MOTOR LEARNING AND FEEDBACK
Introduction
Motor learning is a set of processes associated with practice and experience leading to relatively permanent changes in the capability of movement (Schmidt and Lee, 1999). According to van Dijk (2006), in learning of motor skills, motor processes continuously interact with cognitive and sensory processes. Van Dijk’s statement best summarizes the neurological nature of man’s learning.
How does the nervous system facilitate learning especially of a certain skill or movement? It is a common knowledge among health professionals with neurological interest, that first the objective of the movement is identified using input from the senses (e.g. vision, somatosensation, proprioception, and kinesthesia). Then motor plan is developed at the premotor area of the brain. Here the brain decides on which muscles to activate, how much efforts should these muscles exert, and on how the movement is to be performed. After planning, implementation follows as it is being processed by the primary motor cortex. Execution of this motor response will then extend down to the spinal cord, then to the peripheral nerves and at last to the muscles concerned for that certain task.
Voluntary, skilled movements improve through practice. However as an individual performs and practices a new task, it is inevitable that mistakes in the movement patterns are committed. This is especially true among individuals whose level of proficiency on that certain task is novice, or in the cases of others, manifesting with neurologic problems or pain upon movement.
Error corrections should then be done to refine the motor skill. This is when we need cognition efforts for us to recall which of the components of the movement were done correctly and wrongly, and eventually respond to correct mistakes the next time around (Sherwood and Lee, 2003).
How could a learner be compelled to better use his cognition in correcting errors and eventually learning a skill? One of the answers is feedback. Feedback is very important in learning. It aids learners to recall errors and in turn aids them in devising a plan to execute better in practice.
For the next sections of this discourse, we shall be defining in details what feedback is all about. We shall also be identifying its types and examining journals that would be helpful in gauging the efficacy of each feedback type.
Feedback in Motor Learning
Feedback is information arising as a consequence of performance (van Dijk, 2006). It provides basis for evaluation of correctness of movement or task. Recalling what was discussed earlier about the neurologic control of learning, feedback can be a tool that enables the learner to identify the objective of the task at hand.
According to Thorpe (2003), this is an important element for motor learning. And for this she briefly, but clearly gave accounts on the two main types of feedback: the intrinsic and the extrinsic feedback. Thorpe differentiated these two types of feedback. She emphasized that intrinsic feedback is a type which is provided to the performer by the sensory systems (visual, auditory, proprioceptive, vestibular, and cutaneous) as a result of movement. On the other hand, extrinsic feedback, also known as augmented feedback is supplemental information given to the performer about the task. Unlike the intrinsic type, it originates from an external source, such as biofeedback, videotape, and verbal or tactile cues.
Going back to van Dijk’s works, he termed the intrinsic feedback as inherent feedback. The reason for this is that inherent feedback originates from the sensory information that is a natural part of performing a skill. In other words, it is a feedback which is given by a performer to his self. On the other hand, van Dijk also introduced the term artificial feedback when referring to augmented or extrinsic type of feedback. He also stated that the adjective “augmented” refers to adding to or enhancing task-intrinsic feedback with an external source (e.g. training devices).
Upon knowing the differences between the two, we now have to deal with these important questions. Which learner and task require intrinsic feedback? Which require augmented feedback?
Thorpe explains that when intrinsic feedback is not available, critical task requirements are not clear, or the learner is not familiar with the relationship between the goal and required movement, augmented feedback is necessary. Conversely, learning can be inhibited by augmented feedback if the movement provides enough intrinsic feedback to influence behavior.
If we are to interpret Thorpe’s statement, in order to fit the rehabilitation setting, we shall see that augmented feedback can be used if the following conditions are satisfied: unseen targets, disabilities like loss of sensation, or misunderstood intrinsic feedback. So that, if a patient with right hemiplegia is about to start gait training with the use of a cane on his left side, surely we cannot rely on intrinsic feedback in facilitation of learning. Why? This patient suffers with weakness and sensory loss. Even his visual acuity is questionable. And it is probable that this patient do not have any idea about the requirements to carry out the task. This is when our role as physical therapists comes into play. We give this kind of patient visual or tactile cues, verbal coaching, and even record practice sessions, and having him watch his own performance afterwards.
When do we withdraw from using augmented feedback? If sensory or intrinsic feedback is available, understood, and usable, we might as well give less focus in providing augmented feedback. If an individual has intact senses, the target is seen, and/or his level of proficiency is advanced or expert, most of the time there is no use for feedback from external sources. It would only duplicate information that is already available, making it redundant. So if we say to an individual performing reaching exercises that “you reached it”, when the person obviously sees that, it becomes inappropriate and annoying.
Choice of feedback type is also age-dependent. The ability to process intrinsic information may be compromised due to age related changes in information processing or to cognitive/ sensory deficit in certain patient groups. This is true among elderly whose reflexes become slow, muscles become weak, and cognitive-sensory processing becomes poor (Zucker, 2003). In these circumstances these people may be more dependent on augmented feedback to learn motor skills compared to young, healthy adults (van Dijk, 2006).
Even in pediatric cases, feedback is proven beneficial in a child’s capability to learn. Obviously, the feedback of choice is augmented feedback. Hypotheses by Valvano and Carollo (2003) stated that augmented feedback in the form of manual guidance enhances practice in the early phase of learning a novel motor skill. Their basis for such is concepts from Gentile and Newell, stating that the early stages of learning include a learner’s discovery of the conditions that must be met in order to be successful with the task. A child cannot do this alone. And we, in the rehabilitation team, should be the ones providing tactile cues and guidance on the specific part we want a child to utilize in performing the task (manual guidance on the trunk if we are to teach sitting).
Types of Augmented Feedback
Almost all of the authors of literatures featuring motor control and learning agree that there are two types of augmented feedback: knowledge of result (KR) and the knowledge of performance (KP). While KR focuses on feedback about the result or outcome of the learner’s activity, KP provides information on the movement pattern used to achieve the goal.
For example, we are to teach a patient with right below knee amputation to perform three-point gait with the use of crutches, giving feedback in the form of KR means we are to let him know of the distance he was able to travel, or speed that he was able to reach our target distance. But if we are to use KP, we now shift our focus to providing information about how he moves both crutches and how he swings his left lower extremity. This time we are more focused on the biomechanical components of the task being accomplished.
Guadagnoli and Kohl (2001) favors the use of KR in learning a new motor task. However Thorpe admits that some inconsistencies exist, since she quoted Schmidt and Lee’s statements believing that KP is the most powerful and effective type of feedback in motor learning. Nevertheless Magill, another author quoted by Thorpe, cited a condition in using KP. According to him, KP is required specifically if the skill requires high-level movement.
For the next part of the discourse let us examine which of these feedback types is proven by literatures to be superior among others.
Review of Literatures
The researches stated in this section are not purely done within the rehabilitation scene. But all of them tell us a lot on how feedback can affect learning in almost all aspects of task education. As we all know the process of learning is uniform to all individuals, abled or disabled, since the nervous system that makes learning possible is plastic (Cramer and Bastings, 1999), capable of adapting to the demands of the body, and capable of producing appropriate reactions to certain stimuli despite of the damage imposed on its structures . There would only be a difference when it comes to how long would an individual learn given his normal or abnormal conditions.
As early as in the late 70’s onwards various studies had been conducted that show how feedback is being used in teaching new skills. Wallace and Hagler in 1979 conducted a study comparing the effects of KP, KR, and social reinforcements. As we can observe all of the variables that they were concerned of that time are augmented types of feedback. They hypothesized that the level of performance would increase to a greater extent in individuals who received KP and KR feedback, compared to those who received KR and social reinforcements (SR). Using a population of 24 right handed university students with no background in basketball, the hypothesis was tested. These students were divided into three groups. The task consisted of a non-dominant (left) handed shot about 45 degrees to the left of basket, so that the desired outcome occurred without interference from the rim. During the first stage, skill learning, all groups received feedback. Two of the groups received the obvious visual KR feedback as they saw their shots either sink into the net or not. Only one group received social reinforcements (SR) such as “good job,” “awesome,” or “too bad, try again”. The other group, in addition to the KR, received feedback based on the quality of their performance. First this specific feedback offered information about changing one’s stance to demonstrate better outcomes, followed by information regarding the motion of the body during the shot. These 50 trials were followed by a five minute rest period and then 25 performance trials. This second group of trials demonstrated the retention of the learned skill and the result of the feedback on the individual’s original skill level. During this phase, no KP or SR was given; only the evident visual outcome was received by the shooter. Every participant’s performance was graded using a rating system that awarded points per trial depending on the detailed outcome of the shot. The results showed that the group who received KP in addition to KR out-performed the other groups during the performance trials and the learning ones. Additionally, the group who received KP continued to improve after initiation of the performance phase and the withdrawal of the KP feedback. There was no improvement found during the verbal withdrawal trials of the KR and SR group.
In this study we can conclude that good KP feedback has a carry-over when it comes to later stages of doing the task. In addition we can also conclude that providing augmented feedback as early as in the first phase of learning usually leads to better ability for an individual to provide himself with inherent feedback later on when left alone.
Petruzzello and Corbin (1988) studied the effects of performance feedback (KP) on female self-confidence. They chose a balance task and a pursuit task, and began their study with a questionnaire to potential participants to confirm that the subjects agreed in the skill’s gender neutrality. Results showed that the tasks were considered neutral. A final group of 69 women were then told the objective of the first task and it was to be performed. They were divided into two groups. A practice session was held, followed by completion of a questionnaire of the prediction of performance. Then each participant underwent three trials. One group received KP feedback after each trial of the given task. Another group received no feedback at all meaning they have to rely on their natural or inherent feedback. The group that received no feedback was told to relax and wait between the trials. The same procedure was followed with the second task as well.
Significant interaction was found between confidence levels of the females and the absence or presence of KP feedback. The KP feedback group demonstrated considerably more self-confidence than the group who received no feedback on the tasks.
This time we can infer that if we delayed augmented feedback or do not give it at all, this might lead to low level of self-confidence. We can also say that by doing so, a person’s intrinsic feedback becomes poor or weak.
Butler and Nisan (1985) also conducted a study showcasing the importance of feedback. In their study they gathered three groups of students which will carry out uniform activities for three sessions from standardized work booklets. One group received KP in the form of task-related comments after the first and the second sessions. The other group received KR in the form of numerical scores also after the first and the second session. However the last group did not receive any augmented feedback at all. The results of the third session were not returned to the students but after the said session, all of the groups were asked to answer a motivation questionnaire.
Result showed that KP group was mostly motivated than any of the other groups. It also showed that the groups with augmented feedback performed better than the group with none (only intrinsic feedback). As between the KP and KR groups, KP group proved to be much better than the other group that received KR.
Another study by Hodges and Franks (2001) proves the superiority of KP over KR. The task that was performed is circle-making on a computer screen. One group of subjects received KR in the form of goal attainment while the other received KP in the form of limb positioning awareness with the use of mirrors. In this study, KP group appeared to have less error in doing the task compared to the KR group.
Conclusions
Basing from the studies that we discussed, KP seems to be the most potent tool in rendering feedback as well as boosting a performer’s intrinsic feedback mechanism (especially later on in training when we stop giving augmented feedback). In the rehabilitation setting, especially among neurologic patients we treat them as learners of new tasks or recently lost ability. It would be justifiable if we are also to consider the use of augmented type of feedback especially KP. Why? As rehabilitation professionals we need to understand that the patients we handle need to be acquainted and/or reoriented with how it feels to move or to do the task at hand. Not only that we cannot rely on their inherent perceptions alone given their disabilities they themselves cannot rely on their own selves alone. And so they need us.
References :
Butler, R. and Nisan, M. (1985). Effects of no feedback, task-realted comments; and
grades on intrinsic motivation and performance. Journal of Education
Psychology.
Cramer, S. and Bastings, E. (1999). Mapping clinically relevant plasticity after stroke.
Neuropharmacology. www.elsevier.com
Guadagnoli, M. and Kohl, R. (2001). Knowledge of Results for Motor Learning: the
Relationship between Error Estimation anf Frequency. University of Nevada
Las Vegas.
Hodges, N. J., Franks, I. M. (2001). Learning a coordination skill: Interactive efforts of
instruction and feedback. Research Quarterly for Exercise and Sport, 72, 132-142.
Petruzzello, S. J., Corbin, C. B. (1988). Effects of performance feedback on female self-
confidence. Journal of Sport and Exercise Psychology, 10, 174-183.
Schmidt, R.A., and Lee, T.D. (1999). Motor control and learning: implication for
neurological rehabilitation. New York.
Sherwood, D.E. and Lee, T.D. (2003). Schema theory: critical review and implications
for the role of cognition in a new theory of motor learning. Research Quarterly. American Alliance for Health.74, 376-382.
Thorpe, D.E. (2003). Differential effect of internal versus external focus of attention in
the learning of a novel motor task in children. Center for Human Movement Science.
Valvano, J. and Carollo J. (2003). The role of manual guidance in pediatric physical
therapy interventions. Tampa, FL.
Wallace, S. A., Hagler, R. W. (1979). Knowledge of performance and the learning of a
closed motor skill. Research Quarterly. 50, 265-271.
Zucker, E. (2003). Caregiver;’s resourcebook. Prentice Hall. New Jersey.
Introduction
Motor learning is a set of processes associated with practice and experience leading to relatively permanent changes in the capability of movement (Schmidt and Lee, 1999). According to van Dijk (2006), in learning of motor skills, motor processes continuously interact with cognitive and sensory processes. Van Dijk’s statement best summarizes the neurological nature of man’s learning.
How does the nervous system facilitate learning especially of a certain skill or movement? It is a common knowledge among health professionals with neurological interest, that first the objective of the movement is identified using input from the senses (e.g. vision, somatosensation, proprioception, and kinesthesia). Then motor plan is developed at the premotor area of the brain. Here the brain decides on which muscles to activate, how much efforts should these muscles exert, and on how the movement is to be performed. After planning, implementation follows as it is being processed by the primary motor cortex. Execution of this motor response will then extend down to the spinal cord, then to the peripheral nerves and at last to the muscles concerned for that certain task.
Voluntary, skilled movements improve through practice. However as an individual performs and practices a new task, it is inevitable that mistakes in the movement patterns are committed. This is especially true among individuals whose level of proficiency on that certain task is novice, or in the cases of others, manifesting with neurologic problems or pain upon movement.
Error corrections should then be done to refine the motor skill. This is when we need cognition efforts for us to recall which of the components of the movement were done correctly and wrongly, and eventually respond to correct mistakes the next time around (Sherwood and Lee, 2003).
How could a learner be compelled to better use his cognition in correcting errors and eventually learning a skill? One of the answers is feedback. Feedback is very important in learning. It aids learners to recall errors and in turn aids them in devising a plan to execute better in practice.
For the next sections of this discourse, we shall be defining in details what feedback is all about. We shall also be identifying its types and examining journals that would be helpful in gauging the efficacy of each feedback type.
Feedback in Motor Learning
Feedback is information arising as a consequence of performance (van Dijk, 2006). It provides basis for evaluation of correctness of movement or task. Recalling what was discussed earlier about the neurologic control of learning, feedback can be a tool that enables the learner to identify the objective of the task at hand.
According to Thorpe (2003), this is an important element for motor learning. And for this she briefly, but clearly gave accounts on the two main types of feedback: the intrinsic and the extrinsic feedback. Thorpe differentiated these two types of feedback. She emphasized that intrinsic feedback is a type which is provided to the performer by the sensory systems (visual, auditory, proprioceptive, vestibular, and cutaneous) as a result of movement. On the other hand, extrinsic feedback, also known as augmented feedback is supplemental information given to the performer about the task. Unlike the intrinsic type, it originates from an external source, such as biofeedback, videotape, and verbal or tactile cues.
Going back to van Dijk’s works, he termed the intrinsic feedback as inherent feedback. The reason for this is that inherent feedback originates from the sensory information that is a natural part of performing a skill. In other words, it is a feedback which is given by a performer to his self. On the other hand, van Dijk also introduced the term artificial feedback when referring to augmented or extrinsic type of feedback. He also stated that the adjective “augmented” refers to adding to or enhancing task-intrinsic feedback with an external source (e.g. training devices).
Upon knowing the differences between the two, we now have to deal with these important questions. Which learner and task require intrinsic feedback? Which require augmented feedback?
Thorpe explains that when intrinsic feedback is not available, critical task requirements are not clear, or the learner is not familiar with the relationship between the goal and required movement, augmented feedback is necessary. Conversely, learning can be inhibited by augmented feedback if the movement provides enough intrinsic feedback to influence behavior.
If we are to interpret Thorpe’s statement, in order to fit the rehabilitation setting, we shall see that augmented feedback can be used if the following conditions are satisfied: unseen targets, disabilities like loss of sensation, or misunderstood intrinsic feedback. So that, if a patient with right hemiplegia is about to start gait training with the use of a cane on his left side, surely we cannot rely on intrinsic feedback in facilitation of learning. Why? This patient suffers with weakness and sensory loss. Even his visual acuity is questionable. And it is probable that this patient do not have any idea about the requirements to carry out the task. This is when our role as physical therapists comes into play. We give this kind of patient visual or tactile cues, verbal coaching, and even record practice sessions, and having him watch his own performance afterwards.
When do we withdraw from using augmented feedback? If sensory or intrinsic feedback is available, understood, and usable, we might as well give less focus in providing augmented feedback. If an individual has intact senses, the target is seen, and/or his level of proficiency is advanced or expert, most of the time there is no use for feedback from external sources. It would only duplicate information that is already available, making it redundant. So if we say to an individual performing reaching exercises that “you reached it”, when the person obviously sees that, it becomes inappropriate and annoying.
Choice of feedback type is also age-dependent. The ability to process intrinsic information may be compromised due to age related changes in information processing or to cognitive/ sensory deficit in certain patient groups. This is true among elderly whose reflexes become slow, muscles become weak, and cognitive-sensory processing becomes poor (Zucker, 2003). In these circumstances these people may be more dependent on augmented feedback to learn motor skills compared to young, healthy adults (van Dijk, 2006).
Even in pediatric cases, feedback is proven beneficial in a child’s capability to learn. Obviously, the feedback of choice is augmented feedback. Hypotheses by Valvano and Carollo (2003) stated that augmented feedback in the form of manual guidance enhances practice in the early phase of learning a novel motor skill. Their basis for such is concepts from Gentile and Newell, stating that the early stages of learning include a learner’s discovery of the conditions that must be met in order to be successful with the task. A child cannot do this alone. And we, in the rehabilitation team, should be the ones providing tactile cues and guidance on the specific part we want a child to utilize in performing the task (manual guidance on the trunk if we are to teach sitting).
Types of Augmented Feedback
Almost all of the authors of literatures featuring motor control and learning agree that there are two types of augmented feedback: knowledge of result (KR) and the knowledge of performance (KP). While KR focuses on feedback about the result or outcome of the learner’s activity, KP provides information on the movement pattern used to achieve the goal.
For example, we are to teach a patient with right below knee amputation to perform three-point gait with the use of crutches, giving feedback in the form of KR means we are to let him know of the distance he was able to travel, or speed that he was able to reach our target distance. But if we are to use KP, we now shift our focus to providing information about how he moves both crutches and how he swings his left lower extremity. This time we are more focused on the biomechanical components of the task being accomplished.
Guadagnoli and Kohl (2001) favors the use of KR in learning a new motor task. However Thorpe admits that some inconsistencies exist, since she quoted Schmidt and Lee’s statements believing that KP is the most powerful and effective type of feedback in motor learning. Nevertheless Magill, another author quoted by Thorpe, cited a condition in using KP. According to him, KP is required specifically if the skill requires high-level movement.
For the next part of the discourse let us examine which of these feedback types is proven by literatures to be superior among others.
Review of Literatures
The researches stated in this section are not purely done within the rehabilitation scene. But all of them tell us a lot on how feedback can affect learning in almost all aspects of task education. As we all know the process of learning is uniform to all individuals, abled or disabled, since the nervous system that makes learning possible is plastic (Cramer and Bastings, 1999), capable of adapting to the demands of the body, and capable of producing appropriate reactions to certain stimuli despite of the damage imposed on its structures . There would only be a difference when it comes to how long would an individual learn given his normal or abnormal conditions.
As early as in the late 70’s onwards various studies had been conducted that show how feedback is being used in teaching new skills. Wallace and Hagler in 1979 conducted a study comparing the effects of KP, KR, and social reinforcements. As we can observe all of the variables that they were concerned of that time are augmented types of feedback. They hypothesized that the level of performance would increase to a greater extent in individuals who received KP and KR feedback, compared to those who received KR and social reinforcements (SR). Using a population of 24 right handed university students with no background in basketball, the hypothesis was tested. These students were divided into three groups. The task consisted of a non-dominant (left) handed shot about 45 degrees to the left of basket, so that the desired outcome occurred without interference from the rim. During the first stage, skill learning, all groups received feedback. Two of the groups received the obvious visual KR feedback as they saw their shots either sink into the net or not. Only one group received social reinforcements (SR) such as “good job,” “awesome,” or “too bad, try again”. The other group, in addition to the KR, received feedback based on the quality of their performance. First this specific feedback offered information about changing one’s stance to demonstrate better outcomes, followed by information regarding the motion of the body during the shot. These 50 trials were followed by a five minute rest period and then 25 performance trials. This second group of trials demonstrated the retention of the learned skill and the result of the feedback on the individual’s original skill level. During this phase, no KP or SR was given; only the evident visual outcome was received by the shooter. Every participant’s performance was graded using a rating system that awarded points per trial depending on the detailed outcome of the shot. The results showed that the group who received KP in addition to KR out-performed the other groups during the performance trials and the learning ones. Additionally, the group who received KP continued to improve after initiation of the performance phase and the withdrawal of the KP feedback. There was no improvement found during the verbal withdrawal trials of the KR and SR group.
In this study we can conclude that good KP feedback has a carry-over when it comes to later stages of doing the task. In addition we can also conclude that providing augmented feedback as early as in the first phase of learning usually leads to better ability for an individual to provide himself with inherent feedback later on when left alone.
Petruzzello and Corbin (1988) studied the effects of performance feedback (KP) on female self-confidence. They chose a balance task and a pursuit task, and began their study with a questionnaire to potential participants to confirm that the subjects agreed in the skill’s gender neutrality. Results showed that the tasks were considered neutral. A final group of 69 women were then told the objective of the first task and it was to be performed. They were divided into two groups. A practice session was held, followed by completion of a questionnaire of the prediction of performance. Then each participant underwent three trials. One group received KP feedback after each trial of the given task. Another group received no feedback at all meaning they have to rely on their natural or inherent feedback. The group that received no feedback was told to relax and wait between the trials. The same procedure was followed with the second task as well.
Significant interaction was found between confidence levels of the females and the absence or presence of KP feedback. The KP feedback group demonstrated considerably more self-confidence than the group who received no feedback on the tasks.
This time we can infer that if we delayed augmented feedback or do not give it at all, this might lead to low level of self-confidence. We can also say that by doing so, a person’s intrinsic feedback becomes poor or weak.
Butler and Nisan (1985) also conducted a study showcasing the importance of feedback. In their study they gathered three groups of students which will carry out uniform activities for three sessions from standardized work booklets. One group received KP in the form of task-related comments after the first and the second sessions. The other group received KR in the form of numerical scores also after the first and the second session. However the last group did not receive any augmented feedback at all. The results of the third session were not returned to the students but after the said session, all of the groups were asked to answer a motivation questionnaire.
Result showed that KP group was mostly motivated than any of the other groups. It also showed that the groups with augmented feedback performed better than the group with none (only intrinsic feedback). As between the KP and KR groups, KP group proved to be much better than the other group that received KR.
Another study by Hodges and Franks (2001) proves the superiority of KP over KR. The task that was performed is circle-making on a computer screen. One group of subjects received KR in the form of goal attainment while the other received KP in the form of limb positioning awareness with the use of mirrors. In this study, KP group appeared to have less error in doing the task compared to the KR group.
Conclusions
Basing from the studies that we discussed, KP seems to be the most potent tool in rendering feedback as well as boosting a performer’s intrinsic feedback mechanism (especially later on in training when we stop giving augmented feedback). In the rehabilitation setting, especially among neurologic patients we treat them as learners of new tasks or recently lost ability. It would be justifiable if we are also to consider the use of augmented type of feedback especially KP. Why? As rehabilitation professionals we need to understand that the patients we handle need to be acquainted and/or reoriented with how it feels to move or to do the task at hand. Not only that we cannot rely on their inherent perceptions alone given their disabilities they themselves cannot rely on their own selves alone. And so they need us.
References :
Butler, R. and Nisan, M. (1985). Effects of no feedback, task-realted comments; and
grades on intrinsic motivation and performance. Journal of Education
Psychology.
Cramer, S. and Bastings, E. (1999). Mapping clinically relevant plasticity after stroke.
Neuropharmacology. www.elsevier.com
Guadagnoli, M. and Kohl, R. (2001). Knowledge of Results for Motor Learning: the
Relationship between Error Estimation anf Frequency. University of Nevada
Las Vegas.
Hodges, N. J., Franks, I. M. (2001). Learning a coordination skill: Interactive efforts of
instruction and feedback. Research Quarterly for Exercise and Sport, 72, 132-142.
Petruzzello, S. J., Corbin, C. B. (1988). Effects of performance feedback on female self-
confidence. Journal of Sport and Exercise Psychology, 10, 174-183.
Schmidt, R.A., and Lee, T.D. (1999). Motor control and learning: implication for
neurological rehabilitation. New York.
Sherwood, D.E. and Lee, T.D. (2003). Schema theory: critical review and implications
for the role of cognition in a new theory of motor learning. Research Quarterly. American Alliance for Health.74, 376-382.
Thorpe, D.E. (2003). Differential effect of internal versus external focus of attention in
the learning of a novel motor task in children. Center for Human Movement Science.
Valvano, J. and Carollo J. (2003). The role of manual guidance in pediatric physical
therapy interventions. Tampa, FL.
Wallace, S. A., Hagler, R. W. (1979). Knowledge of performance and the learning of a
closed motor skill. Research Quarterly. 50, 265-271.
Zucker, E. (2003). Caregiver;’s resourcebook. Prentice Hall. New Jersey.
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