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Implicit Memory in Physiotherapy
w
Derby 2014 w
Avon and Wiltshire Mental Health Partnership NHS Trust
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User Warning
A Person Centred Approach will help you decide which approaches to use.
Please keep this in mind: This is not MSK Physiotherapy.
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3 Approaches
1. Traditional Approach (Fitts & Posner)
2. Rosemary Oddy http://www.alzheimers.org.uk/mobilitystrategies
3. Implicit Memory Approaches. Andrew Clyne - Agility Journal Summer 2013
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Fitts and Posner Model 1967
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Objectives
• Implicit vs. Explicit Memory
• Priming
• Errorless learning
• Repeated Constant Practice
• Required Repetitions
• Avoiding Multi-tasking
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Implicit and Explicit Memory
.
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Changing Lanes Macuga et al 2007
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Implicit Memory and MoodSabat 2006
• .
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Implicit Memory and Communication
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Priming.
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Henry Gustav Molaison - HM
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Errorless Learning
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Errorless Learning Maxwell et al 200180 x 50 = 400 Reps
Error full Learning
Develop hypothesis
Correct Errors
Explicit Learning
•More vulnerable to breakdown under dual task •Lower level of retention of skill
Errorless Learning
Passive Learning
Little hypothesis
Implicit Learning
•Less likely to breakdown under dual task •Higher level of retention of skill
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Constant Practice (Dick et al 1996)
0
0.5
1
1.5
2
2.5
3
PreTest PT1 PT2 PT3
HC
AD
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Variable Practice (Dick et al 1996)
0
0.5
1
1.5
2
2.5
3
PreTest PT1 PT2 PT3
HC
AD
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How Many Reps?
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How Many Passes?
http://www.youtube.com/watch?v=Ahg6qcgoay4
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Avoiding Multi-TaskingBoyd and Winstein 2006
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Case Study (Aug 2013)
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Objectives
• Implicit vs. Explicit Memory
• Priming
• Errorless learning
• Repeated Constant Practice
• Required Repetitions
• Avoiding Multi-Tasking
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Rehab Potential?
Motor learning may represent an island of saved functioning in the midst of the devastating cognitive losses associated with (Alzheimer’s) dementia. (Dick et al 1996)
We should be fitting our approaches to the patient not judging people’s ability to fit our traditional approach.