Motor learning in humans

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Shalista
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Motor learning in humans

Post by Shalista »

So I'm having a small chuckle here. I'm nearing the end of my time at school for Physical Therapist Assistant. (I know many of you are in the UK idk what your version would be. do you have Physio assistants?) and we're learning about motor learning and I thought you guys might enjoy knowing that so many of the principles we apply to dog training also are used in rehab for motor learning.

Things like starting in quiet, calm environment when learning a new task and then when they get better adding distractions.
Breaking a complicated task down into small steps.
lots of positive reinforcement.
tailoring each task to a patient's individual needs.
making learning fun.

Idk, we were doing motor learning and i just was laughing because it was so familiar to me. everything i've done with Bax I'm going to be doing for my patients :lol:
Baxter (AKA Bax, Chuckles, Chuckster) Rat Terrier, born 01/16/13
Erica
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Re: Motor learning in humans

Post by Erica »

You could even look into TAGteach (rebranded clicker training for humans) for your patients! I started saying it as a joke but they've taught surgeons using TAGteach, why not the patients? ;P
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JudyN
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Re: Motor learning in humans

Post by JudyN »

Shalista wrote: Fri Mar 31, 2017 5:51 pm (I know many of you are in the UK idk what your version would be. do you have Physio assistants?)
I was thinking I hadn't heard of them, but then I found this: https://nationalcareersservice.direct.g ... -assistant :D
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Nettle
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Re: Motor learning in humans

Post by Nettle »

I worked as a physiotherapist (that's what we call them in UK) for just short of 10 years. The modern training is different from mine, and I think loses some important foundations. We were big on massage and passive exercises, but nowadays there is NO massage to warm up the body first and it is all about getting the patients to do exercises by themselves. Also we would go up to the pain barrier but not through it - modern physios over here take patients repeatedly through the pain barrier and to my mind that is not constructive because people then won't do their exercises or won't do them properly. Also they approach their sessions with an attitude of dislike or even fear, which stops them getting the maximum benefit.

I never worked with an assistant, but I did teach at physio school. I like teaching but I would not want to get a patient so far then hand over to another person unless I was closely supervising them.
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Shalista
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Re: Motor learning in humans

Post by Shalista »

holy crap Judy thats not what i do AT all. we need to go through an accredited 2 year program before passing a rigorous board exams. that looks like what we would call a physical therapy aid... and those aren't allowed to actually touch a patient.

Basically in USA the 'physio' will do an evaluation and set up the plan of care and then the PTA will handle most of the treatment from there out. the 'physio' is usually involved mostly in additional evaluation and reassessments, they'll work on the harder cases that they dotn trust to the PTA, and do the discharge.

Over here the 'physio's complain that mostly what they do is evaluations and paper work. the PTA's handle most of the treatments. (note - not all therapy places HAVE PTA's, we're kind of a new breed over here and not super well trusted or understood by physios.)

And i think it varies from setting to setting here Nettle. some places are really big on manual stuff others just drop you on a machine and forget about you for an hr. I was really fortunate to have my second clinical at an outpatient setting that was big on manual techniques. No massage but lots of stretching, manual resisted stuff, and PNF techniques. I had a blast!

As far as pushing through the pain threshold I literally have never heard of that over here. we try them out on something new, see how challenging it is for them, ask them to rate their pain and difficulty, and if it's to hard we don't do it. I've stopped a patient cold before based on facial expression alone.
Baxter (AKA Bax, Chuckles, Chuckster) Rat Terrier, born 01/16/13
JudyN
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Re: Motor learning in humans

Post by JudyN »

Sorry, I didn't even read the 'job description' :lol:

As far as I know, then, we don't have the divide that you do. You need to do a 3-year degree course to become a physiotherapist - I imagine when you start work you'd be under supervision of a more experienced physiotherapist... and get promoted till you're at a level when you hardly ever get to do what you loved about the job in the first place and just push paper round instead (don't get me started on how this happens to engineers).

I could be wrong - my only qualification is having a SIL who is a physiotherapist (who disappears as soon as anyone in the family mentions any aches and pains, or just tells us it's old age) :lol:

When OH had a frozen shoulder he was told it was very important he pushed past the pain barrier. I quite enjoyed putting pressure on his arm as he grimaced in pain :twisted: But that's just one specific condition of course.
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Shalista
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Re: Motor learning in humans

Post by Shalista »

oh wow ive been using physio therapist wrong then to O.o

for us what i THOUGHT was a physio is a "physical therapist" ... but thats a doctorate degree O.o PTA's aren't allowed to work without being in contact with a PT

so I'm actually probably closer to your Physio then anything else?
Baxter (AKA Bax, Chuckles, Chuckster) Rat Terrier, born 01/16/13
JudyN
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Re: Motor learning in humans

Post by JudyN »

I'm not sure... a physiotherapist would be qualified to assess etc. as well as treat, I'm just assuming that they'd start off being supervised to make sure they're not so rubbish they pull people's limbs right off or anything, like a newly qualified medical doctor would be. As far as I can see, PhDs (which would be a further three years on top of the three-year degree) in physiotherapy have only been introduced very recently (see http://www.csp.org.uk/news/2016/02/26/s ... -course-uk ) and I'm not sure it would permit you to do anything you couldn't do with the degree. But this is a combination of guesswork and googling so don't go quoting me on any of it :wink:
Jasper, lurcher, born December 2009
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Nettle
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Re: Motor learning in humans

Post by Nettle »

Bearing in mind that I qualified in 1991 after a 3 year course that I fast-tracked (as a mature student who already had relevant qualifications) down to 2 years, it's pretty certain that I could not do that now because the criteria have changed dramatically. Whether that makes for a better practitioner or not is a moot point.

Frozen shoulder is an interesting one. Theoretically the patient should be pushed through the pain barrier, but the plain truth is that most people can't take it, and you can't successfully treat a patient who is tense and scared. Pain is a foreign concept to most people nowadays, unless they participate in dangerous sports. I have treated a lot of frozen shoulders, and they do respond to more considerate work, but the best result I ever heard of was with a patient who was making good progress and then went on holiday to Russia. While there, she signed up for a deep massage, and her therapist spoke no English.

She was mercilessly pulled and kneaded. She screamed, she howled, she begged for mercy, she wept. The therapist ignored her - she knew what was needed, and she was going to do it no matter what.

For the rest of that day and the following day my client was in agony. Over the next few days, the pain eased, until there was none. She was cured!

I would never have dared treat anyone like that :lol: but that IS exactly what is needed. I lost a client under the nicest of terms (I was so pleased for her) and gained a funny story.
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Re: Motor learning in humans

Post by JudyN »

:lol: OH is quite stoic really - in this house, I'm the one who gets manflu :wink: I'm convinced it's something to do with having fairly severe eczema as a child where he simply had to learn to ignore the intense itching if he wasn't going to rake holes in himself.
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Shalista
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Re: Motor learning in humans

Post by Shalista »

hahaha for frozen shoulder sometimes we'll knock them out and while they're under we just crack it to pop it free so they can't feel it =P it's such a pain to work free (both for the patients and the therapist)
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Re: Motor learning in humans

Post by JudyN »

Oh, I should have tried that - it would have been even more funImage :mrgreen:
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Nettle
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Re: Motor learning in humans

Post by Nettle »

Do you take medication profiles before you treat, Shalista? It's interesting how many people develop frozen shoulder soon after being prescribed statins.
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Shalista
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Re: Motor learning in humans

Post by Shalista »

that would be under evaluations which PTA's cannot do =(
Baxter (AKA Bax, Chuckles, Chuckster) Rat Terrier, born 01/16/13
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Nettle
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Re: Motor learning in humans

Post by Nettle »

Ah, fair enough - but do you get to see the notes so you can learn under supervision?


It's a lovely career you have chosen - so good to be able to help people get better mobility. :D
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