Does Overpractice Improve Motor Learning?

Utah System of Higher Education (USHE)

Status: Completed

Conditions: Aging

Treatments: Behavioral: Motor Practice of a Standing Serial Reaction Time Task

Study type: Interventional

Funder types: Other

Identifiers

NCT02898701

IRB_00085515

Details and patient eligibility

About

This study contains two pilot studies: 1) one study will investigate practice dosage of a postural stepping task in healthy young individuals in order to determine an operational definition of performance plateau, and 2) the other study will investigate whether practicing beyond reaching a performance plateau improves learning of a postural stepping task in healthy older adults, compared to discontinuing practice immediately after reaching a performance plateau. The investigators hypothesize that the group that continues to practice beyond reaching their performance plateau will learn and retain the motor task better than the other group.

Full description

What is the ideal amount, or dose, of practice needed for a person to learn a motor skill? Studies suggest that "more is better," but the optimal dose of motor practice is unknown. Motor learning is defined as a set of internal processes leading to a relatively permanent change in the capability for a motor skill. Older adults and people with neurological disorders have a critical need to learn and relearn motor skills to remain independent, but standard clinical rehabilitation currently provides practice doses that are insufficient to result in motor learning. Under-dosing of practice results in sub-optimal clinical outcomes, while research studies that are dosed insufficiently to identify between-group differences are prone to misinterpretation. Therefore, it is essential for both clinical care and for research that we determine the practice dose needed to optimize motor learning.

Performance curves (i.e., plots of the average performance of a group or individual for each of a number of practice trials or blocks of trials) demonstrate that performance improves (e.g., error decreases or speed increases) during practice, until a point at which performance improvement begins to plateau. Additional practice provided beyond the point at which an individual reaches a performance plateau will be termed overpractice. Amounts of practice that are insufficient to reach a plateau tend not to demonstrate motor learning, while overpractice typically results in retention of the practiced task.

Pilot Study #1: The first pilot study will include healthy young adults who are randomly assigned to practice a postural stepping task for one day, or for five consecutive days of practice. The investigators will use this data to determine an operational definition (i.e., a mathematical definition) of performance plateau. This definition will be used to differentiate the groups in Pilot Study #2.

Pilot Study #2: The second pilot study will include healthy older adults who will be divided into three groups: a standard of care group (i.e. very low dose), an overpractice group, and a no overpractice group. All groups will practice a postural stepping task. The experimental group will be the overpractice (OVP) group, in which each participant will complete 100% additional practice trials after reaching their performance plateau. In contrast, the two active control groups will be the no overpractice (NoOVP) group (in which each participant will stop practicing immediately after reaching a performance plateau), and the standard of care (SoC) group (in which each participant will perform one block of practice).

Enrollment: 65 patients

Sex: All

Ages: 18 to 95 years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

• Inclusion criteria for individuals considered healthy older adults will be: (a) 60-95 years of age.
• Inclusion criteria for individuals considered healthy young adults will be: (a) 18-45 years of age.

Exclusion Criteria will include the following for all individuals:

• acute medical problems
• uncorrected vision loss
• any other conditions that affect their mobility or balance which might affect their ability to perform the motor task (arthritis, orthopedic complications, metabolic, vestibular, etc)
• Montreal Cognitive Assessment score <26
• non-english speaking

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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65 participants in 3 patient groups

No Overpractice (NoOVP)

Active Comparator group

Description:

Subjects will perform the intervention (i.e., motor practice of a standing serial reaction time task) according to the practice schedule until they reach a performance plateau on the repeated sequence. At that time, members of the NoOVP group will cease practicing.

Treatment:

Behavioral: Motor Practice of a Standing Serial Reaction Time Task

Overpractice (OVP)

Experimental group

Description:

Subjects will perform the intervention (i.e., motor practice of a standing serial reaction time task) according to the practice schedule until they reach a performance plateau on the repeated sequence. At that time, members of the OVP group will continue to practice as part of the overpractice phase until they have completed 100% overpractice.

Treatment:

Behavioral: Motor Practice of a Standing Serial Reaction Time Task

Standard of Care (SoC)

Active Comparator group

Description:

Subjects will perform the intervention (i.e., motor practice of a standing serial reaction time task) until they have performed 144 practice trials over the course of one day. At that time, members of the SoC group will cease practicing.

Treatment:

Behavioral: Motor Practice of a Standing Serial Reaction Time Task