پس از بررسی پارادایمهای توانبخشی حرکتی به معرفی نظریه ی سیستمهای پویا در کنترل حرکت پرداخته شده است و سپس مباحث مختلف یادگیری حرکتی از جمله طبقه بندی مهارتهای حرکتی، مراحل یادگیری حرکتی، انواع تمرین و انواع فیدبک افزوده بیان شده است.
33. حرکتی های مهارت بندی طبقه
•بعدی یک های بندی طبقه:
•محیطی ثبات اساس بر
OPEN // CLOSED
Temporal and Spatial
Environment is not predictable
Spatial Only
Environment is predictable
56. تمرین انواع
برتمرین پذیری تغییر یا تنوع اساس:
• Constant Vs. Variable practice
ای زمینه تداخل اساس بر:
• Random Vs. Blocked practice
تمرین مقدار اساس بر:
• Massed Vs. Distributed practice
تمرین بودن اختصاصی:
• Task specificity
بودن کامل یا جزء جزء اساس بر:
• Part Vs. Whole practice
تکلیف دشواری کاهش:
• Modified Vs. Actual task practice
ذهنی تمرین:
• Mental Vs. Physical practice
75. Feedback
• Questions We Need to Consider:
• How and when should an occupational therapist provide feedback
for patients?
• What kinds of information should be conveyed to them about their
performance?
• Should the therapist attempt to provide feedback about more then
one aspect of a patient’s movement at a time?
• When assisting a particular individual, should the therapist give
feedback after each performance attempt or wait until after the
person makes several attempts before providing feedback?
76. Feedback
• Feedback: “the information that occurs as a result of a movement”
• Some information is received during the movement and some is provided as a result
of the movement
• Feedback is one of the strongest factors that controls the effectiveness of learning
•■ Two types of feedback:
•♦Intrinsic feedback
• Sensory-perceptual information that is a natural part of performing the skill
• Information that is provided as a natural consequence of performing an
action
•♦Augmented feedback
•*Add-on to task intrinsic feedback
•• Adds to information detected
•• Adds to information one cannot detect
77. Augmented Feedback
Information about performing a skill that is supplemental to
sensory feedback and comes from a source external to
the performer and can be presented concurrently or on
termination of the activity
• Giving augmented feedback is a significant role as a
therapist
• Augmented feedback provides answers that save the
learner's time and energy in learning skills
78. Types of Augmented Feedback
■Knowledge of Results- KR
♦ Externally presented information about the outcome of performing a skill
or achieving the goal
♦ KR does not describe the outcome, only tells the performer if they
achieved the goal
■Knowledge of performance- KP
♦ Information about movement characteristics that led to the
performance outcome
♦ It focuses on the quality of the produced movement
81. Benefits of Feedback
• ■ Helps the learner achieve the goal more quickly
• ■ Provide Information for learners so that they may perform
an action more effectively
• ■ Influences the person's perception of his/her own ability
in a skill (motivation)
• ■ Improves the chance that the performer will repeat the
performance (reinforcement)
82. How Essential Is Augmented Feedback?
•ANSWER 1: AUGMENTED FEEDBACK IS ESSENTIAL FOR SKILL ACQUISITION:
•Situations where sensory information is not available (cannot see the target)
•When learner’s sensory pathways are impaired due to injury, accident , age, or disease
•When task intrinsic feedback is available but performer cannot use it! (due to lack of
experience)
•ANSWER 2: AUGMENTED FEEDBACK IS NOT NEEDED:
•Skill that inherently provides task-intrinsic feedback
•Skill that has a detectable external reference in the environment (i.e. targets, basket, goal)
•Observational learning situations in practice where one sees a skilled performer or skilled
peer performing the skill
•ANSWER 3: AUGMENTED FEEDBACK ENHANCES SKILL ACQUISITION:
•Simple skills for which achievement of the performance goal is initially easy to assess
•One can learn them more quickly or perform at a higher level if feedback is given
•Any complex skill where a person must acquire an appropriate multi-limb pattern of
coordination
•ANSWER 4: AUGMENTED FEEDBACK HINDERS SKILL LEARNING:
•When the learner become dependent on feedback while learning a skill
•When the learner is given erroneous feedback
•When the learner is given concurrent feedback
83. The Content of Feedback
• Errors Vs. Correct
• „KR Vs. KP
• „Qualitative Vs. Quantitative information
• „Performance Bandwidths
• „Erroneous Augmented Feedback
84. InformationAbout Errors Vs. CorrectAspects
• Should one provide mistakes he or she made or those aspects of
performance that are correct?
• Research consistently has shown that error information is more effective for
skill improvement.
• Information about correct performance serves to motivate the person to
continue.
Trial Block
1 2 3 4 5 6 7 8 8 10 R1-1R1-2R1-3R1-4R1-5 R7-1R7-2R7-3R7-4R7-5
ConstantError(ms)
-120
-100
-80
-60
-40
-20
0
20
Correct KR
Erroneous KR
85. KR vs. KP: Is one more important?
• Do professionals use one form over the other?
• Fishman & Troy study with physical education showed KP (94%) is given more
than KR.
• „Do KR and KP have the same influence on skill learning?
• ‹Research does not provide a clear cut answer
• ‹But both forms of feedback are valuable in skill learning
„KR
• Used to confirm their own
assessments
• Needed when intrinsic is not
present
• To motivate Promote active
learning
KP
• Skill requires a specific
movement
• Complex, multi-limb movement
• Goal is kinematic, kinetic, or
muscular
• KR is redundant with task
intrinsic feedback
86. Qualitative Vs. Quantitative Information
• Should we provide feedback that is numerical in value or feedback that
identifies the quality of performance?
• In terms of Gentile’s model:
• Early learner needs qualitative feedback;
• Once learned quantitative feedback
87. Augmented Feedback Based On Performance
Bandwidths
• How large an error a performer should make before giving augmented feedback?
• ‹Performances outside the performance bandwidth augmented feedback is given
• ‹Research support the use of bandwidths
• ‹One does not have to reduce the size of bandwidth limits in relation to the stage of
learning
• ‹Participants need to know in advanced that they will not receiving KR if inside the
performance bandwidth
88. Erroneous Augmented Feedback
• When augmented feedback is redundant information, will the learner will
use it rather than ignore it?
• If learner ignores the feedback when it is redundant with intrinsic feedback,
performance is not affected
• If learner used the feedback, then this erroneous information will bias the
performance
• Early stages of learning the beginner will use augmented feedback whether
it is correct or not
• Helps them deal with uncertainty about what intrinsic feedback is telling
them
• Why does augmented feedback appears to hinder learning?
• Augmented feedback may degrade learning by
• Increasing guiding influences
• inducing maladaptive corrections
• blocking other processing activities
• Attention to intrinsic or extrinsic cues
• Generation of solution/action plan
• Development of error-detection capabilities
• Development of reference of correctness
89. Types Of KP
• Verbal Knowledge of performance
• Videotape as augmented feedback
• Movement kinematics as augmented feedback
• Biofeedback as augmented feedback
90. Verbal Knowledge of performance
• The content of what you tell the person practicing is critical.
• Perform a skill analysis of skill being practiced.
• Prioritize each part by listing the most critical parts first and so on.
• Which part of skill must be done properly for entire skill to be
performed correctly
• Practitioner needs to decide the content of the verbal KP
statements
91. Types of Verbal KP
• Descriptive and Prescriptive.
• Descriptive (general) simply describe the movement.
• Indicates something you did, right or wrong
• Prescriptive (precise) tells a person what to do correct it!
• Provides you with precise correction statements about how to improve
your movements
• Which form is best?
• Prescriptive in beginning
• Descriptive once the skill is learned
• Verbal KP should be based on the
most critical error made
Performance
Blocks of Learning Trials
Precise
Feedback
General
Encouragement
High
Low
Early Late
92. VideotapeAs Augmented Feedback
• Videotape replays is a common practice that many assume aids in
skill acquisition
• Effectiveness of video tape replays depends on one’s stage of
learning
• Beginners need assistants to point out critical information
• Advanced player benefit form attention-directing instructions such as
verbal cues or checklists
• Self modeling tapes when combined with instruction is an effective
form
• Swimmers watching their own performance performed better that those who saw the same
skills performed by someone else
93. Movement KinematicAsAugmented Feedback
• Graphic computer simulations of performances
• Graphic kinematic displays is effective for advanced performers rather
than novices.
• Take into account the performer stage of learning
• Beginner need to interpret it
• Skilled can use more complex kinematic info
Biofeedback As Augmented Feedback
• Use of intrinsic feedback related to physiological processes (heart rate,
muscle activity)
• Most common form is EMG
• Biofeedback needs to give the client/student information they can use to alter
movements.
94. Timing of Feedback (When?)
• Concurrent & Terminal Augmented Feedback
• Should one give feedback during or after one has performed?
• The KR-Delay & Post-KR Intervals
• What effect does feedback have just before or after one has performed?
• Frequency of Presenting Augmented Feedback
• How frequently should I give feedback?
95. Presenting Feedback During Or After?
• Feedback given during performing is Concurrent feedback
• I.E. Steering a car through traffic; knee extension device that measures
ROM; walking to class
• Feedback at the end is Terminal feedback
• Which form is better???
• Terminal feedback is effective in any skill learning situation but
concurrent feedback depends on level of intrinsic feedback in
performing.
96. Effects Of Giving ConcurrentAugmented Feedback
• A negative learning effect occurs when:
• Feedback directs the learner attention from critical task intrinsic
feedback and towards the augmented feedback (feedback
becomes the important information).
• Elderly adults and Parkinson’s patients who saw their drawing on a
computer screen improved during practice but not in retention.
• Enhances skill learning when:
• Concurrent feedback enhances intrinsic feedback.
• Involved skills where task intrinsic feedback were difficult to
process.
• Training pilot using a Flight simulator
• Activation of a muscle group in therapy
• Learning bimanual tasks
97. Predicting Effects Of ConcurrentAugmented Feedback
• When information value of task intrinsic feedback is low,
augmented feedback information value high learner will
depend on concurrent feedback
• Concurrent feedback must facilitate the learning of critical
features in the task
• Negative effects of feedback occur when it distracts
attention away from these features
98. Give feedback before or after?
• KR-delay interval is between the end of one practice
attempt and the augmented feedback
• Post-KR internal is the interval between the augmented
feedback and the beginning of the next practice attempt
99. Relationship Between IntervalsAnd Skill Learning
• To understand the relationship we need to understand
the influence of two variables:
• -Length of the intervals (Time)
• -Activity during the intervals
100. • Length Of Kr-delay Interval:
• Augmented feedback has informational value for performers to solve
problems.
• Seems to be a minimum amount of time that must pass before giving
feedback
• Too soon seems to interfere with task intrinsic feedback processing
• ‹But if one waits just a few seconds, task intrinsic feedback processing is
facilitated.
• Activity During The Kr-delay Interval:
• Three Outcomes have been cited in research that indicates that it might
hinder, benefit, or have not have an effect:
• The most common effect is no influence
• Hinder learning when the interfere activity:
• uses the same learning processes as the primary task being learned (motor or
cognitive)
• Subjects engage error estimation activities of another subject.
• Interval benefits learning if the learner is required to evaluate their
performance (subjective performance evaluation strategy):
• Verbalize what they think they did right and wrong
101. • Length Of Post- KR Interval:
• Very important interval because most believe this is the period where
we develop a plan of action.
• There seems to be a minimum length of time for this interval but no
upper length of time limit has not been established
• Activity During Post–KR Interval:
• Engaging activity has similar results to that of KR-delay:
• No effect, hinder, or benefit.
• ‹Most common results is no affect
• Learners engage in important planning activities during this period.
• Learner uses this time to develop intrinsic feedback to determine future
plan of action
102. How Often Should One GiveAugmented Feedback?
• Giving augmented feedback after every trail is not practical nor
optimal for learning
• „Some type of relative or reduced frequency feedback schedule
is appropriate
• Reduced frequency of feedback is better for learning skills
• 100% feedback guides the learner and they become
dependent on augmented feedback
104. Fading Technique
• Form of relative feedback in which one systematically
reduces KR frequency.
• Example:
• •Give augmented feedback for 50% of the trials
• •Give augmented feedback for 25% of the trials
• •Give augmented feedback for 12% of the trials
• •Give augmented feedback when requested
105. Self-selected Frequency
• The practitioner gives the learner augmented feedback
only when they ask for it
• Self-regulates the presentation of augmented feedback
• Janelle, et al. overhand throwing study showed that only 11% of feedback in
self-controlled condition was needed.
• Why do we ask for help?
• Because we actually need it
• Use it to confirm our self-evaluation of the trial
106.
107. Summary Augmented Feedback
• Defined as listing performance related augmented
feedback after a certain number of trials
• What is the optimal number of performance trials to be
included in summary feedback?
• No specific number of trials
• But longer summaries are better for simple skills where as shorter
summaries are better for complex skills
No Summary T1 KR1 T2 KR2 T3 KR3 T4 KR4 T5 KR5..
Summary T1 T2 T3 T4 T5 KR1 KR2 KR3 KR4 KR5..
109. When in the Learning Process is
Information Feedback Needed Most?
110. Guidelines For GivingAugmented Feedback
• 1. The person must be capable of using the information.
• - Beginners need “ballpark” info
• - Skilled needs more specific info
• 2. Combine error-based feedback and performance
information of what is done correctly
• 3. Verbal KP should be based on the most critical errors
made during practice
• - Analysis of skill
• - Prioritize list of components of skill
111. Guidelines…
• 4. Prescriptive KP is better for novice; descriptive KP is
appropriate for advanced
• 5. Videotape replays can be effective with beginners
• - Practitioners provide direction to help them detect
• 6. Computer generated displays is effective for advanced
Performers
• 7. Biofeedback needs to give performance info they can
use to alter movements
112. Guidelines…
• 8. Do not give feedback after every trial and develop a faded
feedback schedule using bandwidth standards.
• 9. Wait a few seconds before giving feedback.
• 10. Have the client engage in self-evaluation of their
performance then give feedback.
• 11. Summary feedback should be provided over trials. More
trials for easy skill and less trial for more complex tasks.
• 12. Give the performer a choice in when they want feedback.
119. • The evaluation of functional mobility is structured as five
functional mobility treatment areas (FMTAs):
• (1) mat/bed mobility and supine-to-sit;
• (2) sitting activities, including reach, grasp, and manipulation of
objects;
• (3) sit-to-stand and transfers;
• (4) standing and single-step reaching activities;
• (5) gait activities.
121. General considerations for planning and adapting
motor-teaching strategies
• Stage of learning
• Initial/verbal-cognitive
• Intermediate/motor
• Later/autonomous
• Clarity of practice goal
• Motor learning: Retention and transfer
• Motor performance: Skill improvement
123. Specific considerations and strategies during practice
• Types of tasks
• Purposeful
• Voluntary regulated
• Goal-directed
• Meaningful
• Individual rhythm
• Anticipatory skills
• Individual context
• Biomechanical factors
• Time allowance
• Feedback
• Motivational
• Corrective
• Repetition and sequencing of tasks
• 'Regular' context
• Sequencing
• general/specific
• more/less complex
• blocked/random
• whole/progressive-part
• Mental practice
• Physical practice/rest periods
• massed/distributed
• high/low variability
• relative facilitation-guidance
• trial-and-error/discovery
124. Specific considerations and strategies after practice
• Feedback
• Qualitative
• positive
• negative
• Quantitative
• knowledge of results (KR)
• knowledge of performance (KP)
• More/less precision
• Continuous/relative frequency
• Delay periods
126. Case Study
A 64 years old man with Stroke and left Hemiplegia. He can
use his arm minimally. Main problems are using his left
hand in functional activities and problem of balance in
standing. He also has problem in standing up from a chair.
1. Select and set appropriate goals
2. Select and analyze tasks
3. Schedule practice
4. Select appropriate feedback regimen
127. Goals:
• 4 weeks
• 2D-stationary regulatory conditions,
intertrial variability, with object
manipulation, and body transport
brushing teeth, bathing himself, and getting himself dressed
• Long term:
• 3B-regulatory conditions in motion,
no intertrial variability
128. • Augmented Feedback
1. Knowledge of Performance (KP)
-Prescriptive feedback
2. Knowledge of Results (KR)
• Video feedback -> home practice
129. • Multi-tasking *Harvey needs to be able to do multiple
tasks simultaneously to perform many of his activities of
daily living.
Exercises:
- Walking and holding a phone
- Standing and washing dishes
- Walking and touching nose Contextual Interference
Random-practice
130. • -Exercises:
*Grasping a toothbrush, phone, spoon, etc.
*Picking up objects and transferring them
*Drawing shapes
*Side-step
*Toe tapping
*Standing up from a seated position and sitting back down
(from various heights)