Motorisches Lernen - Therapierelevante Forschungsergebnisse

Zusammenfassung

Einleitung: Um Alltagsaktivitäten (wieder) durchführen zu können, müssen Patienten häufig Bewegungsabläufe erlernen oder neu erlernen. Es stellt sich die Frage, wie diese Lernprozesse für eine effektive, effiziente und langfristig erfolgreiche Therapie optimiert werden können.

Methode: Die Forschung zum motorischen Lernen untersucht die Lernprozesse von Gesunden und Menschen mit Beeinträchtigungen, z. B. nach Schlaganfall oder mit Parkinson. In Experimenten wird verglichen, wie sich verschiedene Arten von Instruktionen, Feedback und Übungsreihenfolgen, selbst kontrolliertes Üben und Üben mit einem Partner auf langfristige Lernergebnisse auswirken.

Ergebnisse: Die unmittelbar beobachtbaren Auswirkungen von Übungsbedingungen auf die Leistung stimmen nicht mit den tatsächlichen langfristigen Lerneffekten überein. Vielmehr können die Bedingungen zunächst die Leistung beeinträchtigen, führen aber zu stabileren langfristigen Lerneffekten. Besonders günstig sind wechselnde Übungsreihenfolge, sparsames und zeitlich leicht verzögertes Feedback, einen externalen Aufmerksamkeitsfokus bewirkende Instruktionen, selbst kontrolliertes Üben und Üben mit einem Partner.

Schlussfolgerungen: Die Forschungsergebnisse zum motorischen Lernen liefern wichtige Hinweise für die Therapiegestaltung und können wesentlich zum Therapieerfolg beitragen. Die Ergebnisse sollten in der klinischen Anwendung mit verschiedenen Patientengruppen überprüft werden.

Abstract

Introduction: In order to be able to (again) perform activities of daily living, patients often have to learn or relearn certain motor skills. The question arises, how these learning processes can be optimized, making therapy more effective and efficient and successful in the long term. Method: Research on motor learning investigates learning processes in healthy persons as well as in persons with impairments, such as stroke patients or those with Parkinson's disease. Experiments compared the learning effects of different kinds of instructions, feedback, and task orders, self-controlled practice, as well as practice with a partner. Results: The immediate effects of various practice conditions on learning do not necessarily correspond to their long-term effects on learning. Practice conditions (e.g. a random practice order, reduced feedback frequency, or delayed feedback) tend to degrade performance during practice but ultimately enhance learning. Random practice, reduced or delayed feedback, instructions inducing an external focus of attention, self-controlled practice, and practicing with a partner have been shown to be beneficial for learning. Conclusion: Research findings related to motor learning have important implications for the design of physical therapy practice. Taking into account these findings has the potential to enhance the effectiveness of treatment. Future studies are needed to examine the generalizability of those results to different patient populations.

Schlüsselwörter

Motorisches Lernen - Therapiegestaltung - Aufmerksamkeitsfokus - Feedback - Übungsreihenfolge

Key words

Motor learning - therapy structure - attentional focus - feedback - task order

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