Task Practice Schedules to Enhance Recovery after Stroke

描述（由申请人提供）：尽管心理学和神经科学取得了巨大的进步，但治疗中风患者的物理治疗师仍然依赖于不明确的指导方针来确定功能性运动技能再习得的任务练习时间表。本研究新颖地从心理学习理论出发，定义了具体的康复实践方案，特别强调了实践试验的“微计划”，以提高学习效果。以往关于单词学习和运动技能学习的研究表明，1)任务呈现时间可变，或2)单个任务呈现时间间隔扩大的练习计划，显著提高了学习的长期记忆和泛化。在这项初步研究中，pi使用手动抓取任务，并建议与中风偏瘫患者一起证明大量，随机和扩展的可变练习计划对习得表现和运动技能学习的影响是不同的。此外，使用分层实验设计，他们旨在展示练习时间表和损伤严重程度之间的相互作用，这样最佳练习时间表取决于中风的严重程度。假设是轻度缺陷的受试者从扩展的可变练习中获益最多，而中度缺陷的受试者从大量的练习计划中获益最多。

DESCRIPTION (provided by applicant): Despite tremendous progress in psychology and neuroscience, physical therapists treating patients with stroke still rely on unspecific guidelines to determine task practice schedules for functional motor skill reacquisition. The present proposal is novel in defining specific rehabilitation practice protocols derived from psychological learning theory, with particular emphasis on the "micro-scheduling" of the practice trials to enhance learning. Previous research in word-learning and motor skill learning shows that practice schedules 1) in which the task presentations are variable, or 2) in which the intervals between presentations of individual tasks are expanded, significantly enhance long-term retention and generalization of learning. In this pilot study, the PIs use a manual grasping task, and propose to demonstrate with participants who are recovering from stroke-hemiparesis that massed, random, and expanded variable practice schedules affect differentially the acquisition performance and the learning of motor skills. Further, using a stratified experimental design, they aim to show an interaction between practice schedule and impairment severity such that the best practice schedule depends on stroke severity. The hypothesis is that subjects with mild deficits benefit most from expanded variable practice, whereas subjects with moderate deficits benefit most from massed practice schedules.