AgingNCT02898701
Does Overpractice Improve Motor Learning?
A study testing Motor Practice of a Standing Serial Reaction Time Task in people with Aging, run by University of Utah at 1 site in United States.
Trial summary
This study contains two pilot studies: 1) one study will investigate practice dosage of a postural stepping task in healthy young individuals in order to determine an operational definition of performance plateau, and 2) the other study will investigate whether practicing beyond reaching a performance plateau improves… Read more about this study
- Who is it for?
- Ages 18 to 95 yearsHealthy volunteers can take part
- Conditions the study is for
- Aging
- What is being tested?
- Motor Practice of a Standing Serial Reaction Time Task
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 65 participants
- Where
- 1 siteUnited States
- Study dates
- 1 Sep 2016to 17 Mar 2020
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 95 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Inclusion criteria for individuals considered healthy older adults will be: (a) 60-95 years of age.
- Inclusion criteria for individuals considered healthy young adults will be: (a) 18-45 years of age.
- Exclusion Criteria will include the following for all individuals:
- acute medical problems
- uncorrected vision loss
- any other conditions that affect their mobility or balance which might affect their ability to perform the motor task (arthritis, orthopedic complications, metabolic, vestibular, etc)
- Montreal Cognitive Assessment score <26
- non-english speaking
Who cannot join
None listed.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Does Practice Beyond Performance Plateau Improve Motor Learning in Healthy Adults?
This study contains two pilot studies: 1) one study will investigate practice dosage of a postural stepping task in healthy young individuals in order to determine an operational definition of performance plateau, and 2) the other study will investigate whether practicing beyond reaching a performance plateau improves learning of a postural stepping task in healthy older adults, compared to discontinuing practice immediately after reaching a performance plateau. The investigators hypothesize that the group that continues to practice beyond reaching their performance plateau will learn and retain the motor task better than the other group.
Read the detailed description
What is the ideal amount, or dose, of practice needed for a person to learn a motor skill? Studies suggest that "more is better," but the optimal dose of motor practice is unknown. Motor learning is defined as a set of internal processes leading to a relatively permanent change in the capability for a motor skill. Older adults and people with neurological disorders have a critical need to learn and relearn motor skills to remain independent, but standard clinical rehabilitation currently provides practice doses that are insufficient to result in motor learning. Under-dosing of practice results in sub-optimal clinical outcomes, while research studies that are dosed insufficiently to identify between-group differences are prone to misinterpretation. Therefore, it is essential for both clinical care and for research that we determine the practice dose needed to optimize motor learning.
Performance curves (i.e., plots of the average performance of a group or individual for each of a number of practice trials or blocks of trials) demonstrate that performance improves (e.g., error decreases or speed increases) during practice, until a point at which performance improvement begins to plateau. Additional practice provided beyond the point at which an individual reaches a performance plateau will be termed overpractice. Amounts of practice that are insufficient to reach a plateau tend not to demonstrate motor learning, while overpractice typically results in retention of the practiced task.
Pilot Study #1: The first pilot study will include healthy young adults who are randomly assigned to practice a postural stepping task for one day, or for five consecutive days of practice. The investigators will use this data to determine an operational definition (i.e., a mathematical definition) of performance plateau. This definition will be used to differentiate the groups in Pilot Study #2.
Pilot Study #2: The second pilot study will include healthy older adults who will be divided into three groups: a standard of care group (i.e. very low dose), an overpractice group, and a no overpractice group. All groups will practice a postural stepping task. The experimental group will be the overpractice (OVP) group, in which each participant will complete 100% additional practice trials after reaching their performance plateau. In contrast, the two active control groups will be the no overpractice (NoOVP) group (in which each participant will stop practicing immediately after reaching a performance plateau), and the standard of care (SoC) group (in which each participant will perform one block of practice).
- Conditions
- Aging
- Being tested
- Motor Practice of a Standing Serial Reaction Time Task
- Keywords
- Motor Learning, Dose of Motor Practice, Postural Control, Serial Reaction Time Task, Retention, Transfer, Overpractice, Overtraining, Overlearning
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Motor Practice of a Standing Serial Reaction Time TaskBehavioural
Subjects will perform a standing serial reaction time task on a step reaction mat. Subjects will step to a series of targets, based on a series of stimuli that are presented. One trial is composed of two 12-step sequences. One of the 12-step sequences is random, while the other is a repeated sequence; sequences are presented in random order. After each trial, the subject rests for 25 seconds. Six trials equal 1 block of practice, which is followed by a 4 minute rest break. After each block, feedback is provided about average response time (RT) on all steps included in the block. One complete day of practice consists of 6 blocks of practice in which each block consists of 6 trials.
| Study group | Role | What they receive |
|---|---|---|
| No Overpractice (NoOVP) | Active comparator | Subjects will perform the intervention (i.e., motor practice of a standing serial reaction time task) according to the practice schedule until they reach a performance plateau on the repeated sequence. At that time, members of the NoOVP group will cease practicing. Receives: Behavioral: Motor Practice of a Standing Serial Reaction Time Task |
| Overpractice (OVP) | Experimental | Subjects will perform the intervention (i.e., motor practice of a standing serial reaction time task) according to the practice schedule until they reach a performance plateau on the repeated sequence. At that time, members of the OVP group will continue to practice as part of the overpractice phase until they have completed 100% overpractice. Receives: Behavioral: Motor Practice of a Standing Serial Reaction Time Task |
| Standard of Care (SoC) | Active comparator | Subjects will perform the intervention (i.e., motor practice of a standing serial reaction time task) until they have performed 144 practice trials over the course of one day. At that time, members of the SoC group will cease practicing. Receives: Behavioral: Motor Practice of a Standing Serial Reaction Time Task |
What is being measured
The primary outcome is the main question the study is designed to answer.
Retention on the Postural Stepping Task
Retention is the ability to maintain performance improvements of a motor skill after a period of no practice. Response time (RT) is collected \& defined as reaction time (amount of time from stimulus presentation to initial release of foot from electrode) plus movement time (amount of time from initial release of foot to foot reaching target). The first half of Block 1 of Day 1 serves as the pre-test performance. The primary outcome measure is the difference in the RT between pre-test and retention test. A decrease in RT over the course of practice reflects an increased response speed and a corresponding improvement in performance.
Measured: 3 or 4 days after training ends (i.e., 2 or 3 days of no training prior to retention test)
Secondary outcomes (1)
Transfer to an Untrained Task
Transfer is the gain or the loss of proficiency on one task as a result of previous practice or experience on another task. The secondary outcome measure is improvement on the transfer task. The transfer task is the 4 Square Step Test, and is scored based on the number of seconds the participant requires to complete the test. Each participant will perform the 4 Square Step Test at baseline (pre-test) and will perform it three days after the acquisition phase ends (post-test). The post-test score will be subtracted from pre-test score, which will provide a transfer test change score. A positive number will suggest improvement, while a negative number will suggest that the participants worsened on the transfer task.
Measured: 3 or 4 days after training ends (i.e., 2 or 3 days of no training prior to retention test)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Sep 2016 (estimated)
- Study start1 Sep 2016
- Primary completion17 Mar 2020
- Study completion17 Mar 2020
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (12)Papers the sponsor has linked to this study.
- Other trials for AgingStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 65 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Utah
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Genevieve Olivier, University of Utah
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02898701
- Sponsor's protocol ID
- IRB_00085515
- Status last verified
- Jun 2021
- First submitted
- 7 Sep 2016
- Last updated
- 15 Jun 2021
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Trewartha KM, Garcia A, Wolpert DM, Flanagan JR. Fast but fleeting: adaptive motor learning processes associated with aging and cognitive decline. J Neurosci. 2014 Oct 1;34(40):13411-21. doi: 10.1523/JNEUROSCI.1489-14.2014.
PubMed 25274819Clark BC, Manini TM. Functional consequences of sarcopenia and dynapenia in the elderly. Curr Opin Clin Nutr Metab Care. 2010 May;13(3):271-6. doi: 10.1097/MCO.0b013e328337819e.
PubMed 20154609Kleim JA, Jones TA. Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage. J Speech Lang Hear Res. 2008 Feb;51(1):S225-39. doi: 10.1044/1092-4388(2008/018).
PubMed 18230848Lang CE, Macdonald JR, Reisman DS, Boyd L, Jacobson Kimberley T, Schindler-Ivens SM, Hornby TG, Ross SA, Scheets PL. Observation of amounts of movement practice provided during stroke rehabilitation. Arch Phys Med Rehabil. 2009 Oct;90(10):1692-8. doi: 10.1016/j.apmr.2009.04.005.
PubMed 19801058Lohse KR, Lang CE, Boyd LA. Is more better? Using metadata to explore dose-response relationships in stroke rehabilitation. Stroke. 2014 Jul;45(7):2053-8. doi: 10.1161/STROKEAHA.114.004695. Epub 2014 May 27.
PubMed 24867924Lang CE, MacDonald JR, Gnip C. Counting repetitions: an observational study of outpatient therapy for people with hemiparesis post-stroke. J Neurol Phys Ther. 2007 Mar;31(1):3-10. doi: 10.1097/01.npt.0000260568.31746.34.
PubMed 17419883Krueger WFC. Further studies in overlearning. Journal of Experimental Psychology. 1930;13(2):152-163.
Melnick MJ. Effects of overlearning on the retention of a gross motor skill. Res Q. 1971 Mar;42(1):60-9. No abstract available.
PubMed 5279070Schendel JD, Hagman JD. On sustaining procedural skills over a prolonged retention interval. Journal of Applied Psychology. 1982;67(5):605-610.
Driskell JE, Willis RP, Copper C. Effect of overlearning on retention. Journal of Applied Psychology. 1992;77(5):615-622.
Jones MB. Nonimposed overpractice and skill retention. DTIC Document;1986.
Olivier GN, Dibble LE, Paul SS, Lohse KR, Walter CS, Marker RJ, Hayes HA, Foreman KB, Duff K, Schaefer SY. Personalized practice dosages may improve motor learning in older adults compared to "standard of care" practice dosages: A randomized controlled trial. Front Rehabil Sci. 2022 Aug 3;3:897997. doi: 10.3389/fresc.2022.897997. eCollection 2022.
PubMed 36189036
Study at a glance
From the registry record, last updated by the sponsor on 15 Jun 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Does Practice Beyond Performance Plateau Improve Motor Learning in Healthy Adults?
- ClinicalTrials.gov ID
- NCT02898701
- Acronym / sponsor ID
- IRB_00085515
- Conditions
- Aging
- Keywords
- Motor Learning, Dose of Motor Practice, Postural Control, Serial Reaction Time Task, Retention, Transfer, Overpractice, Overtraining
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 65 participants (actual)
- Lead sponsor
- University of UtahUniversity, hospital or other
- Study start
- 1 Sep 2016 (actual)
- Primary completion
- 17 Mar 2020 (actual)
- Study completion
- 17 Mar 2020 (actual)
- First posted
- 13 Sep 2016 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study contains two pilot studies: 1) one study will investigate practice dosage of a postural stepping task in healthy young individuals in order to determine an operational definition of performance plateau, and 2) the other study will investigate whether practicing beyond reaching a performance plateau improves learning of a postural stepping task in healthy older adults, compared to discontinuing practice immediately after reaching a performance plateau. The investigators hypothesize that the group that continues to practice beyond reaching their performance plateau will learn and retain the motor task better than the other group.
Detailed description
What is the ideal amount, or dose, of practice needed for a person to learn a motor skill? Studies suggest that "more is better," but the optimal dose of motor practice is unknown. Motor learning is defined as a set of internal processes leading to a relatively permanent change in the capability for a motor skill. Older adults and people with neurological disorders have a critical need to learn and relearn motor skills to remain independent, but standard clinical rehabilitation currently provides practice doses that are insufficient to result in motor learning. Under-dosing of practice results in sub-optimal clinical outcomes, while research studies that are dosed insufficiently to identify between-group differences are prone to misinterpretation. Therefore, it is essential for both clinical care and for research that we determine the practice dose needed to optimize motor learning.
Performance curves (i.e., plots of the average performance of a group or individual for each of a number of practice trials or blocks of trials) demonstrate that performance improves (e.g., error decreases or speed increases) during practice, until a point at which performance improvement begins to plateau. Additional practice provided beyond the point at which an individual reaches a performance plateau will be termed overpractice. Amounts of practice that are insufficient to reach a plateau tend not to demonstrate motor learning, while overpractice typically results in retention of the practiced task.
Pilot Study #1: The first pilot study will include healthy young adults who are randomly assigned to practice a postural stepping task for one day, or for five consecutive days of practice. The investigators will use this data to determine an operational definition (i.e., a mathematical definition) of performance plateau. This definition will be used to differentiate the groups in Pilot Study #2.
Pilot Study #2: The second pilot study will include healthy older adults who will be divided into three groups: a standard of care group (i.e. very low dose), an overpractice group, and a no overpractice group. All groups will practice a postural stepping task. The experimental group will be the overpractice (OVP) group, in which each participant will complete 100% additional practice trials after reaching their performance plateau. In contrast, the two active control groups will be the no overpractice (NoOVP) group (in which each participant will stop practicing immediately after reaching a performance plateau), and the standard of care (SoC) group (in which each participant will perform one block of practice).
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| No Overpractice (NoOVP) | Active comparator | Behavioral: Motor Practice of a Standing Serial Reaction Time TaskSubjects will perform the intervention (i.e., motor practice of a standing serial reaction time task) according to the practice schedule until they reach a performance plateau on the repeated sequence. At that time, members of the NoOVP group will cease practicing. |
| Overpractice (OVP) | Experimental | Behavioral: Motor Practice of a Standing Serial Reaction Time TaskSubjects will perform the intervention (i.e., motor practice of a standing serial reaction time task) according to the practice schedule until they reach a performance plateau on the repeated sequence. At that time, members of the OVP group will continue to practice as part of the overpractice phase until they have completed 100% overpractice. |
| Standard of Care (SoC) | Active comparator | Behavioral: Motor Practice of a Standing Serial Reaction Time TaskSubjects will perform the intervention (i.e., motor practice of a standing serial reaction time task) until they have performed 144 practice trials over the course of one day. At that time, members of the SoC group will cease practicing. |
Who may qualify
- Ages
- 18 to 95 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- Inclusion criteria for individuals considered healthy older adults will be: (a) 60-95 years of age.
- Inclusion criteria for individuals considered healthy young adults will be: (a) 18-45 years of age.
- acute medical problems
- uncorrected vision loss
- any other conditions that affect their mobility or balance which might affect their ability to perform the motor task (arthritis, orthopedic complications, metabolic, vestibular, etc)
Key exclusion criteria (0 listed)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Motor Practice of a Standing Serial Reaction Time TaskSubjects will perform a standing serial reaction time task on a step reaction mat. Subjects will step to a series of targets, based on a series of stimuli that are presented. One trial is composed of two 12-step sequences. One of the 12-step sequences is random, while the other is a repeated sequence; sequences are presented in random order. After each trial, the subject rests for 25 seconds. Six trials equal 1 block of practice, which is followed by a 4 minute rest break. After each block, feedback is provided about average response time (RT) on all steps included in the block. One complete day of practice consists of 6 blocks of practice in which each block consists of 6 trials. | Behavioural | No Overpractice (NoOVP), Overpractice (OVP), Standard of Care (SoC) |
Primary outcome
Retention on the Postural Stepping Task
Time frame: 3 or 4 days after training ends (i.e., 2 or 3 days of no training prior to retention test)
Retention is the ability to maintain performance improvements of a motor skill after a period of no practice. Response time (RT) is collected \& defined as reaction time (amount of time from stimulus presentation to initial release of foot from electrode) plus movement time (amount of time from initial release of foot to foot reaching target). The first half of Block 1 of Day 1 serves as the pre-test performance. The primary outcome measure is the difference in the RT between pre-test and retention test. A decrease in RT over the course of practice reflects an increased response speed and a corresponding improvement in performance.
1 secondary outcome
Transfer to an Untrained Task
Time frame: 3 or 4 days after training ends (i.e., 2 or 3 days of no training prior to retention test)
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Jun 2021.
- Background: PubMed 25274819Trewartha KM, Garcia A, Wolpert DM, Flanagan JR. Fast but fleeting: adaptive motor learning processes associated with aging and cognitive decline. J Neurosci. 2014 Oct 1;34(40):13411-21. doi: 10.1523/JNEUROSCI.1489-14.2014.
- Background: PubMed 20154609Clark BC, Manini TM. Functional consequences of sarcopenia and dynapenia in the elderly. Curr Opin Clin Nutr Metab Care. 2010 May;13(3):271-6. doi: 10.1097/MCO.0b013e328337819e.
- Background: PubMed 18230848Kleim JA, Jones TA. Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage. J Speech Lang Hear Res. 2008 Feb;51(1):S225-39. doi: 10.1044/1092-4388(2008/018).
- Background: PubMed 19801058Lang CE, Macdonald JR, Reisman DS, Boyd L, Jacobson Kimberley T, Schindler-Ivens SM, Hornby TG, Ross SA, Scheets PL. Observation of amounts of movement practice provided during stroke rehabilitation. Arch Phys Med Rehabil. 2009 Oct;90(10):1692-8. doi: 10.1016/j.apmr.2009.04.005.
- Background: PubMed 24867924Lohse KR, Lang CE, Boyd LA. Is more better? Using metadata to explore dose-response relationships in stroke rehabilitation. Stroke. 2014 Jul;45(7):2053-8. doi: 10.1161/STROKEAHA.114.004695. Epub 2014 May 27.
- Background: PubMed 17419883Lang CE, MacDonald JR, Gnip C. Counting repetitions: an observational study of outpatient therapy for people with hemiparesis post-stroke. J Neurol Phys Ther. 2007 Mar;31(1):3-10. doi: 10.1097/01.npt.0000260568.31746.34.
- BackgroundKrueger WFC. Further studies in overlearning. Journal of Experimental Psychology. 1930;13(2):152-163.
- Background: PubMed 5279070Melnick MJ. Effects of overlearning on the retention of a gross motor skill. Res Q. 1971 Mar;42(1):60-9. No abstract available.
- BackgroundSchendel JD, Hagman JD. On sustaining procedural skills over a prolonged retention interval. Journal of Applied Psychology. 1982;67(5):605-610.
- BackgroundDriskell JE, Willis RP, Copper C. Effect of overlearning on retention. Journal of Applied Psychology. 1992;77(5):615-622.
- BackgroundJones MB. Nonimposed overpractice and skill retention. DTIC Document;1986.
- Derived from this study: PubMed 36189036Olivier GN, Dibble LE, Paul SS, Lohse KR, Walter CS, Marker RJ, Hayes HA, Foreman KB, Duff K, Schaefer SY. Personalized practice dosages may improve motor learning in older adults compared to "standard of care" practice dosages: A randomized controlled trial. Front Rehabil Sci. 2022 Aug 3;3:897997. doi: 10.3389/fresc.2022.897997. eCollection 2022.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Motor Practice of a Standing Serial Reaction Time Task in people with Aging, run by University of Utah at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 0 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 15 Jun 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Retention on the Postural Stepping Task (time frame: 3 or 4 days after training ends (i.e., 2 or 3 days of no training prior to retention test)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02898701, which also lists 12 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Jun 2021.