Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver; International Collaboration on Repair Discoveries (ICORD), Vancouver.
International Collaboration on Repair Discoveries (ICORD), Vancouver; Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver.
Arch Phys Med Rehabil. 2020 Jan;101(1):1-10. doi: 10.1016/j.apmr.2019.07.017. Epub 2019 Sep 4.
To identify whether motor skill-based training improves wheeling biomechanics in older adults and whether transfer or retention occurs.
Randomized controlled trial.
Human mobility laboratory.
Able-bodied older adults 50 years and older deemed ready to participate in physical activity (N=34).
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.
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.
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).
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.
确定基于运动技能的训练是否能改善老年人的轮椅运动生物力学，以及是否存在转移或保持。
随机对照试验。
人体运动实验室。
身体健全的老年人，年龄在 50 岁及以上，被认为已经准备好参加体育活动（N=34）。
参与者随机分为 3 组之一：进行 6 次基于运动技能的训练的实验组、剂量匹配的无指导练习的主动对照组和无训练或练习的 inactive 对照组。实验组的训练课程包括两次 5 分钟的轮椅推进训练，中间休息 5 分钟，总共进行 60 分钟的轮椅运动。休息时间包括与轮椅推进相关的教育和讨论。训练重点是增加推角、降低推频、降低负制动力量，并使用圆形推轮模式进行平滑推动。
在稳态轮椅运动期间评估时空和动力学变量（即推角、推频、总力和切向力、负力），并使用 SmartWheel 临床方案评估生物力学变量以确定转移。
与练习组（P<.05）和对照组（P<.05）相比，训练组的推角明显增加，推频明显降低，随着时间的推移得到保持，并转移到瓷砖上的地面轮椅运动（P≤.05）。剂量匹配的练习组与 inactive 对照组在任何变量上都没有差异（P>.05）。
老年人在基于运动技能的训练后改善了某些生物力学变量，这些变量随着时间的推移得到保持，并转移到地面轮椅运动中。与 inactive 对照组相比，接受无指导练习的主动对照组的参与者没有得到改善。
