Motor Learning in Children with Unilateral Cerebral Palsy

Motor Learning in Children with Unilateral Cerebral Palsy

Disability and Rehabilitation published research to examine explicit and implicit learning in children with unilateral cerebral palsy.  The study compared the motor learning of children with left and right unilateral cerebral palsy and typically developing children while they shuffled disks toward a target using a prism-adaptation design.  Each trial consisted of pre-exposure, prism exposure, and post-exposure phases with half of the participants being instructed about the function of the prism glasses while the other half were not.

To measure motor learning, the distance between the target and the shuffled disk was measured.  Explicit and implicit motor learning was determined using the prism adaptation design.  Prism adaptation is when the motor system adapts to new visuospatial coordinates imposed by prisms that displace the visual field. Once the prisms are withdrawn, the degree and strength of the adaptation can be measured by the spatial deviation of the motor actions in the direction opposite to the visual displacement imposed by the prisms, a phenomenon known as after effect.

The results indicated the following:

• no significant effects were revealed between typically developing participants and participants with unilateral cerebral palsy.
• participants with right unilateral cerebral palsy had a significantly lower rate of adaptation than participants with left unilateral cerebral palsy, but only when no instructions were provided.
• the magnitude of the negative after-effects did not differ significantly between participants with right and left unilateral cerebral palsy.

The researchers concluded that the capacity for explicit motor learning is reduced among individuals with right unilateral cerebral palsy when the accumulation of declarative knowledge is unguided (i.e., discovery learning).  It was recommended to use implicit motor learning interventions for individuals with cerebral palsy, especially for children with right unilateral cerebral palsy.  When using explicit motor learning interventions use singular verbal instruction.

References:

Fernández-Ruiz, J., & Díaz, R. (1999). Prism adaptation and aftereffect: specifying the properties of a procedural memory system. Learning & Memory, 6(1), 47-53.

van der Kamp, J., Steenbergen, B., & Masters, R. S. (2017). Explicit and implicit motor learning in children with unilateral cerebral palsy. Disability and Rehabilitation, 1-8.

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