Motor learning benefits of self-controlled practice in persons with Parkinson's disease

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The present study examined the effectiveness of a training method to enhance balance in people with PD, which could potentially reduce their risk for falls. Specifically, we investigated whether the benefits of the self-controlled use of a physical assistance device for the learning of a balance task, found previously in healthy adults, would generalize to adults with PD. Twenty-eight individuals with PD were randomly assigned to one of two groups, a self-control and a yoked (control) group. The task required participants to stand on a balance platform (stabilometer), trying to keep the platform as close to horizontal as possible during each 30-s trial. In the self-control group, participants had a choice, on each of 10 practice trials, to use or not to use a balance pole. Participants in the yoked group received the same balance pole on the schedule used by their counterparts in the self-control group, but did not have a choice. Learning was assessed one day later by a retention test. The self-control group demonstrated more effective learning of the task than the yoked group. Questionnaire results indicated that self-control participants were more motivated to learn the task, were less nervous, and less concerned about their body movements relative to yoked participants. Possible reasons for the learning benefits of self-controlled practice, including a basic psychological need for autonomy, are discussed.