Motor Learning Principles for Arthroscopic Motor Skill Teaching

Perceptual motor abilities

Control precision

Ability to make highly controlled movement adjustments, especially those involving larger muscle groups

Multi-limb coordination

Ability to coordinate numerous

Response orientation

Ability to rapidly select a response from a number of alternatives, as in choice reaction time (RT) situations

Reaction time

Ability to rapidly initiate a response to a stimulus

Speed of limb movement

Ability to make a gross rapid limb movement without regard for reaction time

Rate control

Ability to make continuous speed and direction adjustments with precision when tracking

Manual dexterity

Ability to control manipulations of large objects using arms and hands

Finger dexterity

Ability to control manipulations of small objects primarily through use of fingers

Arm-hand steadiness

Ability to make precise arm-hand positioning movements where involvement of strength and speed are minimal

Wrist-finger speed

Ability to move the wrist and fingers rapidly

Aiming

Ability to quickly and accurately direct hand movements at a small object

Physical proficiency abilities

Static strength

Ability to generate maximum force against external object

Dynamic strength

Muscular endurance or ability to exert force repeatedly

Explosive strength

Muscular power or ability to create maximum effort by combining force and velocity

Trunk strength

Dynamic strength of trunk muscles

Extent flexibility

Ability to move trunk and back muscles through large ROM (range of motion)

Dynamic flexibility

Ability to make repeated, rapid flexing movements

Gross body coordination

Ability to coordinate numerous movements simultaneously while the body is in motion

Gross body equilibrium

Ability to maintain balance without visual cues

Stamina

Cardiovascular endurance or ability to sustain effort

2.3 Movement Preparation

Movement preparation is started when a surgeon generates a goal directed action to accomplish a task in surgical setting. As the movement is continued, information regarding its advancement is fed back to the surgeon. Information which is called “intrinsic feedback” can be used to make adjustments towards perfection of the movement.

Movement is performed under certain factors.

1.

Response preparation
2.

Attention
3.

Arousal

2.3.1 Response Preparation

The short time lapse between the moment a stimulus is presented and the initiation of a response is known as reaction time. Reaction time is a measure of the time needed to prepare a response.

Under a given situation, as the amount of movement selections increases, the amount of time needed to prepare a response increases. If the trainee is given advanced information about what will occur next but also when it will occur has a positive effect on reducing response time.

2.3.2 Attention

Beginners have limits to number of procedures they can pay attention at any given time. In addition, as the procedure at target increases in complexity, the attentional demands will increase and further reduce attentional space that would otherwise be used for additional tasks. Designing tasks with less complexity for the beginners will help them not to be overloaded attentionally.

The instructor should be careful about the verbal exchange during performance with the learner because attentional limits may be exceeded even when correcting performance. The learner in time needs to know where and when to focus his/her attention so they can improve their attentional interchanging skills.

2.3.3 Arousal

Arousal is the physiological state of the individual that may vary from deep sleep to intense excitement which is not the same thing as anxiety. Higher anxiety, due to probable failure, may increase arousal. Lower levels of arousal will be preferred as a task increases in complexity.

As arousal decreases, a performer’s attentional focus expands. Wide attention focus unfortunately will lead relevant and irrelevant stimulus to become available to the performer. Unnecessary focus of the performer will cause response delays and a resultant decrease in performance is inevitable. Optimal arousal levels will enable the learner to concentrate on the relevant stimulus ignoring the irrelevant ones. This narrowing of attentional focus is termed perceptual narrowing [5].

2.4 Motor Control

Once a learner puts together what movement to perform in a given situation, he/she subconsciously retrieves the appropriate learned motor program from memory. Followed by the retrieval estimated parameter values are added that will achieve the desired outcome. The details of the targeted movement are therefore organized in advance by the motor program and sent to the rest of the body to be executed.

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