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.
This research concerning the experience and future of zoos was carried out from 2011-2012 and takes regional ideas concerning Zoo Emmen as well as global visions into account. The research focuses partly on Zoo Emmen, its present attractions and visitors while also comparing and contrasting visions on the future in relationship to other international zoos in the world. In this way, remarkable experiences and ideas will be identified and in the light of them, it can serve as inspiration for stakeholders of zoos at large. The main research subject is a look at the future zoos in view of: The Zoo Experience – an international experience benchmark; The Zoo of the Future – a Scenario Planning approach towards the future; The virtual zoo - zoo’s in the internet domain.
The goal for the coming years is to get insight in the guest experience in hotels. What is guest experience? How to measure guest experience? What is the relation between guest experience and guest loyalty? And finally, what tangible elements in the physical environment of hotels and the contact with hotel employees may improve the experience of hotel guests? And in what way should these elements be changed? This paper describes the first and second step towards this goal: a theoretical background of guest experience and the development of the Guest Experience Scan for NH Hoteles. This Guest Experience Scan is a quantitative instrument trying to measure guests’ affective evaluation of the physical environment of the hotel and the contact with the hotel employees.
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