Rethinking physical and rehabilitation medicine - New technologies induce new learning strategies

Title Page

Copyright Page

Members of the European Academy of Rehabilitation Medicine

CONTRIBUTORS

Table of Contents

EXECUTIVE SUMMARY

FOREWORD

PART I LEARNING AND EDUCATION INTO REHABILITATION STRATEGY

Learning and teaching: two processes to bear in mind when rethinking physical medicine and rehabilitation

Rehabilitation, a clear objective

Learning and teaching: the two pillars of PRM strategy

The overwhelming power of normality and standards

The weight of empiricism and dogma

The weight of habit and received wisdom

Learning and teaching, toward new paradigms

Learning and teaching without going overboard

Conclusion

References

The International Classification of Functioning, Disability and Health (ICF), a unifying model for physical and rehabilitation medicine (PRM)

Introduction

The ICF

The ICF in the Perspective of the WHO and the UN System

Development of the ICF

The Structure of the ICF

Validity of the ICF

ICF-based classification and measurement

ICF categories: building blocks and reference units

ICF-based practical tools: ICF Checklist and ICF Core Sets

ICF Checklist

ICF Core Sets

Mapping the world of measures to the ICF and vice versa

ICF-based measurement of functioning

Measuring a single ICF category

Measuring across ICF categories

The ICF, a unifying model for PRM

ICF-based conceptualization of the public health strategy rehabilitation and the medical specialty (PRM)

ICF-based organization of “human functioning and rehabilitation research”

Developing PRM in the context of “human functioning and rehabilitation”

The ICF in rehabilitation management

Assessment

Assignment and intervention

Evaluation

Conclusion

References

Rehabilitation and norms

Meanings of the word “normal”

The “abnormal other”: a long history of discrimination

PRM: an alternate construction of the normal-abnormal contrast

The social model of disability: how the issue of normality shifted from the individual to the environment

Is it possible to reconcile medical practice and the socialmodel of disability?

Conclusion

References

PART II MPLICIT LEARNING: A BASIC LEARNING PROCESS

A historical perspective on learning: the legacy and actuality of I. M. Pavlov and N. A. Bernstein

Introduction

Biographies and historical context of the controversy between Pavlov and Bernstein

Biography of Ivan Petrovich Pavlov

Conditioned reflexes and Pavlov’s theory

Biography of Nicolaï Alexandrovitch Bernstein

The psychology of activity

Goal-directed activity and levels of description

A developmental approach

Interaction, mediation, internalization

The Bernstein-Pavlov controversy

Legacy

Pavlov and Behaviorism

Expansion of behaviorism in the United States

Hebb and adaptation in formal neural networks

Hebbian learning and cerebellar physiology

Bernstein and Russian Cybernetics

Presence and impact on motor control and sensorimotor learning today

Motor control: problems to solve in the control of movement

Acquisition of internal models and programs: role of reinforcement learning

Schmidt and generalized motor programs

Brain control of movement

Adaptive motor learning and internal models in the cerebellum

A dynamical view on motor control in Bernstein’s tradition

Synergies and the use of variability

Mass-spring models and equilibrium point control

Dynamical systems for learning and development

Conclusion

References

Introducing implicit learning: from the laboratory to the real life

Introduction

What are the characteristics of implicit learning?

In which situation do humans learn implicitly?

Implicit learning in the laboratory

Learning contemporary musical grammar: an example of real life implicit learning

What is the nature of the knowledge acquired through implicit learning?

Conclusion

References

Implicit learning, development, and education

Introduction

Implicit learning processes in development

Implicit learning processes in infancy, childhood, and aging

Implicit learning processes and pathology

The question of IQ independency

The question of resistance to neurological or psychological damages

Implicit learning processes and education or reeducation

Implicit learning processes outside of laboratory

A rationale for building implicit learning situations

Conclusion

References

Implicit learning and implicit memory in moderate to severe memory disorders

Introduction

Implicit learning and implicit memory in pathological conditions

Amnesia

Alzheimer’s disease

Implications for rehabilitation

Implicit memory

Learning statistical regularities

Conclusion

References

Learning processes and recovery of higher functions after brain damage

What are the principles of training in neuropsychology?

What are the theoretical bases of training in neuropsychology?

Training by the strategy of restoration of the function in deficit

Training by the strategy of reorganization

Pragmatic or “ecological” training

What are the neuropsychophysiological bases of training in neuropsychology?

Learning processes and reeducation of language disorders: development of ideas

Reconciliation of training techniques in aphasia

The pragmatic approach and the psychosocial approach

Learning processes and reeducation of perceptual gnostic disorders

Learning processes and memory disorders

Strategies of recovery

Strategies using preserved memory capacities (57)

Is training for the acquisition of complex knowledge possible?

Learning processes and executive function disorders

Do possibilities exist for training in dementias of the Alzheimer type?

Conclusion

References

PART III LEARNING, MEDICAL TRAINING, AND REHABILITATION PRACTICE

Benefits of learning technologies in medical training, from full-scale simulators to virtual reality and multimedia presentations

Introduction

Learning complex emergency procedures with a full-scale patient simulator during student medical training

An experimental study with experts and novices

Conclusion, future direction, and recommendations in full-scale simulator

From a full-scale mannequin-based simulator to computer screen-based microworld simulators in medical training

Limits of full-scale mannequin-based simulators

Potential benefits of microworld simulators

Virtual reality, haptic, and depth perception properties

Examples in medical training

Some “difficult” limiting questions

Spatial cognition and medical activities

Multimedia learning, animated pictures, 2-D, and 3-D

Animations versus static pictures to learn dynamic processes

Interactivity and user control upon the speed of the process principle

Cueing principle

Segmentation principle

Conclusion

References

Auditory training in deaf children

Introduction

Auditory education in deaf children: principles and traditional practice

Our experiment

Conclusion

References

Virtual reality for learning and rehabilitation

Introduction

Fundamental VR basic issues

Some VR tools

Computer basis of a virtual system

Visual sensory interfaces

Other sensory interfaces

Motor interfaces

Software tools

VR applications in cognitive learning for rehabilitation

VR applications in functional evaluation and training

VR applications in motor learning for rehabilitation

VR assets for learning and rehabilitation

Limitations

Conclusion

References

Augmented feedback, virtual reality and robotics for designing new rehabilitation methods

Introduction

Motor learning in patients with cerebral lesions

Augmented feedback for rehabilitation

Rehabilitation

Task-oriented rehabilitation

Task-oriented rehabilitation at the impairment level

Rationale

Studies using visual feedback

Studies using auditory feedback

Activity workbenches and augmented feedback

Real objects

Computer games and instrumented joysticks

Combining AF with robotics

Robotics and mechanical support of the upper limbs

Rehabilitation of hand function

VR and haptic technology

VR and assisted gait training

Use of augmented feedback to modify action-perception coupling

Visual-proprioception conflict and error management

Optic flow

Training regimens

Motor imagery and movement observation

Conclusion

References