THEORIES OF MOTOR LEARNING

Although models of motor control focus on how the bio- logical system organizes and
adapts movement as it occurs, models of motor learning consider how the individual
comes to understand and consistently perform a particular behav- ioral task. The
outcome of effective motor learning is mas- tery of skilled behaviors so that the
individual can function appropriately in his or her physical and social environment.
Most models of motor learning are founded on four distinct notions about learning:

1. Motor learning is a dynamic process that leads to acquisi- tion of ability for skilled
actions.

2. In order for motor learning to occur, there must be an opportunity to

practice and build experience. Making errors is a necessary part of the
learning process; as learn- ing occurs motor memories are established. 


3. Motor learning itself cannot be observed directly; it is inferred by

observation of changes in motor behavior that become consistent over time. 


4. Learning produces relatively permanent changes in the capability for

skilled behavior, by building motor memory; as a result, what has been
learned can be applied or adapted when altered task or environmental
constraints occur. 


In order to effectively master a novel motor task or recover from disease-disrupted

motor function, the individual must52,124: • Develop sensory and perceptual strategies
for collecting

information relevant to the task at hand and the environ-

ment in which is occurring


• Understand key features of the task, the performance

environment, and any tools required to complete the task

successfully

• Activate the components of the motor control system

(anticipatory, guiding, corrective, and reactive) necessary

for skillful performance of the task

• Apply (transfer) knowledge of the task, environment and

tools in order to adapt skilled motor performance to situ- ations that are different from
the one in which learning took place

Rehabilitation professionals must be careful to distin-

guish between the concepts of motor learning and motor performance. Motor
performance is the observable action or behavior that can be measured (rated)
qualitatively or quan- titatively by an observer.41 As health care professionals who
focus on function, therapists are quite skilled at examining motor performance, and
determining whether an individual is moving normally or is coping with some form of
move- ment dysfunction. Physical therapists use both subjective rat- ings (e.g., ratings
of perceived exertion; using the terms “poor, fair, good, normal/excellent” to describe
static postural con- trol, dynamic balance ability, or endurance), and objective
performance-based scales and measures (e.g., self-selected and fast walking speeds,
Timed Up and Go times, Functional Reach distances, Dynamic Gait Index scores, 6-
minute walk test distance, Gross Motor Functional Measure scores, among many
others).125–131

In contrast, motor learning refers to the process that leads to changes in the quality,
consistency, and efficiency of motor performance of a given individual. This process is
not easily measured except by considering consistency or how other dimensions of
performance of the task change over time. Comparisons of baseline performance to
postinter- vention performance indicate changes in quality of perfor- mance. Although
motor performance tends to transiently improve after a single practice session, we
cannot be confi- dent that learning has occurred until performance becomes consistent
after multiple sessions over a period of time.132,133 Improvement in motor performance
to the level of con- sistency infers that effective motor learning has occurred. Motor
learning has occurred when the task can be accom- plished in various ways as
situations demand.

Evolution of Models of Motor Learning

Initial models of motor learning were published in the early 1970s, the most prominent
being Adams’ closed-loop theory and Schmidt's schema theory.134,135 Both models
assume that, as a result of the motor learning process, the brain develops generalized
motor programs: rules for timing and sequenc- ing of muscle activity for key tasks.132
The closed-loop theory proposes that sensory information generated from move- ments
occurring during performance of functional tasks
Chapter 3 Motor Control, Motor Learning, and Neural Plasticity in Orthotic and
Prosthetic Rehabilitation 47

provides feedback necessary to build the memory and percep- tual traces that guide and
refine subsequent performance of the task.134 In contrast, schema theory suggests that
an open- loop process occurs, in which a general set of rules for a par- ticular
movement is developed (motor recall and sensory recognition schema) over time. Such
schemas allow the indi- vidual to continuously compare actual outcomes of move-
ment with anticipated (feedforward)/predicted outcomes via error detection and
correction mechanism.135,136 According to schema models, variability of practice must
occur to establish and strengthen the movement schema over time.137,138

In the 1990s, Newell proposed an alternative ecological model of motor learning

(resonant with Bernstein's dynamic systems model of motor control) that suggests
individuals use a problem-solving approach to discover the optimal strategy to produce
the task (performance) given both environmental and task influences.139,140 By exploring
the perceptual motor work- space during practice, individuals begin to recognize
salient sensory/perceptual cues as they explore movement options that might lead to
successful task completion. In viewing a demonstration, perceptual information helps
the learner better understand the nature of the task and task-related movements that
need to be mastered. Perception during (knowledge of performance) and perception
after (knowledge of results) task- related movement provides intrinsic feedback that
assists the problem solving process in the development of optimal strat- egies for the
task at hand. Therapists can provide augmented information (explicit cues and extrinsic
feedback) to facilitate an individual's search for optimal strategies. In this way, the
perception (salient cues about the task and the environmental) and action (adaptive
motor performance of the task.) are linked so that task-relevant connection is
established.145

Refer to Shumway-Cook and Woollacott132 and Schmidt and Lee128 for a more detailed
discussion of these theoretical models.