Show me the money: motor learning

Can cold hard cash deliver improved upper-limb performance? Billy Mann didn't wait around to find out. He was too eager to bank the profits 

I recently took part in a research project at the National Hospital for Neurology and Neurosurgery in Queen Square, London, which aimed to test and record motor learning skills. The test used a specially constructed mechanical arm, which is operated by the test subject to different specifications and under different constraints. 

Very simply, my stroke-affected left arm is placed in a moving mechanical arm beneath table-top screen at the centre of which is located a cursor. At given intervals a square appears randomly on the table-top screen into which I was required to move the cursor as quickly as possible. This is measured by the researcher as data and analysed in some way. To mix it up a bit, a spring resistance is added to the mechanical arm to alter the difficulty of the task. So, if the target square appears randomly in the 10 o'clock position, my attempt to move the cursor to that target is thwarted, as if somebody is pushing my arm in the opposite direction. 

To mix it up further, in one test, each successful meeting of cursor and target is rewarded with a point. And each point is rewarded with a monetary value that I struggled to determine. I scored enough points to pocket £31.60.

Search for the hero: goal setting

Motivation – where does it come from? By Billy Mann

I occasionally ask myself to what extent the small and slow improvements I make in my post-stroke rehabilitation can be attributed to the fantastic work of the therapists I have been lucky enough to work with, and to what degree are they attributable to my own determination and focus along with my personality. The short answer is probably both, in roughly equal measure. The long answer is that I am the hero really, the star striker, and all the health professionals, family, friends, colleagues and people who have input into my life in a positive way since my stroke are the rest of a very successful team.

Back of the net: goal setting

Can football help in post-stroke recovery? with Kevin Keegan and Kenny Dalglish on your side, anything is possible, reckons Billy Mann

In April I took part in a conference on post-stroke goal setting at the National Hospital for Neurology and Neurosurgery in Queen Square in London in which I was interviewed by Homerton Hospital physiotherapist Katie Campion. She was presenting on behalf of Bridges Self Management, whose stated aim is to "enable people living with long-term neurological conditions to take control of their rehabilitation and daily lives”. 

During the interview I alluded to ‘goal’ scoring, as in a football match, and spoke of my childhood memories of watching my heroes Kevin Keegan and Kenny Dalglish in action. The goal was, I said, the thing we remember most about the game, the ball struck by a player hitting the back of the net. Then the crowd goes mental. Nobody remembers the goal nearly scored. But, I said, a great goal is often the product of a series of “baby steps”, a collection of passes, tackles and other tactical movements that culminate in a star player making the final strike and basking in the glory of the goal scored. These steps, I argued, are as, if not more significant than the ultimate goal, and the importance of successful passes, shots on target and tackles completed are now being measured by sports statisticians. Players are now ranked not just for the number of goals they score but also for the "goal assists" they provide. 

This gave me a neat way of describing the small hills and big mountains scaled during post-stroke recovery. But that would be taking the mixed metaphor to new extremes.