Abstract
IntroductionEvidence about contextual interference in children with brain lesions when practising motor tasks is lacking. Our main objective was to evaluate the feasibility of a randomised controlled trial (RCT) comparing blocked with random practice order of an upper limb robotic exergame to improve reaching in children with neuromotor disorders with a pilot trial.MethodsWe recruited children with brain lesions and impaired upper limb functions who underwent a 3-week schedule that consisted of baseline assessments, intervention period (participants were randomised to a blocked or random order group), and follow-up assessment. We evaluated ten feasibility criteria, including the practicability of the inclusion/exclusion criteria, recruitment rate, feasibility of randomisation, scheduling procedure, and the participants’ programme adherence.ResultsThe inclusion/exclusion criteria were not completely feasible as patients who were not able to perform the exergames were included. Twelve participants were recruited, and six datasets were used for analysis. The scheduling and randomisation procedures were generally feasible, but the procedure was only partially feasible for the participants, as some sessions were aborted due to lack of motivation and fatigue.ConclusionAn RCT following this study protocol is not feasible. We formulated suggestions for future studies that aim to investigate contextual interference as in this pilot study.Trial registrationClinicalTrials.gov Identifier: NCT02443857, registered on May 14, 2015
Highlights
Evidence about contextual interference in children with brain lesions when practising motor tasks is lacking
Our main objective was to evaluate the feasibility of a randomised controlled intervention trial assessing the contextual interference effect by comparing blocked with random order practice of an exergame played with a robotic upper-limb exoskeleton device to improve reaching movements in children with neuromotor disorders. We designed this randomised controlled pilot study with two intervention arms in line with the Consolidated Standards of Reporting Trials (CONSORT) statement extension for randomised pilot and feasibility trials [20], the recommendations about conducting a pilot study provided by Thabane et al 2010, and the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) [21]
Based on notes from the lab journal, we evaluated the number of aborted sessions and complete terminations due to the overload of the participants
Summary
Evidence about contextual interference in children with brain lesions when practising motor tasks is lacking. It is important for successful neurorehabilitation that a practised motor skill can be maintained over time and generalised to another setting or situation. Motor learning requires practice, consisting of a high number of repetitions but not of the exact same movement [3], as practice should include some variability (‘repetition without repetition’ [4]). ‘repetition without repetition’ is not repeating the solution for a specific motor problem but repeating the process of solving the problem by improving it with every trial [4]. Performing a large number of repetitions can be tedious, especially for children. Another reason for implementing variable practice is to influence the motivation needed to perform so many repetitions constantly in a positive way
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