Abstract
Objective
To identify whether motor skill-based training improves wheeling biomechanics in older
adults and whether transfer or retention occurs.
Design
Randomized controlled trial.
Setting
Human mobility laboratory.
Participants
Able-bodied older adults 50 years and older deemed ready to participate in physical
activity (N=34).
Intervention
Participants were randomized to 1 of 3 groups: experimental group with 6 motor skill-based
training sessions, active control group with dose-matched uninstructed practice, and
the inactive control group (no training or practice).
The experimental group's training sessions consisted of two 5-minute blocks of wheelchair
propulsion training, separated by a 5-minute break, for a total of 60 minutes of wheeling.
Breaks included education and discussion related to wheelchair propulsion. Training
focused on increasing push angle, decreasing push frequency, decreasing negative braking
forces, and using a circular wheeling pattern with smooth pushes.
Main Outcome Measures
Temporal spatial and kinetic variables (ie, push angle, push frequency, total and
tangential forces, negative force) were evaluated during steady-state wheeling and
biomechanical variables were assessed with the SmartWheel Clinical Protocol to identify
transfer.
Results
The training group significantly increased push angle and decreased push frequency
compared with the practice (P<.05) and control groups (P<.05), which were retained over time and transferred to overground wheeling on tile
(P≤.05). The dose-matched practice group did not differ from the inactive control group
for any variables (P>.05).
Conclusions
Older adults improve select biomechanical variables following motor skill-based training,
which are retained over time and transfer to overground wheeling. Participants in
the active control group did not improve with uninstructed practice compared with
the inactive control group.
List of abbreviations:
BMI (body mass index), GLMM (generalized linear mixed-effects model), MWU (manual wheelchair user), RCT (randomized controlled trial)Keywords
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Article info
Publication history
Published online: September 04, 2019
Footnotes
Supported by participant honorariums from an International Collaboration on Repair Discoveries Seed Grant.
Clinical Trial Registration No.: NCT02123043.
Identification
Copyright
© 2019 by the American Congress of Rehabilitation Medicine
