MENTAL PRACTICE AND MOTOR LEARNING OF A FUNCTIONAL MOTOR TASK IN OLDER ADULTS.

Abstract

Purpose/Hypothesis: The purpose of this study was to examine the influence of mental practice on motor learning of a functional motor task in older adults following a single session of guided physical practice. The task under investigation involved the use of a quad cane to ambulate on level surfaces and to ascend and descend 4 steps following a specific gait sequence. Our hypothesis is that mental practice will improve motor learning of a functional motor task in older adults. Number of Subjects: Nineteen community dwelling older adults (aged 66-89) independent in ambulation and stairclimbing, with no prior experience using a quad cane, and with no diagnosis of dementia participated in the study. Materials/Methods: A standard large base quad cane, a flight of stairs with at least 4 steps and a railing on the right side on ascent, a video camcorder, blank videotapes, and a stopwatch were needed, a consent form and a general information questionnaire, The Mini Mental State Examination (MMSE). A motor task scoring form developed for use in this study All subjects were trained in a specific gait sequence for ambulation on level surfaces and ascending and descending 4 stairs with a quad cane following a scripted training procedure. Those in the experimental group received a set of written instructions with photographs describing the motor task procedure, and were instructed to mentally rehearse the task 4 times in the interval between training and testing. Control subjects did not receive instructions and did not mentally rehearse the motor task. Neither group engaged in physical practice in the interval between training and testing. Subjects were scored on their performance of the motor task on the final practice trial of the training session, and again 48- 72 hours later, using a specially designed scoring form. Scores achieved on the motor test by the group who engaged in mental practice were compared with those without mental practice. Results: Subjects in the mental practice group scored significantly higher on the motor test date than the control subjects (p<.01). A comparison of the difference in scores from training to test date between the two groups revealed that the mental practice group retained the learned novel skill significantly better than the control group(p<0.05). Conclusions: These findings suggest that for older adults, mental practice facilitates motor learning of a functional motor task following a single session of guided physical practice. Clinical Relevance: Mental rehearsal may be beneficial in situations where physical practice is restricted, contraindicated, where safety concerns exist, where assistance for physical practice is needed but unavailable, where there are medical complications, or for an individual who is deconditioned and fatigues easily.