A patient with a new lower-extremity prosthesis is being gait-trained. He walks very slowly, requires upper-extremity support, and cannot hold a conversation during gait training. Which stage of motor learning is he most likely in?

A patient with a new lower-extremity prosthesis is being gait-trained. He walks very slowly, requires upper-extremity support, and cannot hold a conversation during gait training. Which stage of motor learning is he most likely in?

• A. Associative
• B. Cognitive
• C. Autonomous
• D. Novice

Answer: (B)

The main concept tested is the cognitive stage of motor learning. In this stage, the learner uses conscious attention to figure out the new task, relies heavily on guidance and feedback, and shows slow, variable performance as the movement is being formed. With a new lower-extremity prosthesis, the patient must actively plan and coordinate unfamiliar movements, often needing upper-extremity support to maintain balance during gait. This high cognitive load also explains why he cannot hold a conversation during training. With practice, movements become more consistent and efficient, enabling less reliance on external support and the ability to speak during gait, which reflects progression to later stages. The other stages involve progressively automatic control with reduced conscious effort, which isn’t yet evident here. The term novice is sometimes used for early learning, but cognitive stage best fits this description.

The main concept tested is the cognitive stage of motor learning. In this stage, the learner uses conscious attention to figure out the new task, relies heavily on guidance and feedback, and shows slow, variable performance as the movement is being formed. With a new lower-extremity prosthesis, the patient must actively plan and coordinate unfamiliar movements, often needing upper-extremity support to maintain balance during gait. This high cognitive load also explains why he cannot hold a conversation during training. With practice, movements become more consistent and efficient, enabling less reliance on external support and the ability to speak during gait, which reflects progression to later stages. The other stages involve progressively automatic control with reduced conscious effort, which isn’t yet evident here. The term novice is sometimes used for early learning, but cognitive stage best fits this description.