Abstract
The development of more effective rehabilitative interventions requires a better understanding of how humans learn and transfer motor skills in real-world contexts. Presently, clinicians design interventions to promote skill learning by relying on evidence from experimental paradigms involving simple tasks, such as reaching for a target. While these tasks facilitate stringent hypothesis testing in laboratory settings, the results may not shed light on performance of more complex real-world skills. In this perspective, we argue that virtual environments (VEs) are flexible, novel platforms to evaluate learning and transfer of complex skills without sacrificing experimental control. Specifically, VEs use models of real-life tasks that afford controlled experimental manipulations to measure and guide behavior with a precision that exceeds the capabilities of physical environments. This paper reviews recent insights from VE paradigms on motor learning into two pressing challenges in rehabilitation research: 1) Which training strategies in VEs promote complex skill learning? and 2) How can transfer of learning from virtual to real environments be enhanced? Defining complex skills by having nested redundancies, we outline findings on the role of movement variability in complex skill acquisition and discuss how VEs can provide novel forms of guidance to enhance learning. We review the evidence for skill transfer from virtual to real environments in typically developing and neurologically-impaired populations with a view to understanding how differences in sensory-motor information may influence learning strategies. We provide actionable suggestions for practicing clinicians and outline broad areas where more research is required. Finally, we conclude that VEs present distinctive experimental platforms to understand complex skill learning that should enable transfer from therapeutic practice to the real world.
Highlights
The goal of rehabilitation interventions for clients with neurological impairments is tolearn motor skills during therapeutic practice and transfer those improvements to functional activities in daily life
We propose that Virtual environments (VE) themselves can serve as useful experimental platforms to gain this knowledge as they allow the study of these complex skills with sufficient experimental control to draw scientifically tractable conclusions [2]
Larger perturbations had detrimental effects on performance and on retention and transfer [37]. These results demonstrated that while externally-induced perturbations may increase variability, the nature of this variability is very different from the internally-produced variability that may benefit motor learning
Summary
The goal of rehabilitation interventions for clients with neurological impairments is to (re)learn motor skills during therapeutic practice and transfer those improvements to functional activities in daily life. Levac et al Journal of NeuroEngineering and Rehabilitation (2019) 16:121 practiced tasks to non-treatment contexts This is true for the rehabilitation-based use of virtual environments (VEs): computer hardware and software systems that generate simulations of real or imagined environments with which participants interact using their own movements [5]. While practice in a variety of VEs offers promising evidence for skill acquisition as compared to conventional interventions in many rehabilitation populations, [e.g. 7–10] the focus has been predominantly on training simplified movements. This may be one reason why successful transfer of skill learning to non-practiced tasks and reallife contexts often remains a challenge [11–16]. We propose that VEs themselves can serve as useful experimental platforms to gain this knowledge as they allow the study of these complex skills with sufficient experimental control to draw scientifically tractable conclusions [2]
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