Effects of Practice Conditions in Improving Motor Performance in Neurorehabilitation: A Narrative Review

Learning motor skills is an important aspect of life that requires practice to obtain an optimal level of performance. Structured practice leads to improvement in function, quality of skill performed, and response timing, which in turn results in neuroplastic changes in the brain. In whole or part, the practice can be varied in order (blocked or random) and in scheduling (massed or distributed). Application of these principles of motor learning to the learning of new skills may enhance performance. Hence, the present review was conducted to observe the effects of various practice conditions in motor rehabilitation. We used a comprehensive systematic search of 5 databases (PubMed, CINHAL, Scopus, Cochrane, Clinical Key) using predefined MeSH terms. Randomized controlled trials comparing the effects of different practice conditions published between 2003 and 2018 were considered. We independently examined titles and abstracts based on inclusion criteria and selected 9 for data synthesis. The studies compared the effects of random and blocked and massed and distributed practice conditions on continuous and discrete skills among healthy, stroke, and Parkinson’s disease populations. They reported that blocked practice improved continuous tasks in the acquisition phase and random practice improved performance in retention tests. Massed practice and distributed practice had similar effects on learning and performance in most of the studies, but distributed practice had the added effect of reduced participant fatigue. Evidence gained from the present review suggests that varying practice conditions produce high-performance gains through the application of motor learning principles.