Background/Aims: Analogy learning, a motor learning strategy that uses biomechanical metaphors to chunk together explicit rules of a to-be-learned motor skill. This proof-of-concept study aims to establish the feasibility and potential benefits of analogy learning in enhancing stride length regulation in people with Parkinson’s. Methods: Walking performance of thirteen individuals with Parkinson’s was analysed using a Codamotion analysis system. An analogy instruction; “following footprints in the sand” was practiced over 8 walking trials. Single- and dual- (motor and cognitive) task conditions were measured before training, immediately after training and 4-weeks post training. Finally, an evaluation form was completed to examine the interventions feasibility. Findings: Data from 12 individuals (6 females and 6 males, mean age 70, Hoehn and Yahr I-III) were analysed, one person withdrew due to back problems. In the single task condition, statistically and clinically relevant improvements were obtained. A positive trend towards reducing dual task costs after the intervention was demonstrated, supporting the relatively implicit nature of the analogy. Participants reported that the analogy was simple to use and became easier over time. Conclusions: Analogy learning is a feasible and potentially implicit (i.e. reduced working memory demands) intervention to facilitate walking performance in people with Parkinson’s.
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Objectives: To investigate immediate changes in walking performance associated with three implicit motor learning strategies and to explore patient experiences of each strategy. Design: Participants were randomly allocated to one of three implicit motor learning strategies. Within-group comparisons of spatiotemporal parameters at baseline and post strategy were performed. Setting: Laboratory setting. Subjects: A total of 56 community-dwelling post-stroke individuals. Interventions: Implicit learning strategies were analogy instructions, environmental constraints and action observation. Different analogy instructions and environmental constraints were used to facilitate specific gait parameters. Within action observation, only videotaped gait was shown. Main measures: Spatiotemporal measures (speed, step length, step width, step height) were recorded using Vicon 3D motion analysis. Patient experiences were assessed by questionnaire. Results: At a group level, three of the four analogy instructions (n=19) led to small but significant changes in speed (d=0.088m/s), step height (affected side d=0.006m) and step width (d=–0.019m), and one environmental constraint (n=17) led to significant changes in step width (d=–0.040m). At an individual level, results showed wide variation in the magnitude of changes. Within action observation (n=20), no significant changes were found. Overall, participants found it easy to use the different strategies and experienced some changes in their walking performance. Conclusion: Analogy instructions and environmental constraints can lead to specific, immediate changes in the walking performance and were in general experienced as feasible by the participants. However, the response of an individual patient may vary quite considerably.
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Worldwide, sedentary behaviours and overweight are major health concerns. Most adolescents are insufficiently physically active and have overweight. Moreover, most work is sedentary or requires only light activity. And most people live in cities, a context which discourages participation in physical activity. How can we change this situation? An analogy between urban design and facility design is introduced to elucidate spatial properties that may be beneficial in both contexts. It is the purpose of this paper to use this analogy for the advancements of health and well-being of both workers and city dwellers.
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