Two-dimensional kinematic analysis was performed of the reaching movements that six subjects with Parkinson's disease and six healthy subjects produced under self-determined maximal speed and visually cued conditions. Subjects were required to reach as fast as possible to grasp a ball (i) that was fixed stationary in the centre of a designated contact zone on an inclined ramp (self-determined maximal speed condition), or (ii) that rolled rapidly from left to right down the incline and into the contact zone (visually cued condition). Parkinson's disease subjects displayed bradykinesia when performing maximal speed reaches to the stationary ball, but not when they reached for the moving ball. In response to the external driving stimulus of the moving ball, Parkinson's disease subjects showed the ability to exceed their self-determined maximal speed of reaching and still maintain a movement accuracy that was comparable to that of healthy subjects. Thus, the bradykinesia of Parkinson's disease subjects did not seem to be the result of a basic deficit in their force production capacity or to be a compensatory mechanism for poor movement accuracy. Instead, bradykinesia appeared to result from the inability of Parkinson's disease subjects to maximize their movement speed when required to internally drive their motor output. The occasional failure of Parkinson's disease subjects to successfully grasp the moving ball suggested errors of coincident anticipation and impairments in grasp performance rather than limitations in the speed or accuracy of their reaches. These results are discussed in relation to the notion that the motor circuits of the basal ganglia play an important role in the modulation of internally regulated movements.
The physical rehabilitation of patients with stroke is shifting from a medical model of treating neurophysiological impairment to an educational model that emphasizes the reeducation of patients in motor tasks. This greater focus on patient learning requires knowledge not only in how to assist patients in the restoration of efficient movement patterns, but also in how to help patients learn to create and modify movement strategies to solve the functional problems they encounter in daily tasks. This article provides an overview of principles to be considered when attempting to optimize the motor learning of stroke patients. A model of motor learning is presented, followed by a discussion of contemporary research and clinical issues in the areas of information processing and practice. It is proposed that only through the combination of clinical research and critical introspection of our treatment practices can we gain a more complete insight to the motor learning behavior of stroke patients.
Introduction. Faculty in U.S. physical therapy education programs made a rapid, reactive curricular modifications in response to the COVID-19 pandemic. e Discussion and Conclusion. An appreciation of faculty challenges and concerns during the COVID-19 pandemic and priorities for moving forward are important for programs making curricular transformations hybrid education to be better prepared for program disruptions.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.