Psychosocial Modulators of Motor Learning in Parkinson’s Disease

Abstract

Using the remarkable overlap between brain circuits affected in Parkinson’s disease (PD) and those underlying motor sequence learning, we may improve the effectiveness of motor rehabilitation interventions by identifying motor learning facilitators in PD. For instance, additional sensory stimulation and task cueing enhanced motor learning in people with PD, whereas exercising using musical rhythms or console computer games improved gait and balance, and reduced some motor symptoms, in addition to increasing task enjoyment. Yet, despite these advances, important knowledge gaps remain. Most studies investigating motor learning in PD used laboratory-specific tasks and equipment, with little resemblance to real life situations. Thus, it is unknown whether similar results could be achieved in more ecological setups and whether individual’s task engagement could further improve motor learning capacity. Moreover, the role of social interaction in motor skill learning process has not yet been investigated in PD and the role of mind-set and self-regulatory mechanisms have been sporadically examined. Here, we review evidence suggesting that these psychosocial factors may be important modulators of motor learning in PD. We propose their incorporation in future research, given that it could lead to development of improved non-pharmacological interventions aimed to preserve or restore motor function in PD.

The many facets of motor learning and their relevance for Parkinson's disease

“…The effectiveness of motor rehabilitation interventions may further improve by adding sensory stimulation, cueing, and music in pleasant social contexts and environment that increase task enjoyment (Volpe et al 2013). These approaches are now gaining more attention: each factor that makes motor training more attractive and improves motivation during the tasks can increase the patients’ compliance and prevents the worsening of motor performance (for a review: Zemankova et al 2016). Relevant is also the application of strategies during the exercise itself, which include the use of feedback, external cues, reward and motivation; this type of approach produce good results probably by allowing the execution of correct movements under attention-volitional control, with a direct access to cortical resources and limiting the use of automaticity mechanisms that are affected by PD (Nieuwboer et al 2009).…”

Expectancy and affective response to challenging balance practice conditions in individuals with Parkinson’s disease

“…Regression results provide evidence to support that self‐efficacy may have an additional, though small, modulating impact on motor performance and learning in individual with PD, beyond the effects of practice. This study provides evidence that pertains to the potential impact of psychological factors on motor learning in PD (Zemankova, Lungu, & Bares, 2016). Clinicians should be aware of the potential impact of self‐efficacy on motor learning in individuals with PD.…”

Inpatient Enhanced Multidisciplinary Care Effects on the Quality of Life for Parkinson Disease: A Quasi-Randomized Controlled Trial

“…16 A recent review has suggested that psychosocial factors are important modulators of motor learning. 42 Motor learning may be important for the long-term maintenance of rehabilitation effects and its generalization to ADL. There were many opinions regarding how the motivation for daily activity was improved by group exercise and educational programs according to our questionnaire.…”