van der Kamp John, Steenbergen Bert, Masters Rich S W
a Research Institute MOVE Amsterdam , Faculty of Behavioural and Movement Sciences, VU University Amsterdam , Amsterdam , The Netherlands.
b School of Public Health , University of Hong Kong , Hong Kong SAR , China.
Disabil Rehabil. 2018 Nov;40(23):2790-2797. doi: 10.1080/09638288.2017.1360403. Epub 2017 Jul 30.
The current study aimed to investigate the capacity for explicit and implicit learning in children with unilateral cerebral palsy.
Children with left and right unilateral cerebral palsy and typically developing children shuffled disks toward a target.
A prism-adaptation design was implemented, consisting of pre-exposure, prism exposure, and post-exposure phases. Half of the participants were instructed about the function of the prism glasses, while the other half were not.
For each trial, the distance between the target and the shuffled disk was determined. Explicit learning was indicated by the rate of adaptation during the prism exposure phase, whereas implicit learning was indicated by the magnitude of the negative after-effect at the start of the post-exposure phase. Results No significant effects were revealed between typically developing participants and participants with unilateral cerebral palsy. Comparison of participants with left and right unilateral cerebral palsy demonstrated that 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 capacity for explicit motor learning is reduced among individuals with right unilateral cerebral palsy when accumulation of declarative knowledge is unguided (i.e., discovery learning). In contrast, the capacity for implicit learning appears to remain intact among individuals with left as well as right unilateral cerebral palsy. Implications for rehabilitation Implicit motor learning interventions are recommended for individuals with cerebral palsy, particularly for individuals with right unilateral cerebral palsy Explicit motor learning interventions for individual with cerebral palsy - if used - best consist of singular verbal instruction.
本研究旨在调查单侧脑瘫患儿的显性和隐性学习能力。
患有左侧和右侧单侧脑瘫的儿童以及发育正常的儿童将圆盘移向目标。
采用棱镜适应设计,包括预暴露、棱镜暴露和暴露后阶段。一半参与者被告知棱镜眼镜的功能,而另一半则未被告知。
对于每次试验,确定目标与移动圆盘之间的距离。显性学习通过棱镜暴露阶段的适应率来表示,而隐性学习通过暴露后阶段开始时负后效的大小来表示。结果:发育正常的参与者与单侧脑瘫参与者之间未发现显著影响。对左侧和右侧单侧脑瘫参与者的比较表明,右侧单侧脑瘫参与者的适应率明显低于左侧单侧脑瘫参与者,但仅在未提供指导时如此。右侧和左侧单侧脑瘫参与者的负后效大小没有显著差异。
当陈述性知识的积累无引导时(即发现学习),右侧单侧脑瘫个体的显性运动学习能力会降低。相比之下,左侧和右侧单侧脑瘫个体的隐性学习能力似乎保持完好。对康复的启示:建议对脑瘫个体,特别是右侧单侧脑瘫个体进行隐性运动学习干预。对脑瘫个体的显性运动学习干预——如果使用——最好由单一的口头指导组成。