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Updated: Jul 3, 2026
A Structured Rehabilitation Protocol for Improved Multifunctional Prosthetic Control: A Case Study
Published on: November 6, 2015
The role of order of practice in learning to handle an upper-limb prosthesis
Hanneke Bouwsema1, Corry K van der Sluis, Raoul M Bongers
1Center of Human Movement Sciences, University of Groningen, Groningen, The Netherlands. H.Bouwsema@rug.nl
Objective:
To determine which order of presentation of practice tasks had the highest effect on using an upper-limb prosthetic simulator.
Design:
A cohort analytic study.
Setting:
University laboratory.
Participants:
Healthy, able-bodied participants (N=72) randomly assigned to 1 of 8 groups, each composed of 9 men and 9 women.
Interventions:
Participants (n=36) used a myoelectric simulator, and participants (n=36) used a body-powered simulator. On day 1, participants performed 3 tasks in the acquisition phase. On day 2, participants performed a retention test and a transfer test. For each simulator, there were 4 groups of participants: group 1 practiced random and was tested random, group 2 practiced random and was tested blocked, group 3 practiced blocked and was tested random, and group 4 practiced blocked and was tested blocked.
Main Outcome Measures:
Initiation time, the time from the starting signal until the beginning of the movement, and movement time, the time from the beginning until the end of the movement.
Results:
Movement times got faster during acquisition (P<.001). The blocked group had faster movement times (P=.009), and learning in this group extended over the complete acquisition phase (P<.001). However, this advantage disappeared in the retention and transfer tests. Compared with a myoelectric simulator, movements with the body-powered simulator were faster in acquisition (P=.004) and transfer test (P=.034).
Conclusions:
Performance in daily life with a prosthesis is indifferent to the structure in which the training is set up. However, practicing in a blocked fashion leads to faster performance; in novice trainees, it might be suggested to practice part of the training tasks in blocks.
