Zoekresultaten

Multidisciplinary Views on Applying Explicit and Implicit Motor Learning in Practice

Background A variety of options and techniques for causing implicit and explicit motor learning have been described in the literature. The aim of the current paper was to provide clearer guidance for practitioners on how to apply motor learning in practice by exploring experts’ opinions and experiences, using the distinction between implicit and explicit motor learning as a conceptual departure point. Methods A survey was designed to collect and aggregate informed opinions and experiences from 40 international respondents who had demonstrable expertise related to motor learning in practice and/or research. The survey was administered through an online survey tool and addressed potential options and learning strategies for applying implicit and explicit motor learning. Responses were analysed in terms of consensus ( 70%) and trends ( 50%). A summary figure was developed to illustrate a taxonomy of the different learning strategies and options indicated by the experts in the survey.

Promoting explicit instruction of strategies for self-regulated learning

The effects of implicit and explicit motor learning in gait rehabilitation of people after stroke

Background: A significant part of neurological rehabilitation focuses on facilitating the learning of motor skills. Training can adopt either (more) explicit or (more) implicit forms of motor learning. Gait is one of the most practiced motor skills within rehabilitation in people after stroke because it is an important criterion for discharge and requirement for functioning at home. Objective: The aim of this study was to describe the design of a randomized controlled study assessing the effects of implicit motor learning compared with the explicit motor learning in gait rehabilitation of people suffering from stroke. Methods: The study adopts a randomized, controlled, single-blinded study design. People after stroke will be eligible for participation when they are in the chronic stage of recovery (>6 months after stroke), would like to improve walking performance, have a slow walking speed (<1 m/s), can communicate in Dutch, and complete a 3-stage command. People will be excluded if they cannot walk a minimum of 10 m or have other additional impairments that (severely) influence gait. Participants will receive 9 gait-training sessions over a 3-week period and will be randomly allocated to an implicit or explicit group. Therapists are aware of the intervention they provide, and the assessors are blind to the intervention participants receive. Outcome will be assessed at baseline (T0), directly after the intervention (T1), and after 1 month (T2). The primary outcome parameter is walking velocity. Walking performance will be assessed with the 10-meter walking test, Dynamic Gait Index, and while performing a secondary task (dual task). Self-reported measures are the Movement Specific Reinvestment Scale, verbal protocol, Stroke and Aphasia Quality of Life Scale, and the Global Perceived Effect scale. A process evaluation will take place to identify how the therapy was perceived and identify factors that may have influenced the effectiveness of the intervention. Repeated measures analyses will be conducted to determine significant and clinical relevant differences between groups and over time. Results: Data collection is currently ongoing and results are expected in 2019. Conclusions: The relevance of the study as well as the advantages and disadvantages of several aspects of the chosen design are discussed, for example, the personalized approach and choice of measurements.

Analysing and visualising the trends in knowledge management

The purpose of this study was to analyse knowledge management research trends to understand the development of the field using a combination of scientometric, bibliometric, and visualisation techniques, subsequently developing a normative framework of knowledge management from the results.282 articles between the years 2010–2015 were retrieved, analysed, and visualised to produce the state of knowledge management during the selected timeframe. The results of this study provide a visualisation of the current research trends to understand the development of the knowledge management discipline. There are signals that the literature about knowledge management is progressing towards academic maturity. This study is one of the first studies to combine bibliometric and scientometric methods to assess productivity along with visualisation, and subsequently provide a knowledge management framework drawing from the results of these methods.

Implicit and explicit motor learning interventions have similar effects on walking speed in people after stroke

Objective. Clinicians may use implicit or explicit motor learning approaches to facilitatemotor learning of patients with stroke. Implicit motor learning approaches have shown promising results in healthy populations. The purpose of this study was to assess whether an implicit motor learning walking intervention is more effective compared with an explicit motor learning walking intervention delivered at home regarding walking speed in people after stroke in the chronic phase of recovery. Methods. This randomized, controlled, single-blind trial was conducted in the home environment. The 79 participants, who were in the chronic phase after stroke (age = 66.4 [SD = 11.0] years; time poststroke = 70.1 [SD = 64.3] months; walking speed = 0.7 [SD = 0.3] m/s; Berg Balance Scale score = 44.5 [SD = 9.5]), were randomly assigned to an implicit (n = 38) or explicit (n = 41) group. Analogy learning was used as the implicit motor learning walking intervention, whereas the explicit motor learning walking intervention consisted of detailed verbal instructions. Both groups received 9 training sessions (30 minutes each), for a period of 3 weeks, targeted at improving quality of walking. The primary outcome was walking speed measured by the 10-MeterWalk Test at a comfortable walking pace. Outcomes were assessed at baseline, immediately after intervention, and 1 month postintervention. Results. No statistically or clinically relevant differences between groups were obtained postintervention (between-group difference was estimated at 0.02 m/s [95% CI = −0.04 to 0.08] and at follow-up (between-group difference estimated at −0.02 m/s [95% CI = −0.09 to 0.05]). Conclusion. Implicit motor learning was not superior to explicit motor learning to improve walking speed in people after stroke in the chronic phase of recovery. Impact. To our knowledge, this is the first study to examine the effects of implicit compared with explicit motor learning on a functional task in people after stroke. Results indicate that physical therapists can use (tailored) implicit and explicit motor learning strategies to improve walking speed in people after stroke who are in the chronic phase of recovery.

Food for thought

The focus of the thesis is an exploration into students’ vocational knowledge in the context of Dutch vocational education and training (VET). The reason students’ vocational knowledge requires exploration is because there is no consensus among scholars in the field of VET about how to theorise the nature of students’ vocational knowledge; most (not all) scholars rely on dichotomous conceptualisations, such as theory versus practice, general versus specific or explicit versus implicit. However, such commonly used dichotomies are not very helpful to understand the complex nature of vocational knowledge. Vocational knowledge is more than putting bits of theoretical and practical knowledge together, it is characterised by sometimes-intimate relationships between knowledge and actions. As a result of the above-mentioned gap in the VET literature, there is little empirical research on how VET students develop vocational knowledge and the extent to which this is occupation-specific knowledge. To understand students’ vocational knowledge, four different aims are formulated and carried out in four studies. The aim of the first study is to identify powerful vocational learning environments to enable the selection of a case that represents high quality vocational learning and teaching. With an eye on analysing students’ vocational knowledge, the second study aims to conceptualise the nature of vocational knowledge that avoids dichotomies. Therefore, two conceptual frameworks are integrated; the idea of contextualising is introduced which is based on cultural-historical theory to highlight the crucial role activity plays in knowledge development and to understand the relationships between the mind (i.e., what people think (and feel)), and action (i.e., what people do). Secondly, the theory is supplemented with ideas from inferentialism, a philosophical semantic theory of meaning to provide a useful way to focus on students’ processes of knowing and to reveal students’ vocational knowledge in terms of ongoing reasoning processes. The third study uses the conceptualisation of vocational knowledge to explore how students develop vocational knowledge in occupational practice, and to illustrate the process of contextualising. The forth study aims to describe what characterises students’ vocational knowledge using an analytic framework that distinguishes between occupation-specific knowledge components and qualities. This thesis contributes to research scholarship in the field of VET and an understanding of students’ vocational knowledge in practice. The theoretical framework of contextualising supplemented with inferentialism provides an alternative way to focus on students’ processes of knowing and helps to reveal students’ vocational knowledge in terms of reasoning processes. The empirical explorations and illustrations of students’ vocational knowledge contribute to the scholarly literature and practice on understanding the nature of vocational knowledge, how students develop vocational knowledge and what characterises their vocational knowledge. The intention to introduce the idea of contextualising is not about reinventing the wheel but rather an attempt to understand how it turns and how it functions. The intention of this thesis is to encourage dialogue and move the debate about the nature of vocational knowledge further, and hence, to provide some “food for thought”.