Simulated practice effects on the transfer and retention of gait sequences from the upper to the lower extremity.

This study investigated transfer of training from upper extremity limbs (the index fingers) to the lower extremity limbs (the legs) for performance of three gait sequences of different difficulty. Fifteen subjects participated in the study. Subjects in an iPad training group practiced by sequentially moving their left-and right-hand index fingers across tiles to each of three targets displayed on an iPad for 20 trials. Subjects in a gait training group practiced by sequentially walking across tiles to each of the 3 targets displayed on a screen for 20 trials. A no practice group did not receive practice trials. Immediately following practice of each level of difficulty, a transfer test (20 trials) was given for which subjects walked to the target just practiced. A retention test of 36 trials (12 trials at each difficulty level) was administered 20 min following performance of the last transfer test trial. The retention test showed that reaction times were shorter for the iPad training than gait training and no training groups; anticipatory postural adjustment times were equivalent for the iPad and gait training groups, but shorter than for the no training group; and movement times were shorter for the iPad training group than for the gait training and no training groups. These results suggest that iPad training (upper extremity) followed by performance of gait training (lower extremity) had greater benefits for learning (as measured by the delayed retention test) the gait sequences than practicing the actual gait sequences themselves.