Week 1 Y. Wooten EBP Article

Demery,J.,Giuffridaic,C., Haron, R., Lebowitts, B.,Reyes,L. (2009). Functional skill learning in men with traumatic brain injury. American Journal of Occupational Therapy, 63, 398-407.

       This article describes a study conducted to investigate the effects of different practice schedule on functional skill learning for men with TBI.  It is known that TBI is one of the leading causes of disability among adults and that it often adversely effects a person’s ability to perform functional task such as personal care.  Occupational therapists over the years have shown that teaching functional skills has a greater impact in the rehabilitation of TBI patients than therapeutic exercises.  Past research on non-brain injury patients have shown that random ordered practice schedule ( high contextual interference) greatly improves functional skill learning with retention and transfer of learning. This study aims to see if such practice condition could be appropriate neurologically impaired patients.

       In this study 6 men with at least 7 years post TBI were assign into one of two groups: blocked ordered practice and random ordered practice schedule.  Blocked ordered practice is a low contextual inference where skills are learned through repetition in the same way each time whereas random ordered practice involves repetition in multiple contexts (the same concept taught in more than one context.)  Patients were treated for 50 minutes a day for 13 consecutive days. Both groups completes the same 3 task: touch typing, using adding machine, and identifying subway stops. Patients were evaluated at the end of 13 days and again 2 weeks later to measure retention and carryover.  This study found that both groups made significant gains in functional skill level and retention from baseline.  However it was found that only the random ordered group was able to transfer skill learning to other task.

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