動作學習在物理治療之應用

The Application of Motor Learning Theories in Physical Therapy

胡名霞(Ming-Hsia Hu)

《中華民國物理治療學會雜誌》 23卷4期 (1998/10) Pp. 297-309

https://doi.org/10.29616/JPTAROC.199810.0005

摘要

物理治療的基本觀念，已經由以往的注重神經反射式的治療，逐漸轉而强調幫助病人「再學習」的治療觀。本文首先舉例說明動作學習之神經生物基礎，其次介紹重要的動作學習理論，再依據動作學習之基模理論討論練習的課程安排、回饋的給予等教學方法對於動作技巧學習成效的影響，以供臨床治療師在教導病患學習動作技能時之參考。
由文獻可知，治療師指導病患學習，因具有重複性，而神經系統又具有塑性，因此對於患者的神經系統重塑過程可能有相當的影響。即使對於記憶喪失的病人，治療師依然可利用患者程序性學習的能力，教導患者獲得某些動作技能。動作分期說及基模理論是現代重要的動作學習理論。依據現代學習理論，患者應當採取分散、隨機練習，而應避免長期一再重複同樣的動作。心像練習及分解動作練習都可作為治療時的選擇。回饋應延期給予幷應减少回饋的次數。回饋的種類除了告知動作的結果以外，關于動作的特質，如角度大小、力量大小、動作快慢等，都可作爲良好的回饋方式。

關鍵字

動作學習 ； 物理治療 ； 神經塑性

並列摘要

Theories of physical therapy have gradually changed from a reflex-based model to a motor relearning concept. However, motor learning theories are not universally included in entry-level physical therapy programs. This article reviews evidences of neural plasticity accompanying learning in animal models, theories of motor learning, as well as the effects of practice schedule and feedback on learning.
It is recommended that physical therapists should aim at improving permanent learning rather than temporary performance while teaching their patients new motor tasks. Based on the Schema theory, practice schedule should be randomized and feedback frequency should be decreased. Mental practice and part-whole transfer techniques may be used clinically to enhance learning in patients. Recent studies have shown that knowledge of performance can be used effectively in improving learning. The therapists may select the most appropriate kinematic or kinetic information as feedback to best enhance the acquisition of motor skills in their patients.

並列關鍵字

Motor learning ； Physical therapy ； Neural plasticity