The development of more effective rehabilitative interventions requires a better understanding of how humans learn and transfer motor skills in real-world contexts. Presently, clinicians design interventions to promote skill learning by relying on evidence from experimental paradigms involving simple tasks, such as reaching for a target. While these tasks facilitate stringent hypothesis testing in laboratory settings, the results may not shed light on performance of more complex real-world skills. In this perspective, we argue that virtual environments (VEs) are flexible, novel platforms to evaluate learning and transfer of complex skills without sacrificing experimental control. Specifically, VEs use models of real-life tasks that afford controlled experimental manipulations to measure and guide behavior with a precision that exceeds the capabilities of physical environments. This paper reviews recent insights from VE paradigms on motor learning into two pressing challenges in rehabilitation research: 1) Which training strategies in VEs promote complex skill learning? and 2) How can transfer of learning from virtual to real environments be enhanced? Defining complex skills by having nested redundancies, we outline findings on the role of movement variability in complex skill acquisition and discuss how VEs can provide novel forms of guidance to enhance learning. We review the evidence for skill transfer from virtual to real environments in typically developing and neurologically-impaired populations with a view to understanding how differences in sensory-motor information may influence learning strategies. We provide actionable suggestions for practicing clinicians and outline broad areas where more research is required. Finally, we conclude that VEs present distinctive experimental platforms to understand complex skill learning that should enable transfer from therapeutic practice to the real world.

中文翻译：

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虚拟现实中复杂运动技能的学习和传递：透视回顾。

发展更有效的康复干预措施需要对人类如何在现实环境中学习和转移运动技能有更好的了解。当前，临床医生设计干预措施以依靠涉及简单任务（例如达到目标）的实验范式的证据来促进技能学习。尽管这些任务有助于在实验室环境中进行严格的假设检验，但结果可能无法说明更复杂的现实世界技能的表现。从这个角度来看，我们认为虚拟环境（VE）是灵活，新颖的平台，可以在不牺牲实验控制的情况下评估复杂技能的学习和转移。具体来说，VE使用现实生活中的任务模型，这些模型提供受控的实验操作，以超过物理环境能力的精度来测量和指导行为。本文从VE范式对运动学习的最新见解中回顾了康复研究中的两个紧迫挑战：1）VE中的哪些培训策略促进了复杂技能的学习？和2）如何增强从虚拟环境到真实环境的学习转移？通过嵌套冗余来定义复杂技能，我们概述了运动变异性在复杂技能获取中的作用的发现，并讨论了VE如何提供新颖形式的指导以增强学习。我们回顾了在典型的发展中和神经功能受损的人群中从虚拟环境向真实环境转移技能的证据，以了解感觉运动信息的差异如何影响学习策略。我们为临床医生提供可行的建议，并概述了需要更多研究的广泛领域。最后，我们得出结论，虚拟现实提出了独特的实验平台，以了解复杂的技能学习，使从治疗实践向现实世界的转移成为可能。