Inter-individual differences in the initial 80 minutes of motor learning of handrim wheelchair propulsion.

Handrim wheelchair propulsion is a cyclic skill that needs to be learned during rehabilitation. Yet it is unclear how inter-individual differences in motor learning impact wheelchair propulsion practice. Therefore we studied how early-identified motor learning styles in novice able-bodied participants impact the outcome of a low-intensity wheelchair-practice intervention. Over a 12-minute pre-test, 39 participants were split in two groups based on a relative 10% increase in mechanical efficiency. Following the pretest the participants continued one of four different low-intensity wheelchair practice interventions, yet all performed in the same trial-setup with a total 80-minute dose at 1.11 m/s at 0.20 W/kg. Instead of focusing on the effect of the different interventions, we focused on differences in motor learning between participants over the intervention. Twenty-six participants started the pretest with a lower mechanical efficiency and a less optimal propulsion technique, but showed a fast improvement during the first 12 minutes and this effect continued over the 80 minutes of practice. Eventually these initially fast improvers benefitted more from the given practice indicated by a better propulsion technique (like reduced frequency and increased stroke angle) and a higher mechanical efficiency. The initially fast improvers also had a higher intra-individual variability in the pre and posttest, which possibly relates to the increased motor learning of the initially fast improvers. Further exploration of the common characteristics of different types of learners will help to better tailor rehabilitation to the needs of wheelchair-dependent persons and improve our understanding of cyclic motor learning processes.