The Role of Order of Practice in Learning to Handle an Upper-Limb Prosthesis

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Bouwsema H, van der Sluis CK, Bongers RM. The role of order of practice in learning to handle an upper-limb prosthesis. Objective: To determine which order of presentation of practice tasks had the highest effect on using an upper-limb prosthetic simulator. Design: A cohort analytic study. Setting: University laboratory. Participants: Healthy, able-bodied participants (N=72) randomly assigned to 1 of 8 groups, each composed of 9 men and 9 women. Interventions: Participants (n=36) used a myoelectric simulator, and participants (n=36) used a body-powered simulator. On day 1, participants performed 3 tasks in the acquisition phase. On day 2, participants performed a retention test and a transfer test. For each simulator, there were 4 groups of participants: group 1 practiced random and was tested random, group 2 practiced random and was tested blocked, group 3 practiced blocked and was tested random, and group 4 practiced blocked and was tested blocked. Main Outcome Measures: Initiation time, the time from the starting signal until the beginning of the movement, and movement time, the time from the beginning until the end of the movement. Results: Movement times got faster during acquisition (P<.001). The blocked group had faster movement times (P=.009), and learning in this group extended over the complete acquisition phase (P<.001). However, this advantage disappeared in the retention and transfer tests. Compared with a myoelectric simulator, movements with the body-powered simulator were faster in acquisition (P=.004) and transfer test (P=.034). Conclusions: Performance in daily life with a prosthesis is indifferent to the structure in which the training is set up. However, practicing in a blocked fashion leads to faster performance; in novice trainees, it might be suggested to practice part of the training tasks in blocks. © 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.




Bouwsema, H., van der Sluis, C. K., & Bongers, R. M. (2008). The Role of Order of Practice in Learning to Handle an Upper-Limb Prosthesis. Archives of Physical Medicine and Rehabilitation, 89(9), 1759–1764.

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