Effect of Blocked Versus Random Practice on Physical Therapy Students’ Manual Force Modulation

This study examined (a) the effect of practice organization on learning to modulate manual force, and (b) the effect of force magnitude on ability to accurately reproduce force. I randomly assigned 52 novice physical therapy students to either blocked or random practice schedules as they learned to apply different manual forces. I tested students immediately after training and one week later, using a three-way mixed design analysis of variance to assess the effects of practice organization (random vs. blocked), test (immediate posttest vs. retention test), and force (high vs. low) on ability to modulate manual forces. I found that blocked versus random practice, led to more accurate force application at the posttest and retention test, F(1, 50) = 5.57, p < .05; both practice groups performed more accurately at the posttest than at the retention test, F(1, 50) = 5.6, p < .05, and both performed more accurately at the lower, compared with the higher, force level, F(1, 50) = 60.9, p < .05. These findings support use of a blocked' practice schedule for this motor training, though relevant contextual interference moderators may include such variables as nature of the task, learners’ skill levels, and practice time. In addition, higher forces resulted in greater errors and must be considered in preparing for and engaging in clinical practice.

Força de preensão palmar em idosos: uma revisão integrativa

Aims: The aim this study is was to review in the literature studies on the handgrip strength analysis in the elderly. Source of data: Were selected manually manuscripts in the Portuguese and English languages indexed in the electronic databases SciELO, Lilacs and MEDLINE starting from the primary descriptor “Força da mão” (“Hand Strength”) in crossroads with the secondary descriptors “Idoso” (“Aged”) and “Envelhecimento” (“Aging”), all according to the Descriptors of Health Sciences. Summary of findings: We included studies, with samples composed of elderly submitted to the hand strength test, by means of manual dynamometry. Was found 4155 articles in the search. Of these, 65 articles were read carefully and 08 were included in the present review. Conclusions: In short, older men have a higher palmar grip strength compared to women. Furthermore, risk factors such as osteoporosis, pain and malnutrition may influence in handgrip strength and general muscular strength of the elderly, and regular physical exercises may increase or prevent loss of manual force.

Forces Applied During Manual Assessments of Low Back Pain Patients

Doctors of chiropractic (DCs) use manual palpation to subjectively assess the relative “stiffness” (resistance) of spinal articulations to help inform decisions regarding where to focus treatment. The objective of this study was to quantify the forces generated by DCs when assessing patients with low back pain (LBP). This is an observational study nested into a three-arm randomized clinical trial evaluating two forms of chiropractic treatment and one sham control. LBP patients of both genders between 21–65 years of age participated in the study. Measurements were collected with the participants lying prone on an examination table embedded with force plates. Three DCs applied manual force downward on the participants to obtain a sense of relative joint resistance over vertebral segments L1-L5, the superior sacrum, and bilateral sacroiliac (SI) joints. Peak forces generated during the manual assessments were extracted using custom-written, semi-automated, MathCad software. The results were descriptively analyzed using SPSS statistical software. Three clinicians manually assessed spinal resistance during 230 observations. Mean peak force ranged from 128–178N. Higher force levels were observed at lower vertebral levels and the pelvis by two of the clinicians. L3 and L4 spinal levels showed the greatest similarity of force applied by 3 DCs.

The Ineffective Role of Cathodal tDCS in Enhancing the Functional Motor Outcomes in Early Phase of Stroke Rehabilitation: An Experimental Trial

Transcranial direct current stimulation (tDCS) is a noninvasive technique that could improve the rehabilitation outcomes in stroke, eliciting neuroplastic mechanisms. At the same time conflicting results have been reported in subacute phase of stroke, when neuroplasticity is crucial. The aim of this double-blind, randomized, and sham-controlled study was to determine whether a treatment with cathodal tDCS before the rehabilitative training might augment the final outcomes (upper limb function, hand dexterity and manual force, locomotion, and activities of daily living) in respect of a traditional rehabilitation for a sample of patients affected by ischemic stroke in the subacute phase. An experimental group (cathodal tDCS plus rehabilitation) and a control group (sham tDCS plus rehabilitation) were assessed at the beginning of the protocol, after 10 days of stimulation, after 30 days from ending of stimulation, and at the end of inpatient rehabilitation. Both groups showed significant improvements for all the assessed domains during the rehabilitation, except for the manual force, while no significant differences were demonstrated between groups. These results seem to indicate that the cathodal tDCS, provided in an early phase of stroke, does not lead to a functional improvement. To depict a more comprehensive scenario, further studies are needed.

Frequency and precision of feedback and the adaptive process of learning a dual motor task

This work investigated the effects of frequency and precision of feedback on the learning of a dual-motor task. One hundred and twenty adults were randomly assigned to six groups of different knowledge of results (KR), frequency (100%, 66% or 33%) and precision (specific or general) levels. In the stabilization phase, participants performed the dual task (combination of linear positioning and manual force control) with the provision of KR. Ten non-KR adaptation trials were performed for the same task, but with the introduction of an electromagnetic opposite traction force. The analysis showed a significant main effect for frequency of KR. The participants who received KR in 66% of the stabilization trials showed superior adaptation performance than those who received 100% or 33%. This finding reinforces that there is an optimal level of information, neither too high nor too low, for motor learning to be effective.