I think that maybe you need to recognize the errors first so you can correct them; so, a third method!
(So you don't believe that errors and error correction are faster ways to learn? See link below.)
Do People With Severe Traumatic Brain Injury Benefit From Making Errors? A Randomized Controlled Trial of Error-Based and Errorless Learning
The relevant line from there:
Conclusion. EBL was found to be more effective than ELL for enhancing skills generalization on a task related to training and improving self-awareness and behavioral competency.
Error augmentation in physical therapy is a
training method that deliberately increases the difficulty of a task by
amplifying a person's natural movement errors to enhance motor learning
and improve performance. Instead
of correcting mistakes, the therapist or system adds resistance, visual
cues, or other challenges to make the movement harder, forcing the
brain and body to adapt and develop more robust motor control. This technique is particularly used in stroke and neurological rehabilitation to help patients overcome motor deficits.
This was already researched in July 2018: Your mentors should have caught that.
The Role of Error Augmentation Versus Error Minimization in Post-Stroke Gait Rehabilitation
Azusa Pacific University
The Role of Error Augmentation Versus Error Minimization in
Post-Stroke Gait Rehabilitation
by
Alyssa Bradley, Isabella Davalos, Elise Garcia, and Megan Goodson
has been approved by the
College of Nursing and Health Sciences
in partial fulfillment of the requirements for the degree Doctor of Physical Therapy
Abstract
Background.
Post-stroke patients often undergo extensive rehabilitation to address neurological
deficits and improve overall function. Gait and reaching (using the paretic side) can be largely
affected. Two common strategies for rehabilitation are error augmentation (EA) and error
minimization (EM). The purpose of the systematic review (SR) was to determine whether EA
strategies are more effective than error minimization strategies in improving the gait of
individuals post-stroke. The purpose of the critically appraised topic (CAT) was to conclude if
EA strategies are more effective than EM strategies in improving upper-extremity reaching with
the involved side of post-stroke individuals.
Methods.
For the SR, four reviewers independently
performed a search across six databases: PubMed, Cochrane Library, Physiotherapy Evidence
Database (PEDro), Cumulative Index to Nursing and Allied Health Literature, MEDLINE, and
Google Scholar in September 2024 and in October 2024. Inclusion criteria were human subjects,
with chronic stroke (>6 months), error augmentation and/or minimization, and gait training.
Publish dates were limited between 2014 and 2024. Exclusion criteria consisted of temporary
ischemic attacks (TIAs), amputations, healthy individuals, and the application of robotics and/or artificial intelligence. For the CAT, four independent reviewers searched the same databases in
November 2024. The search criteria included human subjects with a chronic stroke, EA, EM, and
upper-extremity function. The publication dates were limited between 2014–2024. Robotics were
not excluded from this search. In selecting articles for the SR and CAT, the authors curated a
logic grid relating to their population, intervention, comparison, and outcome (PICO) question.
While performing the search, medical subject headings (MeSH) terms were inputted to each
database. Full texts were screened for relevance, duplicates, and inclusion/exclusion criteria. The
remaining articles were rated and appraised independently using the PEDro and NIH-NHLBI tools to address the risk of bias. Statistics reported for the SR related to lower-extremity gait
6
deficits such as step length symmetry, stance time symmetry, foot trajectory, foot placement,
functional gait assessment, and foot targeting. Statistics reported for the CAT related to upper
extremity reaching trajectory and range of motion.
Results.
The SR showed significant results
with EA in improving gait deficits in five of the six articles reviewed. Statistics from the CAT
showed statistically significant improvements in reaching trajectory through the use of robotics
with EA compared to EM.
Conclusions.
Overall, EA improved lower-extremity gait deficits for
most patients in EA groups compared to control or EM groups. Limitations in methodology,
defining phases of learning, sample sizes, and lack of articles directly comparing EA versus EM
suggest more research is needed for conclusive evidence that supports EA over EM as the better
gait rehabilitation intervention in post-stroke patients. Correspondingly, more articles with
stronger levels of evidence would be beneficial, as only two of the six articles had level I evidence.
Keywords: error augmentation, error minimization, chronic stroke, cerebrovascular
accident, gait symmetry, lower extremity
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