation and treatment-adherence
- Increases treatment results and increases efficiency of treatment
1.4. FEEDBACK
Support for motor learning and motivator (shaping) (Magill 2007)
- Shaping: taak verdelen in ≠subtaken
Needs to be tailored to the skill level of receiver (Magill 2007)
Fading frequency
- Tijd geven om te luisteren naar intrisieke FB
Mogen niet afhankelijk worden van FB
Empty time slot before and after
- After: plannen hoe te ∆ met toepassing FB
Figuur= belangrijke criteria rehab tech
- Global
Verbal; avatar;video;…
- Analytical
EMG;JERK; druk;…
- externe feedback = motor learning
- interne feedback = motivatie
- knowledge of results
score beter? Ping bij einde oef?..
- knowledge of performnce
quality
compensaties,…
- prescripted feedback:
Nala Melis Pagina 2
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