Assessment of Motor Learning with the Jebsen-Taylor Hand Function Test

Öz

Purpose: The primary aim of this study was to assess the effectiveness of motor learning (ML) in adults in the same hand activities performed consecutively over a short time. The secondary aim was to investigate the effect of gender on ML. Material and Methods: One hundred and three people (university students and their friends/relatives) participated in the study. Hand functions were assessed with the Jebsen-Taylor Hand Function Test (JHFT) twice, 10 minutes apart. Results: The JHFT-Total score of the participants in the second assessment was greater than their score in the first assessment (Δ=6.58 ± 8.16), this difference was statistically significant (p<0.001) and the effect of this significance was "large" (d>0.8). Similarly, the second assessment results had a better result than the first in all substages of JHFT and the difference was statistically significant (p<0.001). The improvement in the two assessments was similar between genders (p<0.001), but the effect size in men was greater than women (d=1.01; d=0.66). Conclusion: Participants showed significant ML improvement in this short-term study. Motor learning is critical in terms of assessment and rehabilitation. Although the findings obtained in the study were from a small sample and the interval was short, significant improvement was observed. These findings may contribute to future research on ML or performance-oriented assessment.

Anahtar Kelimeler

• Learning
• Motor Skills
• Functional Status
• Upper Extremity

Motor Öğrenme Süreçlerinin Jebsen-Taylor El Fonksiyon Testi ile Değerlendirilmesi

Öz

Amaç: Çalışmamızın birincil amacı yetişkinlerde kısa bir zaman aralığında peş peşe gerçekleştirilen aynı el aktivitelerindeki motor öğrenmenin etkinliğinin incelenmesiydi. İkincil amacı ise cinsiyetin motor öğrenme üzerindeki etkisinin incelenmesiydi. Gereç ve Yöntem: Çalışmaya üniversite öğrencileri ve yakınlarından oluşan 103 birey katıldı. Katılımcıların el fonksiyonları, 10 dakika arayla iki kez Jebsen-Taylor El Fonksiyon Testi (JEFT) ile değerlendirildi. Sonuçlar: Katılımcıların ikinci ölçümde aldıkları JEFT-Toplam puanının ilk ölçümden aldıkları puandan büyük olduğu (Δ=6,58 ± 8,16), bu farkın istatistiksel olarak çok yüksek düzeyde anlamlı olduğu (p<0,001) ve bu anlamlılığın etkisinin “büyük” olduğu belirlendi (d>0,8). JEFT’nin aşamalarının tamamında benzer şekilde ikinci ölçümün ilk ölçümden daha iyi bir sonuca sahip olduğu ve aradaki farkın istatistiksel olarak anlamlı olduğu belirlendi (p<0,001). Ayrıca iki ölçümdeki gelişimin cinsiyetler açısından benzer olmasına rağmen etki büyüklüğü bakımından erkeklerin kadınlardan (d=1,01; d=0,66) daha iyi olduğu görüldü. Tartışma: Sağlıklı bireylerde aynı ölçümlerin peş peşe yapılması sırasında motor öğrenmedeki gelişim incelendi. Motor öğrenme, değerlendirme yöntemleri ve rehabilitasyon açısından çok önemlidir. Becerinin edinimi üzerinde etkili olan pek çok faktör bulunmaktadır. Bulgular, küçük bir örneklemden elde edilmesine ve iki ölçüm arasındaki süre kısa olmasına rağmen anlamlı gelişme gözlemlendi. Elde edilen bulgular, gelecekteki motor öğrenme veya motor performans odaklı değerlendirme odaklı araştırmalar açısından katkı sağlayabilir.

Anahtar Kelimeler

• öğrenme
• motor beceriler
• fonksiyonel durum
• üst ekstremite

Kaynakça

1. Backman, C., Gibson, S. C. D., & Parsons, J. (1992). Assessment of hand function: The relationship between pegboard dexterity and applied dexterity. Canadian Journal of Occupational Therapy, 59(4), 208-213. https://doi.org/10.1177/000841749205900406
2. Bagrunov, V. P. (1981). Пoлoвые различия в видoвoй и индивидуальнoй изменчивoсти психики челoвека. [Sex differences in the species and ındividual variation in the human psyche]. 157. Багрунoв ВП—Л. (In Russian)
3. Baker, K. L. (2021). Functional tests for dexterity. In T. M. Skirven, A. L. Osterman, J. M. Fedorzyk, P. C. Amadio, S. B. Feldscher, & E. K. Shin (Eds.), Rehabilitation of the Hand and Upper Extremity (7th ed., pp. 133–141). Elsevier Health Sciences.
4. Bassini, L., Patel, M, & Cooper, C. (2007). Pediatric hand therapy. In Fundamentals of hand therapy: Clinical reasoning and treatment guidelines for common diagnoses of the upper extremity (pp. 483-522). Elsevier Health Sciences.
5. Bastian, A. J. (2008). Understanding sensorimotor adaptation and learning for rehabilitation. Current Opinion in Neurology, 21(6), 628-633. https://doi.org/10.1097/WCO.0b013e328315a293
6. Boggio, P. S., Castro, L. O., Savagim, E. A., Braite, R., Cruz, V. C., Rocha, R. R., et al. (2006). Enhancement of non-dominant hand motor function by anodal transcranial direct current stimulation. Neuroscience Letters, 404(1-2), 232-236. https://doi.org/10.1016/j.neulet.2006.05.051
7. Braun, D. A., Aertsen, A., Wolpert, D. M., & Mehring, C. (2009). Motor task variation induces structural learning. Current Biology, 19(4), 352-357. https://doi.org/10.1016/j.cub.2009.01.036
8. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates. https://doi.org/10.4324/9780203771587

9. Emük, Y., Kahraman, T., & Şengül, Y. (2022). Sağlıklı bireylerde cinsiyetler arasında üst ekstremite fonksiyonelliği açısından fark var mıdır? Izmir Democracy University Health Sciences Journal, 5(2), 391–401. https://doi.org/10.52538/iduhes.1116834
10. Flanagan, J. R., Nakano, E., Imamizu, H., Osu, R., Yoshioka, T., & Kawato, M. (1999). Composition and decomposition of internal models in motor learning under altered kinematic and dynamic environments. Journal of Neuroscience, 19(20), RC34.
11. Hackel, M. E., Wolfe, G. A., Bang, S. M., & Canfield, J. S. (1992). Changes in hand function in the aging adult as determined by the Jebsen Test of Hand Function. Physical Therapy, 72(5), 373–377. https://doi.org/10.1093/ptj/72.5.373
12. Hadjiosif, A. M., Morehead, J. R., & Smith, M. A. (2023). A double dissociation between savings and long-term memory in motor learning. PLoS Biology, 21(4), e3001799. https://doi.org/10.1371/journal.pbio.3001799
13. Hummel, F., Celnik, P., Giraux, P., Floel, A., Wu, W. H., Gerloff, C., et al. (2005). Effects of non-invasive cortical stimulation on skilled motor function in chronic stroke. Brain, 128(3), 490–499. https://doi.org/10.1093/brain/awh369
14. Jebsen, R. H. (1969). An objective and standardized test of hand function. Archives of Physical Medicine and Rehabilitation, 50, 311–319.
15. Kantak, S. S., & Winstein, C. J. (2012). Learning–performance distinction and memory processes for motor skills: A focused review and perspective. Behavioral Brain Research, 228(1), 219–231. https://doi.org/10.1016/j.bbr.2011.11.028
16. Karni, A., Meyer, G., Rey-Hipolito, C., Jezzard, P., Adams, M. M., Turner, R., et al. (1998). The acquisition of skilled motor performance: Fast and slow experience-driven changes in primary motor cortex. Proceedings of the National Academy of Sciences, 95(3), 861–868. https://doi.org/10.1073/pnas.95.3.861
17. Kitago, T., & Krakauer, J. W. (2013). Motor learning principles for neurorehabilitation. In Handbook of Clinical Neurology, 110, 93–103. https://doi.org/10.1016/B978-0-444-52901-5.00008-3
18. Krakauer, J. W. (2006). Motor learning: Its relevance to stroke recovery and neurorehabilitation. Current Opinion in Neurology, 19(1), 84–90. https://doi.org/10.1097/01.wco.0000200544.29915.cc
19. Krakauer, J. W. (2009). Motor learning and consolidation: The case of visuomotor rotation. In Advances in Experimental Medicine and Biology, 629, 405–421. https://doi.org/10.1007/978-0-387-77064-2_21
20. Krakauer, J. W., Ghez, C., & Ghilardi, M. F. (2005). Adaptation to visuomotor transformations: Consolidation, interference, and forgetting. Journal of Neuroscience, 25(2), 473–478. https://doi.org/10.1523/JNEUROSCI.4218-04.2005
21. Krakauer, J. W., & Mazzoni, P. (2011). Human sensorimotor learning: Adaptation, skill, and beyond. Current Opinion in Neurobiology, 21(4), 636–644. https://doi.org/10.1016/j.conb.2011.06.012
22. Krakauer, J. W., Pine, Z. M., Ghilardi, M. F., & Ghez, C. (2000). Learning of visuomotor transformations for vectorial planning of reaching trajectories. Journal of Neuroscience, 20(23), 8916–8924. https://doi.org/10.1523/JNEUROSCI.20-23-08916.2000
23. Krebs, H., Hogan, N., Hening, W., Adamovich, S., & Poizner, H. (2001). Procedural motor learning in Parkinson's disease. Experimental Brain Research, 141, 425–437. https://doi.org/10.1007/s002210100871
24. Lee, T. D., & Genovese, E. D. (1988). Distribution of practice in motor skill acquisition: Learning and performance effects reconsidered. Research Quarterly for Exercise and Sport, 59(4), 277–287. https://doi.org/10.1080/02701367.1988.10609373
25. Lee, K. S., & Jung, M. C. (2015). Quantitative comparison of marker attachment methods for hand motion analysis. International Journal of Occupational Safety and Ergonomics, 21(1), 30–38. https://doi.org/10.1080/10803548.2015.1017960
26. Metcalf, C. D., Notley, S. V., Chappell, P. H., Burridge, J. H., & Yule, V. T. (2008). Validation and application of a computational model for wrist and hand movements using surface markers. IEEE Transactions on Biomedical Engineering, 55(3), 1199–1210. https://doi.org/10.1109/TBME.2007.908087
27. Reissner, L., Fischer, G., List, R., Giovanoli, P., & Calcagni, M. (2019). Assessment of hand function during activities of daily living using motion tracking cameras: A systematic review. Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, 233(8), 764–783. https://doi.org/10.1177/095441191985130
28. Schmidt, R. A., Lee, T. D., Winstein, C., Wulf, G., & Zelaznik, H. N. (2018). Evolution of a field of study. In Motor control and learning: A behavioral emphasis (6th ed., pp. 3–21). Human Kinetics.
29. Sears, E. D., & Chung, K. C. (2010). Validity and responsiveness of the Jebsen–Taylor Hand Function Test. Journal of Hand Surgery American Volume, 35(1), 30–37. https://doi.org/10.1016/j.jhsa.2009.09.008
30. Shadmehr, R., & Wise, S. P. (2004). Skills, adaptation, and trajectories. In The computational neurobiology of reaching and pointing: A foundation for motor learning (1st ed., pp. 271–377). MIT Press.
31. Shea, C. H., & Kohl, R. M. (1991). Composition of practice: Influence on the retention of motor skills. Research Quarterly for Exercise and Sport, 62(2), 187–195. https://doi.org/10.1080/02701367.1991.10608709
32. Shishov, N., Melzer, I., & Bar-Haim, S. (2017). Parameters and measures in assessment of motor learning in neurorehabilitation: A systematic review of the literature. Frontiers in Human Neuroscience, 11, 82. https://doi.org/10.3389/fnhum.2017.00082
33. Shmuelof, L., Huang, V. S., Haith, A. M., Delnicki, R. J., Mazzoni, P., & Krakauer, J. W. (2012a). Overcoming motor "forgetting" through reinforcement of learned actions. Journal of Neuroscience, 32(42), 14617–14621. https://doi.org/10.1523/JNEUROSCI.2184-12.2012
34. Shmuelof, L., Krakauer, J. W., & Mazzoni, P. (2012b). How is a motor skill learned? Change and invariance at the levels of task success and trajectory control. Journal of Neurophysiology, 108(2), 578–594. https://doi.org/10.1152/jn.00856.2011
35. Sığırtmaç, İ. C., & Öksüz, Ç. (2021). Investigation of reliability, validity, and cutoff value of the Jebsen-Taylor Hand Function Test. Journal of Hand Therapy, 34(3), 396–403. https://doi.org/10.1016/j.jht.2020.01.004
36. Takla, M. K., Mahmoud, E. A., & El-Latif, N. A. (2018). Jebsen Taylor Hand Function Test: Gender, dominance, and age differences in the healthy Egyptian population. Bulletin of the Faculty of Physical Therapy, 23, 85–93. https://doi.org/10.4103/bfpt.bfpt_11_18
37. Trempe, M., & Proteau, L. (2010). Distinct consolidation outcomes in a visuomotor adaptation task: Off-line learning and persistent after-effect. Brain and Cognition, 73(2), 135–145. https://doi.org/10.1016/j.bandc.2010.04.005
38. Zarahn, E., Weston, G. D., Liang, J., Mazzoni, P., & Krakauer, J. W. (2008). Explaining savings for visuomotor adaptation: Linear time-invariant state-space models are not sufficient. Journal of Neurophysiology, 100(5), 2537–2548. https://doi.org/10.1152/jn.90529.2008