Updates in Motor Learning: Implications for Physical Therapist Practice and Education

Abstract

Over the past 3 decades, the volume of human motor learning research has grown enormously. As such, the understanding of motor learning (ie, sustained change in motor behavior) has evolved. It has been learned that there are multiple mechanisms through which motor learning occurs, each with distinctive features. These mechanisms include use-dependent, instructive, reinforcement, and sensorimotor adaptation-based motor learning. It is now understood that these different motor learning mechanisms contribute in parallel or in isolation to drive desired changes in movement, and each mechanism is thought to be governed by distinct neural substrates. This expanded understanding of motor learning mechanisms has important implications for physical therapy. It has the potential to facilitate the development of new, more precise treatment approaches that physical therapists can leverage to improve human movement. This Perspective describes scientific advancements related to human motor learning mechanisms and discusses the practical implications of this work for physical therapist practice and education.

Keywords: Instructive; Motor Learning; Rehabilitation; Reinforcement; Sensorimotor Adaptation; Use-Dependent.

Figure 1

Key features of 4 distinct motor learning mechanisms. This represents a simplified summary of a large body of research aimed to understand how changes in human motor behavior occur. Alternative terms commonly used in the literature for these mechanisms and their features are provided in parentheses.

Figure 2

Motor learning mechanisms driven by example physical therapist interventions to treat shoulder impingement (A) and gait impairment (B). The relative contribution of each mechanism (represented by circle size and fill) to the targeted motor behavior change depends on the behavioral drivers that are integrated into the intervention by the physical therapist. Note that multiple mechanisms may often occur in parallel as a motor behavior is being learned.

Figure 3

A proposed contribution of use-dependent, instructive, reinforcement, and sensorimotor adaptation motor learning mechanisms to the stages of motor learning described by Fitts and Posner.