Blind moca score interpretation full#
Blind moca score interpretation trial#

Recruitment of participants took place via community practices, rehabilitation institutes in the region and through a local health-related newspaper.

Full details of the study protocol have been published elsewhere 16.

The study adopts a randomized, controlled, single-blinded study design and was approved by the local ethics committee METC-Z in Heerlen, the Netherlands (approval number 17-T-06, Netherlands Trial Register: NL6133). It was hypothesized that implicit motor learning would result in greater improvements of walking speed post intervention (especially at 1-month post intervention). step length 14 and functional outcomes 15. The research question was: Is a 3-week implicit motor learning walking intervention (analogies) more effective compared to a 3-week explicit motor learning walking intervention (verbal detailed instructions) delivered at home with regard to walking speed in people after stroke who are in the chronic phase of recovery? Walking speed was chosen due its integrated results on other gait parameters e.g. Contrary to earlier studies examining implicit motor learning using the same analogy for the entire group 11 the current study also tailored the interventions towards the individual needs, preferences and abilities of the patients. To our knowledge, this is the first randomized controlled trial that examines the effects of implicit motor learning facilitated by analogies compared to explicit motor learning on a functional walking task in people after stroke. In the current study, the effects of analogy learning were compared to detailed verbal instructions when training the clinically relevant task ‘walking’ in a real life setting (home environment). Within the neurological population first pilot studies reveal the feasibility of analogy learning and demonstrate its potential as both clinically relevant and statistically significant changes in walking performance could be obtained 9, 12, 13. Studies in athletes have shown that analogy learning led to better and more stable performance under dual-task conditions 10, 11. Although no technical (explicit) instructions are given, the analogy may facilitate for example a more symmetrical gait, the foot strike from heel to toe and foot-clearance. For example, to facilitate step length a therapist could provide the analogy ‘ Walk as if you follow the footprints in the sand’ 9. In analogy learning, the learner is provided with one single metaphor (or analogy) that strives to encompass all underlying (explicit) knowledge that is necessary to complete the motor skill. One practical approach to induce implicit motor learning is through the use of analogies. In order to be clinically meaningful, implicit and explicit motor learning approaches need to be tailored to the individual needs of the patients and performed in the real-life situations. However, there is still a lack of studies comparing the effects of implicit motor learning post-stroke to explicit motor learning within clinically relevant tasks. Studies show that people after stroke are able to learn implicitly and that performance of an implicitly learned task might be more stable under dual-task condition and more durable over time 8. Implicit motor learning, on the other hand, strives to minimize the involvement of cognitive resources, especially working memory 7 and may therefore be more feasible for people after stroke who apart from physical constraints also suffer from cognitive impairments.

For people after stroke, who often experience cognitive impairments 6, it can be difficult to process large amounts of verbal explicit information. However, this might not always be efficient. Within current clinical practice therapists tend to structure therapy in a more explicit manner or switch between implicit and explicit learning approaches 3– 5. In contrast, implicit motor learning is assumed to take place without much knowledge of the underlying facts and rules of motor skills and has been described as ‘ learning that progresses with no or minimal increase in the verbal knowledge of movement performance and without awareness’ 2(p2). facts and rules about movement performance) and involvement of cognitive resources 2. Explicit motor learning can be referred to as a more conscious form of learning, that is characterized by the generation of verbal knowledge (i.e. In general, therapists use (more) implicit or (more) explicit forms of learning to facilitate improvement of gait. One of the most practiced motor skills in stroke rehabilitation is walking 1.

Blind moca score interpretation full#

Blind moca score interpretation trial#