i mplicit memory in physiotherapy w derby 2014 w andrew.clyne@nhs.net w avon and wiltshire mental...

Implicit Memory in Physiotherapy

w

Derby 2014 w

andrew.clyne@nhs.netw

Avon and Wiltshire Mental Health Partnership NHS Trust

User Warning

A Person Centred Approach will help you decide which approaches to use.

Please keep this in mind: This is not MSK Physiotherapy.

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

Fitts and Posner Model 1967

Objectives

• Implicit vs. Explicit Memory

• Priming

• Errorless learning

• Repeated Constant Practice

• Required Repetitions

• Avoiding Multi-tasking

Implicit and Explicit Memory

.

Changing Lanes Macuga et al 2007

Implicit Memory and MoodSabat 2006

• .

Implicit Memory and Communication

Priming.

Henry Gustav Molaison - HM

Errorless Learning

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

Constant Practice (Dick et al 1996)

0

0.5

1

1.5

2

2.5

3

PreTest PT1 PT2 PT3

HC

AD

Variable Practice (Dick et al 1996)

0

0.5

1

1.5

2

2.5

3

PreTest PT1 PT2 PT3

HC

AD

How Many Reps?

How Many Passes?

http://www.youtube.com/watch?v=Ahg6qcgoay4

Avoiding Multi-TaskingBoyd and Winstein 2006

Case Study (Aug 2013)

Objectives

• Implicit vs. Explicit Memory

• Priming

• Errorless learning

• Repeated Constant Practice

• Required Repetitions

• Avoiding Multi-Tasking

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.

“The session you did for us has

stuck in my mind”

andrew.clyne@nhs.net