Abstract
Abstract Aim: This study aims to investigate the effects of the type of extrinsic feedback provided equally in terms of timing and frequency of delivery on the motor learning after stroke. Methods: Twenty post-stroke individuals were distributed randomly into two groups according to the type of feedback provided: knowledge of performance experimental group (KPEG) and knowledge of results experimental group (KREG). Additionally, a control group (CG) was consisted of 20 healthy individuals age- and feedback-matched with the experimental groups. The task was a pointing skill performed in a virtual reality system. The acquisition phase consisted of 3 days/ 75 trials per day. Two retention tests (ret1 and ret2) were run after four days from the acquisition phase. Dependent variable measures were defined by motor performance and movement pattern. Results: The statistical analysis showed interaction effect F(3,108 = 49.13, p = 0.01) among KPEG and KREG. Based on the motor performance parameters (score) the KPEG improved performance significantly from pre to post (p = 0.001), and maintain it from pre to ret1 (p = 0.002), and from the pre to ret2 (p = 0.001). However, the KREG only showed a difference in motor performance from the pre to post (p = 0.003). Compared to the KREG, the KPEG showed improvement on the movement pattern based on the smoothness (p = 0.004), which suggests that the KPEG performed more corrections of movements in relation to the CG and KREG groups. Conclusion: These findings suggest that KP allowed better motor learning in individuals after stroke.
Highlights
Several studies have demonstrated the provision of extrinsic feedback induces better conditions for motor learning in individuals after stroke[1,2,3]
This information can be characterized into two types: knowledge of results (KR), which refers to information provided to the subject about the result of his or her action in relation to the environmental goal; and knowledge of performance (KP), which refers to information provided to the subject regarding the execution pattern of the movement to reach a goal[8]
Research indicates that sensorimotor performance of the hemiparetic upper extremity after stroke is optimized when different types of extrinsic feedback are used in combination (KP plus KR)[9,10,11]
Summary
Several studies have demonstrated the provision of extrinsic feedback induces better conditions for motor learning in individuals after stroke[1,2,3]. The explanation for that may be associated with the possibility of overcoming the exteroceptive and proprioceptive deficits which are frequently seen after stroke[4,5,6]. This fact makes relevant the offering of extrinsic feedback for this population during motor skill acquisition[7]. There are few studies comparing the effects of KP and KR separately on motor learning in individuals after stroke These investigations presented methodological limitations regarding the different frequency and timing of delivery of feedback, making it difficult to conclude the most appropriate type of feedback on motor learning of these subjects[1,2,3,7]. It is crucial to offer the information in terms of frequency and timing of delivery, being one group that only receives information about KP and the other group only receives information about KR during the practice of a motor task[2]
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