Does Overpractice Improve Motor Learning?

NCT ID: NCT02898701

Last Updated: 2021-06-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

65 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-09-01

Study Completion Date

2020-03-17

Brief Summary

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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.

Detailed Description

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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).

Conditions

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Aging

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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No Overpractice (NoOVP)

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.

Group Type ACTIVE_COMPARATOR

Motor Practice of a Standing Serial Reaction Time Task

Intervention Type BEHAVIORAL

Subjects will perform a standing serial reaction time task on a step reaction mat. Subjects will step to a series of targets, based on a series of stimuli that are presented. One trial is composed of two 12-step sequences. One of the 12-step sequences is random, while the other is a repeated sequence; sequences are presented in random order. After each trial, the subject rests for 25 seconds. Six trials equal 1 block of practice, which is followed by a 4 minute rest break. After each block, feedback is provided about average response time (RT) on all steps included in the block. One complete day of practice consists of 6 blocks of practice in which each block consists of 6 trials.

Overpractice (OVP)

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.

Group Type EXPERIMENTAL

Motor Practice of a Standing Serial Reaction Time Task

Intervention Type BEHAVIORAL

Subjects will perform a standing serial reaction time task on a step reaction mat. Subjects will step to a series of targets, based on a series of stimuli that are presented. One trial is composed of two 12-step sequences. One of the 12-step sequences is random, while the other is a repeated sequence; sequences are presented in random order. After each trial, the subject rests for 25 seconds. Six trials equal 1 block of practice, which is followed by a 4 minute rest break. After each block, feedback is provided about average response time (RT) on all steps included in the block. One complete day of practice consists of 6 blocks of practice in which each block consists of 6 trials.

Standard of Care (SoC)

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.

Group Type ACTIVE_COMPARATOR

Motor Practice of a Standing Serial Reaction Time Task

Intervention Type BEHAVIORAL

Subjects will perform a standing serial reaction time task on a step reaction mat. Subjects will step to a series of targets, based on a series of stimuli that are presented. One trial is composed of two 12-step sequences. One of the 12-step sequences is random, while the other is a repeated sequence; sequences are presented in random order. After each trial, the subject rests for 25 seconds. Six trials equal 1 block of practice, which is followed by a 4 minute rest break. After each block, feedback is provided about average response time (RT) on all steps included in the block. One complete day of practice consists of 6 blocks of practice in which each block consists of 6 trials.

Interventions

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Motor Practice of a Standing Serial Reaction Time Task

Subjects will perform a standing serial reaction time task on a step reaction mat. Subjects will step to a series of targets, based on a series of stimuli that are presented. One trial is composed of two 12-step sequences. One of the 12-step sequences is random, while the other is a repeated sequence; sequences are presented in random order. After each trial, the subject rests for 25 seconds. Six trials equal 1 block of practice, which is followed by a 4 minute rest break. After each block, feedback is provided about average response time (RT) on all steps included in the block. One complete day of practice consists of 6 blocks of practice in which each block consists of 6 trials.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Exclusion Criteria

* 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
Minimum Eligible Age

18 Years

Maximum Eligible Age

95 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Utah

OTHER

Sponsor Role lead

Responsible Party

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Genevieve Olivier

PhD Student, Physical Therapist, Teaching Assistant

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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University of Utah

Salt Lake City, Utah, United States

Site Status

Countries

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United States

References

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Trewartha KM, Garcia A, Wolpert DM, Flanagan JR. Fast but fleeting: adaptive motor learning processes associated with aging and cognitive decline. J Neurosci. 2014 Oct 1;34(40):13411-21. doi: 10.1523/JNEUROSCI.1489-14.2014.

Reference Type BACKGROUND
PMID: 25274819 (View on PubMed)

Clark BC, Manini TM. Functional consequences of sarcopenia and dynapenia in the elderly. Curr Opin Clin Nutr Metab Care. 2010 May;13(3):271-6. doi: 10.1097/MCO.0b013e328337819e.

Reference Type BACKGROUND
PMID: 20154609 (View on PubMed)

Kleim JA, Jones TA. Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage. J Speech Lang Hear Res. 2008 Feb;51(1):S225-39. doi: 10.1044/1092-4388(2008/018).

Reference Type BACKGROUND
PMID: 18230848 (View on PubMed)

Lang CE, Macdonald JR, Reisman DS, Boyd L, Jacobson Kimberley T, Schindler-Ivens SM, Hornby TG, Ross SA, Scheets PL. Observation of amounts of movement practice provided during stroke rehabilitation. Arch Phys Med Rehabil. 2009 Oct;90(10):1692-8. doi: 10.1016/j.apmr.2009.04.005.

Reference Type BACKGROUND
PMID: 19801058 (View on PubMed)

Lohse KR, Lang CE, Boyd LA. Is more better? Using metadata to explore dose-response relationships in stroke rehabilitation. Stroke. 2014 Jul;45(7):2053-8. doi: 10.1161/STROKEAHA.114.004695. Epub 2014 May 27.

Reference Type BACKGROUND
PMID: 24867924 (View on PubMed)

Lang CE, MacDonald JR, Gnip C. Counting repetitions: an observational study of outpatient therapy for people with hemiparesis post-stroke. J Neurol Phys Ther. 2007 Mar;31(1):3-10. doi: 10.1097/01.npt.0000260568.31746.34.

Reference Type BACKGROUND
PMID: 17419883 (View on PubMed)

Krueger WFC. Further studies in overlearning. Journal of Experimental Psychology. 1930;13(2):152-163.

Reference Type BACKGROUND

Melnick MJ. Effects of overlearning on the retention of a gross motor skill. Res Q. 1971 Mar;42(1):60-9. No abstract available.

Reference Type BACKGROUND
PMID: 5279070 (View on PubMed)

Schendel JD, Hagman JD. On sustaining procedural skills over a prolonged retention interval. Journal of Applied Psychology. 1982;67(5):605-610.

Reference Type BACKGROUND

Driskell JE, Willis RP, Copper C. Effect of overlearning on retention. Journal of Applied Psychology. 1992;77(5):615-622.

Reference Type BACKGROUND

Jones MB. Nonimposed overpractice and skill retention. DTIC Document;1986.

Reference Type BACKGROUND

Olivier GN, Dibble LE, Paul SS, Lohse KR, Walter CS, Marker RJ, Hayes HA, Foreman KB, Duff K, Schaefer SY. Personalized practice dosages may improve motor learning in older adults compared to "standard of care" practice dosages: A randomized controlled trial. Front Rehabil Sci. 2022 Aug 3;3:897997. doi: 10.3389/fresc.2022.897997. eCollection 2022.

Reference Type DERIVED
PMID: 36189036 (View on PubMed)

Other Identifiers

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IRB_00085515

Identifier Type: -

Identifier Source: org_study_id

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