Whilst recently reviewing some information on motor learning and performance for a workshop I was giving I was struck by the systematised approach to evaluation which the movement science profession attach to this discipline so today’s post explores some of these oversights. I also think that recognition of these concepts is important to integrate into physiotherapy practice to enhance our treatment outcomes.

The popularisation of muscle imbalance concepts as the fundamental basis for exercise prescription (wrongly in my view) has lead to the popularisation of a particular theory of motor control originally postulated by Posner and Fitts in 1968.  This theory outlined three stages of control;

Cognitive phase

Associative phase

Autonomous phase.

The elements of each of these phases have been well described in the literature and have become an excepted paradigm for clinical interventions.  However, we must remember as clinicians that this is only one theory of motor control and due to the complex interaction of the many elements involved in motor control, we would do well to consider thoughts of Shumway Cook…

“that motor control theory is a group of abstract ideas about the control of movement which provide the following information;

1) a framework for interpreting behaviour,

2) a guide for clinical action,

3) working hypothesis for examination and intervention and

4) new ideas.”

Profound words indeed.

My recent study on this topic highlighted the following elements:

Motor skill classification:

Motor skills can be classified according to task organisation as:

Discrete skills

Serial skills

Continuous skills.

A discrete skill is one, which is characterised by a defined beginning and end and is often of very brief duration i.e. kicking a ball, throwing an implement.

When a series of discrete skills are grouped together to form a more complicated action these are classified as serial skills suggesting that the order of elements is crucial to successful performance.  There may be a number of sub elements that make up the total task in this case.  Most activities of daily living fit into this classification.

The final category of skills in this system are those organised in a way that suggest no particular beginning or end, these are known as continuous skills and often repetitive or rhythmic in nature and would include activities such as swimming, cycling, walking and running.

An alternative means of classifying skills is by quantifying the relative importance of motor and cognitive elements.  With a motor skill the primary element determining movement success is the quality of the movement itself with less emphasis being given to the perceptual and decision making aspects of the task.

On the other hand, with a cognitive skill the nature of the movement is less important to success than is the decision or strategy about which movement to make.  It has been said that a cognitive skill is one that mainly emphasises “knowing what to do”, whereas a motor skill mainly emphasises “doing it correctly” – Of course the big debate here is what constitutes correctness!!.

Classification by environmental predictability:

Another way to classify motor skills is to consider the extent to which the environment is stable and predictable throughout the motor performance.  Open skill is one that is performed in an environment that is variable and unpredictable during the action.  A closed skill in the other hand is one that is performed in an environment that is stable and predictable.  The open/closed skill classification system emphasises the relative demands placed upon the performer to respond to moment-to-moment variations in the environment.  For skills at the closed end of the spectrum individuals have the potential to evaluate the environment in advance, organise the movement without significant time pressure and execute the action without the need for sudden adjustments.  However, skills which are in the open end of the continuum requires the performer to utilise processes of perception, pattern recognition and decision making to adjust the movement, often in a short amount of time in response to changing environmental conditions.

If we review these three classification systems it is clear that there is overlap and as clinicians we need to consider each system simultaneously when attempting to evaluate a skilled task or the means by which we need to structure our intervention.

I was refreshed at exposure to these concepts and will certainly endeavour to incorporate this framework into my decision making, movement analysis and skills training in the clinic.

Enjoy the clinical challenge.

David.

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© David for PhysioDigest - an educational resource for the musculoskeletal rehabilitation community, 2010. | Permalink | No comment | Add to del.icio.us
Post tags: Cognition, Control theory, Decision making, Motor skill, Perception

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