Exploring motor variability in adults with severe athetoid or ataxic cerebral palsy: Impact on error-based and reward-based learning.

Individuals with cerebral palsy (CP) are characterized by elevated movement variability. Movement variability has been proposed as a mechanism that facilitates the exploration of diverse movement strategies. However, in the case of CP, this variability is often excessive, potentially impeding effective error correction and motor learning processes. This study aims to investigate motor variability in adults with severe athetoid and ataxic CP profiles, focusing on its impact on error-based and reward-based learning mechanisms. The study included 13 adults with severe CP and a control group of 18 adults without disabilities. The findings revealed that individuals with CP exhibit significantly greater motor variability than the control group, which correlates with higher absolute error rates and a diminished capacity for task-related adjustments. These results suggest that CP negatively affects motor stability and precision, complicating motor learning. Furthermore, it was observed that error-based tasks are more accessible for individuals with CP, as they showed substantial performance improvements following training, in contrast to the reward-based tasks. This study underscores the importance of personalized motor learning interventions for individuals with CP, considering the variability among CP subtypes and the individual characteristics of each person. The research provides essential insights into motor learning adaptation and retention in individuals with severe CP, highlighting the necessity of continuous practice to sustain long-term improvements.