Effect Of Variable Practice On The Motor Learning Process In Manual Wheelchair Propulsion



Handrim wheelchair propulsion is a cyclic skill that needs to be learned during rehabilitation. It has been suggested that a higher intra-individual variability benefits the motor learning process of wheelchair propulsion. PURPOSE: The goal of the current study was to determine the effect of variable practice, in the form of wheelchair basketball and skills training, on the motor learning process of wheelchair propulsion in novice able-bodied participants. Motor learning was operationalized as improvements in mechanical efficiency (ratio of power output and energy expenditure) and propulsion technique. METHODS: 11 Participants performed a pre-test, 7 practice sessions and a post-test. During the practice sessions, participants performed one-hour of variable practice, consisting of five wheelchair-skill tests and a 30 min wheelchair basketball game. Pre- and post-test were performed in a wheelchair on a motor-driven treadmill (1.11 m/s) at a relative power output of 0.23 W/kg. Energy consumption and the propulsion technique variables were calculated. RESULTS: Comparison of the pre- and the post-test showed that variable practice resulted in a 27% relative increase in mechanical efficiency (4.5 ± 0.6 vs. 5.7 ± 0.7%, p<0.001). With regard to propulsion technique, the push frequency reduced (65.4 ± 12.3 vs. 57.8 ± 8.6 pushes/min, p=0.011), the contact angle of the hand with the handrim increased (67.0 ± 8.6 vs. 77.6 ± 9.1°, <0.001) and the braking torque at (de)coupling reduced (-1.1 ± 0.8 vs. -0.5 ± 0.4 Nm, <0.001). No significant changes were found for the positive work (9.0 ± 1.8 vs. 9.7 ± 1.8 J, p=0.369) and peak torque per push (12.5 ± 2.2 vs. 11.6 ± 1.9 Nm, p=0.084) CONCLUSION: The present study showed that variable practice results in an increase in mechanical efficiency and an improvement in propulsion technique. Interestingly the large relative improvement in mechanical efficiency was concomitant with only moderate improvements in the propulsion technique, suggesting that other factors besides propulsion technique contributed to the higher efficiency. It may be that variable practice facilitated the exploitation of the dynamics of the task and improved coordination, which may have contributed to a less straining propulsion
Originele taal-2English
Pagina's (van-tot)402
Nummer van het tijdschrift5 Supplement 1
StatusPublished - jun-2016

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