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Implicit and explicit motor learning in typically developing children: effects of task, age and working memory
WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS633–eS832
Research Report Platform Presentation Number: RR-PL-3524 Sunday 3 May 2015 11:40 Room 334–335 IMPLICIT AND EXPLICIT MOTOR LEARNING IN CHILDREN BORN VERY PRETERM AND TYPICALLY DEVELOPING CHILDREN M. Jongbloed-Pereboom 1 , A. Janssen 2 , B. Steenbergen 1 , M.W.G. Nijhuis-Van der Sanden 3 1 Radboud University, Behavioural Science Institute, Nijmegen, Netherlands; 2 Radboud University Medical Center, Department of Rehabilitation, Pediatric Physical Therapy, Nijmegen, Netherlands; 3 Radboud University Medical Center, Scientific Institute for Quality of Healthcare, Nijmegen, Netherlands
Background: Motor skills can be learned implicitly and explicitly. Implicit learning is the ability to acquire a new skill without a corresponding increase in knowledge about the skill performance. In contrast, explicit learning uses declarative knowledge to build up a set of performance rules that guide performance or skills. Explicit learning is dependent on working memory, implicit learning is not. Especially children born at a gestational age of less than 33 weeks (very preterm; VPT) are at risk for impairments, including working memory impairments. Purpose: This study examined implicit and explicit learning, and the role of working memory, in VPT children. The hypothesis of the present study was that deficits in working memory capacity in children born preterm will compromise their ability to explicitly learn motor skills. Methods: Three groups of children aged 6–9 years participated (matched for gender, age, IQ): 20 VPT children with motor problems, 20 VPT children without motor problems, and 20 full term controls. Visual working memory was assessed with three subtests of the Automated Working Memory Assessment. Implicit and explicit motor learning was tested with a serial reaction time task on a custom made button box with nine buttons (3 × 3). A sequence consisting of nine button presses was learned, where each button was pressed once in the sequence. In the implicit condition children pressed the button as quickly as possible. The sequence blocks were alternated with random blocks. Children were unaware of learning, and learned without errors. In the explicit condition children were instructed to discover the sequence via trial and error. If they pressed the correct button, it was lighted. Results: VPT children with motor problems had significantly lower scores on visual working memory the controls. Considering movement time, children learned both in the implicit and explicit condition. In the implicit condition, children performed faster on learning blocks than random
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blocks, but were not aware of the sequence. There was no effect of group for movement time in either condition. There was an effect of visual working memory both in the implicit and explicit condition, children with better working memory scores were faster. Children learned without making errors in the implicit condition. In the explicit condition the number of errors decreased across blocks. There was an effect of group, VPT children without motor problems performed better than controls. We found a small effect of visual working memory. Children with better working memory made less errors when learning the sequence on the button box. Conclusion(s): Preterm birth and motor problems did not negatively affect implicit or explicit learning in the sequence learning task. Unexpectedly, visual working memory was positively related to both, implicit, and explicit learning. Implications: These findings warrant further examination, e.g. with other motor learning tasks, as this study questions the strict division between implicit and explicit learning and the role of visual working memory therein. Keywords: Motor learning; Preterm birth; Working memory Funding acknowledgements: This study was funded by the Faculty of Social Sciences of the Radboud University Nijmegen. Ethics approval: This study was approved by the Medical Ethical Committee of the Radboud University Medical Centre. http://dx.doi.org/10.1016/j.physio.2015.03.3540 Research Report Platform Presentation Number: RR-PL-3548 Monday 4 May 2015 16:40 Hall 405 IMPLICIT AND EXPLICIT MOTOR LEARNING IN TYPICALLY DEVELOPING CHILDREN: EFFECTS OF TASK, AGE AND WORKING MEMORY M. Jongbloed-Pereboom 1 , M.W.G. Nijhuis-Van der Sanden 2 , B. Steenbergen 1 1 Radboud
University, Behavioural Science Institute, Nijmegen, Netherlands; 2 Radboud University Medical Center, Scientific Institute for Quality of Healthcare, Nijmegen, Netherlands Background: Motor skills can be learned implicitly and explicitly. Implicit learning is the ability to acquire a new skill without a corresponding increase in knowledge about the skill performance. In contrast, explicit learning uses declarative knowledge to build up a set of performance rules that guide motor performance or skills. Based on research in adults, we expected that explicit learning was dependent
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WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS633–eS832
on working memory (WM) and age, implicit learning is not. Purpose: Implicit and explicit motor learning was examined in children with three different tasks: a buttonbox task, a writing task, and a beanbag throwing task. We examined differences in implicit and explicit learning, and effects of age and WM. Methods: WM was assessed with subtests of the Automated Working Memory Assessment. Implicit and explicit motor learning was tested in a counterbalanced design: - 62 children (5–9 years) performed a serial reaction time task on a button box with nine buttons (3 × 3). In the implicit condition children pressed the lighted button as quickly as possible. In the explicit condition children had to discover the sequence via trial-and-error. - 61 children (5–10 years) learned to write abstract letter-like patterns on a digitizer both implicitly by tracking a moving target, and explicitly via trial-and-error. - -Children (5–9 years) were assigned to either the implicit or explicit condition for this task. Children learned throwing beanbags to a goal implicitly in an error-reduced way (by incrementally raising task difficulty), and explicitly in an error-strewn way (by incrementally lowering task difficulty). Results: For the buttonbox task, children learned the sequence in both conditions. There were clear age effects in both conditions: younger children performed at a lower level than older children, but learning curves were similar. For explicit learning there was an effect of visual working memory, children with higher scores on visual WM, performed better in the learning task. This was not found for implicit learning. For the writing task, children learned to write patterns faster and more accurate during the training phase in both conditions. Significantly more children could reproduce the pattern correctly in the post test after training explicitly compared to implicitly (90% vs 64%). There were again clear age effects in both conditions, younger children performed at a lower level, but learning curves were similar for all ages. There were no main effects of WM on implicit or explicit learning. For the beanbag throwing task, data analysis is in progress. Conclusion(s): Implicit learning is, dependent on age, but independent of WM. Explicit learning was dependent on age and one of the tasks was related to WM. Specifically for learning to write, explicit learning seems more effective. Implications: These results give new insights into implicit and explicit learning of a gross manual, fine manual and throwing task. These insights could be used to determine which method of instruction is most effective for the individual child in a school- or therapeutic setting. Keywords: Motor learning; Working memory; Implicit learning
Funding acknowledgements: This study was funded by the Faculty of Social Sciences of the Radboud University Nijmegen. Ethics approval: This study was approved by the ethical committee of the faculty of Social Sciences of the Radboud University. http://dx.doi.org/10.1016/j.physio.2015.03.3541 Research Report Poster Presentation Number: RR-PO-15-17-Sun Sunday 3 May 2015 12:15 Exhibit halls 401–403 PRAGMATIC EVALUATION OF ASPECTS CONCERNING VALIDITY AND FEASIBILITY OF THE MINI BALANCE EVALUATION SYSTEM TEST IN A SPECIALIZED REHABILITATION SETTING K.S. Roaldsen 1,2 , E. Wakefield 3 , V. Jørgensen 1,2 , A. Opheim 1,4 1 Sunnaas
Rehabilitation Hospital, Department of Research, Oslo, Norway; 2 Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Stockholm, Sweden; 3 Hemsedal Municipality, Norway, Department of Physiotherapy, Hemsedal, Norway; 4 Sahlgrenska Academy, University of Gothenburg, Rehabilitation Medicine, Institute of Neuroscience and Physiology, Gothenburg, Sweden Background: Impaired balance control and increased risk of falling and fall related injuries are common challenges in neurological rehabilitation. In order to improve balance training and fall prevention interventions it is essential to use valid, clinically feasible and applicable assessment methods. Purpose: The aim of the study was to evaluate aspects of validity and feasibility of the Mini Balance Evaluation Systems Test (Mini-BESTest), a test for dynamic balance, for use in a specialized rehabilitation hospital. Methods: A cross-sectional design was applied. Data was collected as part of the regular assessment of dynamic balance in in-patients at Sunnaas Rehabilitation Hospital, Norway, during one year. Dynamic balance was assessed with the Mini-BESTest. A total of 29 physiotherapists (PT’s) tested 38 male and 21 female patients 20–76 years of age with spinal cord injury (n = 20), traumatic brain injury (n = 17), acquired brain injury (n = 9), multiple trauma (n = 6) and other neurological diagnosis (n = 7). Fall history, fall-related self efficacy, fear of falling and PT’s evaluation of the Mini-BESTtest were surveyed by structured questionnaires. Results: The median score on the Mini-BESTest was 22 (1–28) points. There were no differences between fallers/nonfallers, between subjects with high/low fall-related self efficacy or fear of falling or between different patient groups. Patients with independent walking had a significantly better
Research Report Platform Presentation Number: RR-PL-3524 Sunday 3 May 2015 11:40 Room 334–335 IMPLICIT AND EXPLICIT MOTOR LEARNING IN CHILDREN BORN VERY PRETERM AND TYPICALLY DEVELOPING CHILDREN M. Jongbloed-Pereboom 1 , A. Janssen 2 , B. Steenbergen 1 , M.W.G. Nijhuis-Van der Sanden 3 1 Radboud University, Behavioural Science Institute, Nijmegen, Netherlands; 2 Radboud University Medical Center, Department of Rehabilitation, Pediatric Physical Therapy, Nijmegen, Netherlands; 3 Radboud University Medical Center, Scientific Institute for Quality of Healthcare, Nijmegen, Netherlands
Background: Motor skills can be learned implicitly and explicitly. Implicit learning is the ability to acquire a new skill without a corresponding increase in knowledge about the skill performance. In contrast, explicit learning uses declarative knowledge to build up a set of performance rules that guide performance or skills. Explicit learning is dependent on working memory, implicit learning is not. Especially children born at a gestational age of less than 33 weeks (very preterm; VPT) are at risk for impairments, including working memory impairments. Purpose: This study examined implicit and explicit learning, and the role of working memory, in VPT children. The hypothesis of the present study was that deficits in working memory capacity in children born preterm will compromise their ability to explicitly learn motor skills. Methods: Three groups of children aged 6–9 years participated (matched for gender, age, IQ): 20 VPT children with motor problems, 20 VPT children without motor problems, and 20 full term controls. Visual working memory was assessed with three subtests of the Automated Working Memory Assessment. Implicit and explicit motor learning was tested with a serial reaction time task on a custom made button box with nine buttons (3 × 3). A sequence consisting of nine button presses was learned, where each button was pressed once in the sequence. In the implicit condition children pressed the button as quickly as possible. The sequence blocks were alternated with random blocks. Children were unaware of learning, and learned without errors. In the explicit condition children were instructed to discover the sequence via trial and error. If they pressed the correct button, it was lighted. Results: VPT children with motor problems had significantly lower scores on visual working memory the controls. Considering movement time, children learned both in the implicit and explicit condition. In the implicit condition, children performed faster on learning blocks than random
eS693
blocks, but were not aware of the sequence. There was no effect of group for movement time in either condition. There was an effect of visual working memory both in the implicit and explicit condition, children with better working memory scores were faster. Children learned without making errors in the implicit condition. In the explicit condition the number of errors decreased across blocks. There was an effect of group, VPT children without motor problems performed better than controls. We found a small effect of visual working memory. Children with better working memory made less errors when learning the sequence on the button box. Conclusion(s): Preterm birth and motor problems did not negatively affect implicit or explicit learning in the sequence learning task. Unexpectedly, visual working memory was positively related to both, implicit, and explicit learning. Implications: These findings warrant further examination, e.g. with other motor learning tasks, as this study questions the strict division between implicit and explicit learning and the role of visual working memory therein. Keywords: Motor learning; Preterm birth; Working memory Funding acknowledgements: This study was funded by the Faculty of Social Sciences of the Radboud University Nijmegen. Ethics approval: This study was approved by the Medical Ethical Committee of the Radboud University Medical Centre. http://dx.doi.org/10.1016/j.physio.2015.03.3540 Research Report Platform Presentation Number: RR-PL-3548 Monday 4 May 2015 16:40 Hall 405 IMPLICIT AND EXPLICIT MOTOR LEARNING IN TYPICALLY DEVELOPING CHILDREN: EFFECTS OF TASK, AGE AND WORKING MEMORY M. Jongbloed-Pereboom 1 , M.W.G. Nijhuis-Van der Sanden 2 , B. Steenbergen 1 1 Radboud
University, Behavioural Science Institute, Nijmegen, Netherlands; 2 Radboud University Medical Center, Scientific Institute for Quality of Healthcare, Nijmegen, Netherlands Background: Motor skills can be learned implicitly and explicitly. Implicit learning is the ability to acquire a new skill without a corresponding increase in knowledge about the skill performance. In contrast, explicit learning uses declarative knowledge to build up a set of performance rules that guide motor performance or skills. Based on research in adults, we expected that explicit learning was dependent
eS694
WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS633–eS832
on working memory (WM) and age, implicit learning is not. Purpose: Implicit and explicit motor learning was examined in children with three different tasks: a buttonbox task, a writing task, and a beanbag throwing task. We examined differences in implicit and explicit learning, and effects of age and WM. Methods: WM was assessed with subtests of the Automated Working Memory Assessment. Implicit and explicit motor learning was tested in a counterbalanced design: - 62 children (5–9 years) performed a serial reaction time task on a button box with nine buttons (3 × 3). In the implicit condition children pressed the lighted button as quickly as possible. In the explicit condition children had to discover the sequence via trial-and-error. - 61 children (5–10 years) learned to write abstract letter-like patterns on a digitizer both implicitly by tracking a moving target, and explicitly via trial-and-error. - -Children (5–9 years) were assigned to either the implicit or explicit condition for this task. Children learned throwing beanbags to a goal implicitly in an error-reduced way (by incrementally raising task difficulty), and explicitly in an error-strewn way (by incrementally lowering task difficulty). Results: For the buttonbox task, children learned the sequence in both conditions. There were clear age effects in both conditions: younger children performed at a lower level than older children, but learning curves were similar. For explicit learning there was an effect of visual working memory, children with higher scores on visual WM, performed better in the learning task. This was not found for implicit learning. For the writing task, children learned to write patterns faster and more accurate during the training phase in both conditions. Significantly more children could reproduce the pattern correctly in the post test after training explicitly compared to implicitly (90% vs 64%). There were again clear age effects in both conditions, younger children performed at a lower level, but learning curves were similar for all ages. There were no main effects of WM on implicit or explicit learning. For the beanbag throwing task, data analysis is in progress. Conclusion(s): Implicit learning is, dependent on age, but independent of WM. Explicit learning was dependent on age and one of the tasks was related to WM. Specifically for learning to write, explicit learning seems more effective. Implications: These results give new insights into implicit and explicit learning of a gross manual, fine manual and throwing task. These insights could be used to determine which method of instruction is most effective for the individual child in a school- or therapeutic setting. Keywords: Motor learning; Working memory; Implicit learning
Funding acknowledgements: This study was funded by the Faculty of Social Sciences of the Radboud University Nijmegen. Ethics approval: This study was approved by the ethical committee of the faculty of Social Sciences of the Radboud University. http://dx.doi.org/10.1016/j.physio.2015.03.3541 Research Report Poster Presentation Number: RR-PO-15-17-Sun Sunday 3 May 2015 12:15 Exhibit halls 401–403 PRAGMATIC EVALUATION OF ASPECTS CONCERNING VALIDITY AND FEASIBILITY OF THE MINI BALANCE EVALUATION SYSTEM TEST IN A SPECIALIZED REHABILITATION SETTING K.S. Roaldsen 1,2 , E. Wakefield 3 , V. Jørgensen 1,2 , A. Opheim 1,4 1 Sunnaas
Rehabilitation Hospital, Department of Research, Oslo, Norway; 2 Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Stockholm, Sweden; 3 Hemsedal Municipality, Norway, Department of Physiotherapy, Hemsedal, Norway; 4 Sahlgrenska Academy, University of Gothenburg, Rehabilitation Medicine, Institute of Neuroscience and Physiology, Gothenburg, Sweden Background: Impaired balance control and increased risk of falling and fall related injuries are common challenges in neurological rehabilitation. In order to improve balance training and fall prevention interventions it is essential to use valid, clinically feasible and applicable assessment methods. Purpose: The aim of the study was to evaluate aspects of validity and feasibility of the Mini Balance Evaluation Systems Test (Mini-BESTest), a test for dynamic balance, for use in a specialized rehabilitation hospital. Methods: A cross-sectional design was applied. Data was collected as part of the regular assessment of dynamic balance in in-patients at Sunnaas Rehabilitation Hospital, Norway, during one year. Dynamic balance was assessed with the Mini-BESTest. A total of 29 physiotherapists (PT’s) tested 38 male and 21 female patients 20–76 years of age with spinal cord injury (n = 20), traumatic brain injury (n = 17), acquired brain injury (n = 9), multiple trauma (n = 6) and other neurological diagnosis (n = 7). Fall history, fall-related self efficacy, fear of falling and PT’s evaluation of the Mini-BESTtest were surveyed by structured questionnaires. Results: The median score on the Mini-BESTest was 22 (1–28) points. There were no differences between fallers/nonfallers, between subjects with high/low fall-related self efficacy or fear of falling or between different patient groups. Patients with independent walking had a significantly better