Effects of Self-Controlled Practice on Motor Learning in People with Parkinson's Disease

YA YUN LEE, DE JUN LIM
Purpose:

This study aimed to determine the behavioral and neurophysiological effects of self-controlled practice on motor learning in individuals with PD. 

Methods:

This study recruited 32 participants with idiopathic PD. Participants were matched in pairs and allocated into the self-control group (SELF) and the yoked group (YOKED) to practice a finger-pressing task. All participants were required to visit the laboratory 3 times: day 1 (D1), day 2 (D2), and day 7 (D7). On D1 and D2, the participants practiced the finger-pressing task for 2 blocks of 36 trials in each day. During practice, the SELF group could choose when to receive performance feedback, while the YOKED group received feedback according to their counterparts’ choices. A motivation questionnaire was provided to the participants after practice. Ten minutes after practice on D2 and at D7, the participants underwent retention tests of the finger-pressing task. Additionally, the participants were required to estimate the errors of their performance for the retention tests. Besides from behavioral measurements, corticomotor excitability was measured by transcranial magnetic stimulation (TMS).

Results:

Both groups showed significant improvement in the finger-pressing task throughout practice (p 0.001). While both groups performed similarly on the D2 retention test, the SELF group showed better retention of the motor task than the YOKED group at D7 (p = 0.040). The motivation questionnaire and error estimation results showed no significant differences between the two groups. Results from TMS showed a significant group by time interaction (p=0.041) in the resting motor evoked potential (MEP). While the SELF group showed increased corticospinal excitability from D2 to D7, the resting MEP remained at the similar level on 2 days for the YOKED group. 

Conclusion(s):

The study results showed that providing self-controlled practice facilitated motor learning in people with PD. Moreover, the behavioral improvement seemed to accompany with increased corticomotor excitability.

Implications:

Clinicians may consider incorporating self-controlled practice into the rehabilitation regimen, such as providing choices in therapeutic exercise selection and setting goals collaboratively with patients, to enhance the training effects for people with PD. 

Funding acknowledgements:
This study was funded by the National Science and Technology Council, R.O.C, with number of NSTC 113-2314-B-002-044-MY2
Keywords:
Parkinson’s disease
Self-controlled practice
Corticomotor excitability
Primary topic:
Neurology: Parkinson's disease
Second topic:
Disability and rehabilitation
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Research Ethics Committee of National Taiwan University Hospital
Provide the ethics approval number:
202304047RINC
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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