Marquardt D.1, Jongbloed-Pereboom M.2, Overvelde A.1, Staal B.3, Nijhuis-van der Sanden R.1
1Radboud UMC, IQ Healthcare, Nijmegen, Netherlands, 2Radboud University, Behavioural Science Institute, Nijmegen, Netherlands, 3HAN University of Applied Science Arnhem en Nijmegen, Nijmegen, Netherlands
Background: In pediatric physical therapy practice, it is still not fully understood how motor skill performance increases during practice and if motor learning takes place. To analyze and visualize learning, for example retention tests and learning curves are often used in research. But what about using such learning curves as a tool for monitoring the individual child's performance during intervention by pediatric physical therapists?
Purpose: The purpose of this controlled clinical trial was to explore learning curves in typically developing and a-typically developing children of 5- to 7-year-old and to test if the shape of learning curves was task specific.
Methods: Fifty-eight 5-7 year old children (29 typically developing children (TD) and 29 children with question for help concerning motor performance problems in daily life who attended pediatric physiotherapy (MP)) were allocated at random to a feedback group (n = 15 TD, n = 14 MP) or a control group (n = 15 TD, n = 14 MP). Subgroups did not differ in age or gender. Both groups trained three motor tasks at random in three rounds. One round consisted of: one minute placing pegs, tossing 25 beanbags to an A4 paper at a distance of two meters and 5 long jumps in six practice sessions during 6 weeks at school or in practice under supervision. Outcome measurements were: number of pegs placed in one minute, number of bean bags in the goal and the distance jumped. The feedback-group additionally received augmented feedback presented as the shape of individual learning curves per task which the control-group did not. In both groups possible motor skill deficits were tested by M-ABC-2. Retention effects for each outcome measure for one session to the next and changes in performance for each outcome measure for day one till day six were analyzed using repeated measurements analysis with session as within factor and group as between factor. To analyze the curve shapes, curve estimation procedures were performed.
Results: Results of the M-ABC-2 showed motor skill deficits in the MP but not the TD. The retention test showed significant effects for placing pegs and beanbag tossing but not for long jumping. As an effect of practice, performance increased in all tasks with consistently lower performance in children in the MP compared to the TD. Only for beanbag tossing there was a trend for group (performance was higher in the non-feedback group). Curve fitting showed a quadratic slope for placing pegs and for beanbag tossing and a linear slope for long jumping.
Conclusion(s): As expected due to practice motor learning occurred in all tasks and the learning curves showed to be task specific. Augmented feedback seemed to have no influence on performance in this age group.
Implications: Results point into the direction of the existence of typical task related learning curves. Future research will focus on the possibility to use such curves to test learning processes and capacity in individual children with motor learning problems which could be helpful to determine exercise frequency and ceiling effects as result of capacity problems in children.
Funding acknowledgements: Funding was grated by the The Netherlands Organisation for Scientific Research (NWO) (grand number: 023.003.100)
Topic: Paediatrics
Ethics approval: Central Committee on Research involving Human Subjects of Arnhem-Nijmegen and UMC. St. Radboud (CMO number: 2007/187; ABR number: NL19119.091.07).
All authors, affiliations and abstracts have been published as submitted.
