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      Terminology, Taxonomy, and Facilitation of Motor Learning in Clinical Practice: Protocol of a Delphi Study


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          Facilitating motor learning in patients during clinical practice is complex, especially in people with cognitive impairments. General principles of motor learning are available for therapists to use in their practice. However, the translation of evidence from the different fields of motor learning for use in clinical practice is problematic due to lack of uniformity in definition and taxonomy of terms related to motor learning.


          The objective of this paper was to describe the design of a Delphi technique to reach consensus on definitions, descriptions, and taxonomy used within motor learning and to explore experts’ opinions and experiences on the application of motor learning in practice.


          A heterogeneous sample of at least 30 international experts on motor learning will be recruited. Their opinions regarding several central topics on motor learning using a Delphi technique will be collected in 3 sequential rounds. The questionnaires in the 3 rounds will be developed based on the literature and answers of experts from earlier rounds. Consensus will be reached when at least 70% of the experts agree on a certain topic. Free text comments and answers from open questions on opinions and experiences will be described and clustered into themes.


          This study is currently ongoing. It is financially supported by Stichting Alliantie Innovatie (Innovation Alliance Foundation), RAAK-international (Registration number: 2011-3-33int).


          The results of this study will enable us to summarize and categorize expert knowledge and experiences in a format that should be more accessible for therapists to use in support of their clinical practice. Unresolved aspects will direct future research.

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          Most cited references31

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            Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage.

            This paper reviews 10 principles of experience-dependent neural plasticity and considerations in applying them to the damaged brain. Neuroscience research using a variety of models of learning, neurological disease, and trauma are reviewed from the perspective of basic neuroscientists but in a manner intended to be useful for the development of more effective clinical rehabilitation interventions. Neural plasticity is believed to be the basis for both learning in the intact brain and relearning in the damaged brain that occurs through physical rehabilitation. Neuroscience research has made significant advances in understanding experience-dependent neural plasticity, and these findings are beginning to be integrated with research on the degenerative and regenerative effects of brain damage. The qualities and constraints of experience-dependent neural plasticity are likely to be of major relevance to rehabilitation efforts in humans with brain damage. However, some research topics need much more attention in order to enhance the translation of this area of neuroscience to clinical research and practice. The growing understanding of the nature of brain plasticity raises optimism that this knowledge can be capitalized upon to improve rehabilitation efforts and to optimize functional outcome.
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              Cognitive impairment after stroke: frequency, patterns, and relationship to functional abilities.

              Cognitive function was examined in 227 patients three months after admission to hospital for ischaemic stroke, and in 240 stroke-free controls, using 17 scored items that assessed memory, orientation, verbal skills, visuospatial ability, abstract reasoning, and attentional skills. After adjusting for demographic factors with standardised residual scores in all subjects, the fifth percentile was used for controls as the criterion for failure on each item. The mean (SD) number of failed items was 3.4 (3.6) for patients with stroke and 0.8 (1.3) for controls (p 40). It is concluded that cognitive impairment occurs frequently after stroke, commonly involving memory, orientation, language, and attention. The presence of cognitive impairment in patients with strike has important functional consequences, independent of the effects of physical impairment. Studies of stroke outcome and intervention should take into account both cognitive and physical impairments.

                Author and article information

                JMIR Res Protoc
                JMIR Res Protoc
                JMIR Research Protocols
                JMIR Publications Inc. (Toronto, Canada )
                Jan-Jun 2013
                17 May 2013
                : 2
                : 1
                : e18
                [1] 1Research Centre Autonomy and Participation of People with a Chronic Illness Faculty of Health Zuyd University of Applied Sciences HeerlenNetherlands
                [2] 2Adelante Centre of Expertise in Rehabilitation HoensbroekNetherlands
                [3] 3Department of Health Services Research school CAPHRI Maastricht University MaastrichtNetherlands
                [4] 4Centre of Expertise Geriatric Rehabilitation and Chronic Somatic Care Sevagram Zorgcentra HeerlenNetherlands
                [5] 5Department of General Practice Faculty of Health, Medicine and Life Sciences Maastricht University MaastrichtNetherlands
                [6] 6Department of Rehabilitation school CAPHRI Maastricht University MaastrichtNetherlands
                [7] 7Department of Sport and Health Sciences University of Exeter ExeterUnited Kingdom
                [8] 8Institute of Human Performance University of Hong Kong Hong Kong SARChina
                [9] 9Research Centre Technology in Care Faculty of Health Zuyd University of Applied Sciences HeerlenNetherlands
                Author notes
                Corresponding Author: Melanie Kleynen melanie.kleynen@ 123456zuyd.nl
                ©Melanie Kleynen, Michel HC Bleijlevens, Anna JHM Beurskens, Sascha M Rasquin, Jos Halfens, Mark R Wilson, Rich S Masters, Monique A Lexis, Susy M Braun. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 17.05.2013.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included.

                : 11 March 2013
                : 07 April 2013
                : 21 April 2013
                : 27 April 2013

                motor learning,delphi technique,clinical practice,consensus,definitions


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