Contextual interference in children with brain lesions: protocol of a pilot study investigating blocked vs. random practice order of an upper limb robotic exergame

Abstract

Background If adults practice several motor tasks together, random practice leads to better transfer and retention compared to blocked practice. Knowledge about this contextual interference (CI) effect could be valuable to improve neurorehabilitation of children. We present the protocol of a randomised controlled pilot study investigating the feasibility of blocked practice vs. random practice of robot-assisted upper limb reaching in children with brain lesions undergoing neurorehabilitation. Methods Children with affected upper limb function due to congenital or acquired brain lesions undergoing neurorehabilitation will be recruited for a randomised controlled pilot study with a 3-week procedure. In the control week (1), two assessment blocks (robot-assisted reaching tasks, Melbourne assessment 2, subscale fluency), 2 days apart, take place. In the practice week (2), participants are randomly allocated to blocked practice or random practice and perform 480 reaching and backward movements in the horizontal and vertical plane using exergaming with an exoskeleton robot per day during three consecutive days. Assessments are performed before, directly after and 1 day after the practice sessions. In the follow-up week (3), participants perform the assessments 1 week after the final practice session. The primary outcome is the immediate transfer of the Melbourne Assessment 2, subscale fluency. Secondary outcomes are the immediate retention, 1-day and 1-week delayed transfer and retention and acquisition during the practice sessions. We will evaluate the feasibility of the inclusion criteria, the recruitment rate, the scheduling procedure, the randomisation procedure, the procedure for the participants, the handling of the robot, the handling of the amount of data, the choice of the outcome measures and the influence of other therapies. Furthermore, we will perform a power calculation using the data to estimate the sample size for the main trial. Discussion The protocol of the pilot study is a first step towards a future main randomised controlled trial. This low risk pilot study might induce some benefits for the participants. However, we need to place its results into perspective, especially concerning the generalisability, as it remains questionable whether improving reaching constrained within a robotic device will ameliorate daily life reaching tasks. Trial registration ClinicalTrials.gov Identifier: NCT02443857

The effect of learning methods and motivation on learning outcomes of long jump skills

“…This means that psychological factors (motivation) are low, whatever learning method is given the results will be relatively the same (no difference). Block training materials can perform better than individual random exercises during training (Graser et al, 2020).…”

Exergame en educación: mapeando la investigación

“…Los resultados de las variables analizadas para determinar el contexto del estudio indicaron que la mayoría de los estudios tuvo un objetivo educativo (79,2%) como por ejemplo el estudio de Lau et al (2015) que analizaron los efectos de los exergames en intensidad de actividad física en escolares, frente a una minoría que tuvo un objetivo terapeútico (20,8 %) como los de Carvalho y Freitas (2018) y Graser et al (2020) que estudiaron efectos de los exergames en la rehabilitación de niños con cáncer y lesiones cerebrales respectivamente. Por esta razón, la mayoría de estudios se realizaron en la escuela o instituto (66,7 %) como por ejemplo, los estudios de Andrade et al (2020) o Quintás-Hijós et al (2020 que se realizaron en colegios españoles y brasileños respectivamente.…”