Does Motor Learning Generalize Between Distinct Functional Upper Extremity Tasks in Older Adults?

Background: The process of motor learning can decline with age, such that older adults tend to learn new motor skills at a slower rate and to a lesser degree than younger adults. The degree to which aging affects the generalization of motor learning, however, is unclear. Objective: The purpose of this study was to test whether task-specific training on one functional motor task would 1) result in motor learning, and 2) generalize to two untrained tasks in older adults. Methods: Twenty-one adults age 65 years and older participated in this study and were assigned to either a training group or a control group. The training group completed three days of training on a simulated feeding task with their non-dominant hand. The control group received no training. All participants were evaluated at pre-test and at post-test on the feeding task, as well as two other untrained functional upper extremity motor tasks (simulated dressing and writing). Results: The training group significantly improved feeding task performance from pre-test to post-test, whereas the control group did not. These improvements due to motor learning did not, however, generalize to the two untrained tasks, as neither the training nor control group showed any improvement on the simulated dressing or writing tasks from pre-test to post-test. Conclusions: These results suggest that, unlike younger adult samples in our previous studies, older adults may not generalize learned information across functionally distinct tasks. Thus, the process of generalization may be particularly susceptible to aging processes

Generalization of motor learning between distinct functional upper extremity tasks in older adults

Disability and functional limitations in everyday life are especially prevalent in later adulthood. Many older adults also have difficulty in carrying out activities of daily living (ADLs) such as eating, dressing, writing, etc. Task-specific training is a viable approach used to improve ADLs in neurorehabilitation. Practicing all the activities that an individual performs on a daily basis with task-specific training, however, is not feasible in current clinical practice due to limited time and services. Instead, what is practiced in therapy is assumed to generalize to what is not practiced in therapy. We have previously demonstrated that generalization occurs in young adults, but the question remains of whether older adults are also able to generalize motor learning as well. The purpose of this study was to investigate generalization of motor learning in healthy older adults. Participants (n=21; age=76.7±6.6 years) performed three motor tasks to establish baseline: simulated feeding, simulated dressing, and writing. Performance was measured as time to complete one trial. Participants were then placed in either a training or control group. The training group completed three days of training on only the feeding task. All participants were then re-tested on all tasks. All tasks were completed with the nondominant arm. Results showed motor learning over the course of training, given that feeding task performance improved and was retained between days. However, this motor learning did not generalize to the dressing and writing tasks. Our data suggests that the generalization of motor learning may be susceptible to the aging process. These findings have direct implications for clinical neurorehabilitation, during which patients cannot feasibly train specifically at a high enough dose to sufficiently promote motor learning on all of their necessary ADLs

Health-related quality of life in children and young adults with Marfan syndrome

Objective: To assess health-related quality of life (HRQOL) in a large multicenter cohort of children and young adults with Marfan syndrome participating in the Pediatric Heart Network Marfan Trial. Study design: The Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales were administered to 321 subjects with Marfan syndrome (5-25 years). PedsQL scores were compared with healthy population norms. The impact of treatment arm (atenolol vs losartan), severity of clinical features, and number of patient-reported symptoms on HRQOL was assessed by general linear models. Results: Mean PedsQL scores in children (5-18 years) with Marfan syndrome were lower than healthy population norms for physical (P <= .003) and psychosocial (P < .001) domains; mean psychosocial scores for adults (19-25 years) were greater than healthy norms (P < .001). HRQOL across multiple domains correlated inversely with frequency of patient-reported symptoms (r = 0.30-0.38, P < .0001). Those <18 years of age with neurodevelopmental disorders (mainly learning disability, attention-deficit/hyperactivity disorder) had lower mean PedsQL scores (5.5-7.4 lower, P < .04). A multivariable model found age, sex, patient-reported symptoms, and neurodevelopmental disorder to be independent predictors of HRQOL. There were no differences in HRQOL scores by treatment arm, aortic root z score, number of skeletal features. or presence of ectopia lentis. Conclusions: Children and adolescents with Marian syndrome were at high risk for impaired HRQOL. Patient-reported symptoms and neurodevelopmental disorder. but not treatment arm or severity of Marian syndrome-related physical findings, were associated with lower HRQOL