Learning–performance distinction and memory processes for motor skills: A focused review and perspective

The affective response to positive performance feedback is associated with motor learning

Motor skill learning and performance are improved when successful actions are paired with extrinsic rewards, such as money. Positive feedback indicating successful task performance is thought to induce intrinsic reward associated with goal attainment, evidenced by increases in positive affect that correlate with neural reward signaling. However, it is not clear whether the subjective, internal reward processes elicited by positive feedback promote motor learning and performance.Here, we tested the hypothesis that intrinsic reward elicited by positive feedback promotes motor learning and performance. Participants practiced a visuomotor interception task using a joystick, and received feedback during practice indicating success or failure depending on their accuracy. During practice, the accuracy demands were adapted to control and vary the frequency of positive feedback across randomly ordered blocks of practice at either 50%, 70%, or 90%. Performance was measured for each condition as the average accuracy during practice. Learning was estimated by measuring the accuracy pre and post practice in the absence of feedback. We queried participants periodically on their enjoyment of the task to index affective responses to performance feedback.The intrinsic reward elicited by positive feedback, operationalized by the increase in enjoyment immediately following positive versus negative feedback, was positively correlated with learning from pre to post practice. However, increasing the overall amount of positive feedback by lower accuracy demands did not improve performance. These results suggest that experiencing intrinsic reward due to positive feedback benefits motor learning only when it is contingent on good performance.

Visuospatial Skills Explain Differences in the Ability to Use Propulsion Biofeedback Post-stroke

BACKGROUND AND PURPOSE

Visual biofeedback can be used to help people post-stroke reduce biomechanical gait impairments. Using visual biofeedback engages an explicit, cognitively demanding motor learning process. Participants with better overall cognitive function are better able to use visual biofeedback to promote locomotor learning; however, which specific cognitive domains are responsible for this effect are unknown. We aimed to understand which cognitive domains were associated with performance during acquisition and immediate retention when using visual biofeedback to increase paretic propulsion in individuals post-stroke.

METHODS

Participants post-stroke completed cognitive testing, which provided scores for different cognitive domains, including executive function, immediate memory, visuospatial/constructional skills, language, attention, and delayed memory. Next, participants completed a single session of paretic propulsion biofeedback training, where we collected treadmill-walking data for 20 min with biofeedback and 2 min without biofeedback. We fit separate regression models to determine if cognitive domain scores, motor impairment (measured with the lower-extremity Fugl-Meyer), and gait speed could explain propulsion error and variability during biofeedback use and recall error during immediate retention.

RESULTS

Visuospatial/constructional skills and motor impairment best-explained propulsion error during biofeedback use (adjusted R 2  = 0.56, P = 0.0008), and attention best-explained performance variability (adjusted R 2  = 0.17, P = 0.048). Language skills best-explained recall error during immediate retention (adjusted R 2  = 0.37, P = 0.02).

DISCUSSION AND CONCLUSIONS

These results demonstrate that specific cognitive domain impairments explain variability in locomotor learning outcomes in individuals with chronic stroke. This suggests that with further investigation, specific cognitive impairment information may be useful to predict responsiveness to interventions and personalize training parameters to facilitate locomotor learning.

The Effect of Internal and external imagery on learning badminton long serve skill: The role of visual and audiovisual imagery

This study aimed to examine the impact of internal and external audiovisual imagery on the learning of the badminton long serve skill. A lot of 42 right-handed novice women were selected using availability sampling. Participants were categorized into four groups based on their scores from the visual imagery ability questionnaire and Bucknell auditory questionnaire: Visual-Internal imagery, Visual-External imagery, AudioVisual-Internal imagery and AudioVisual-External imagery groups. To generate an auditory pattern, the shoulder joint's angular velocity of a skilled individual was recorded and translated into sound based on frequency characteristic changes. Subjects underwent four sessions of 40 trials each and subsequently participated in retention and transfer tests. Performance accuracy of the badminton long serve was assessed using the Scott and Fox standard test and repeated measures ANOVA was employed to compare performance across groups during test stages. While no significant differences were noted between groups during the acquisition stages, indicated that subjects in the AudioVisual imagery conditions outperformed those in Visual imagery during the retention test. Additionally, the AudioVisual-Internal Imagery group demonstrated superior performance compared to other groups. Internal imagery groups also exhibited better performance in the later stages of acquisition, retention and transfer tests compared to external imagery groups. These findings suggest that the incorporation of audiovisual imagery utilizing movement sonification, alongside physical practice, improves skill development more effectively than visual imagery alone.

Comparative analysis of motor skill acquisition in a novel bimanual task: the role of mental representation and sensorimotor feedback

Introduction

This study investigates the multifaceted nature of motor learning in a complex bimanual task by examining the interplay between mental representation structures, biomechanics, tactile pressure, and performance. We developed a novel maze game requiring participants to maneuver a rolling sphere through a maze, exemplifying complex sequential coordination of vision and haptic control using both hands. A key component of this study is the introduction of cognitive primitives, fundamental units of cognitive and motor actions that represent specific movement patterns and strategies.

Methods

Participants were divided into two groups based on initial performance: poor performers (PPG) and good performers (GPG). The experimental setup employed motion capture and innovative tactile sensors to capture a detailed multimodal picture of the interaction process. Our primary aims were to (1) assess the effects of daily practice on task performance, biomechanics, and tactile pressure, (2) examine the relationship between changes in mental representation structures and skill performance, and (3) explore the interplay between biomechanics, tactile pressure, and cognitive representation in motor learning.

Results

Performance analysis showed that motor skills improved with practice, with the GPG outperforming the PPG in maze navigation efficiency. Biomechanical analysis revealed that the GPG demonstrated superior movement strategies, as indicated by higher peak velocities and fewer velocity peaks during task execution. Tactile feedback analysis showed that GPG participants applied more precise and focused pressure with their right-hand thumb, suggesting enhanced motor control. Cognitively, both groups refined their mental representation structures over time, but the GPG exhibited a more structured and sophisticated cognitive mapping of the task post-practice.

Discussion

The findings highlight the intertwined nature of biomechanical control, tactile feedback, and cognitive processing in motor skill acquisition. The results support established theories, such as the cognitive action architecture approach, emphasizing the role of mental representation in planning and executing motor actions. The integration of cognitive primitives in our analysis provides a theoretical framework that connects observable behaviors to underlying cognitive strategies, enhancing the understanding of motor learning across various contexts. Our study underscores the necessity of a holistic approach to motor learning research, recognizing the complex interaction between cognitive and motor processes in skill acquisition.

Acute stress does not influence the learning of a precise manual task: A randomized clinical trial

Acute stress is frequent in sports and rehabilitation contexts and can impact cognitive processes essential for motor learning. This study aimed to investigate the influence of induced acute stress on the learning of a precise manual task, examining its effect on five key parameters of fine motor control: trajectory error, trajectory error direction, time error, tracing accuracy, and task accuracy. A double-masked, randomized clinical trial with 62 participants (average age 20.65 ± 2.54 years; 39 females; 23 males) was conducted. To examine the effects of stress, participants were assigned to either a stress or a control group through stratified randomization by sex. Initially, all participants underwent the Maastricht Acute Stress Test (in its acute stress and control versions, respectively). Subsequently, they performed the precise manual task on a graphic tablet at three stages of the learning process: acquisition, short-term retrieval, and long-term retrieval. Electrodermal activity and heart rate variability were recorded to assess stress induction. Data analysis from 30 stress group participants and 25 control group participants revealed no statistically significant differences between groups in any of the variables studied at the three learning stages. Both groups exhibited statistically significant improvements in time error, trajectory error direction, and tracing accuracy during both short-term and long-term retrieval compared to acquisition. Our findings suggest that acute physical and psychological stress does not markedly impair learning a precise manual task of adhering to a specific trajectory and pace among young adults.

Effect of Phasic Experimental Pain Applied during Motor Preparation or Execution on Motor Performance and Adaptation in a Reaching Task: A Randomized Trial

Musculoskeletal conditions often involve pain related to specific movements. However, most studies on the impact of experimental pain on motor performance and learning have used tonic pain models. This study aimed to evaluate the effect of experimental phasic pain during the preparation or execution of a reaching task on the acquisition and retention of sensorimotor adaptation. Participants were divided into three groups: no pain, pain during motor preparation, and pain during motor execution. Pain was induced over the scapula with a laser while participants performed a force field adaptation task over two days. To assess the effect of pain on motor performance, two baseline conditions (with or without pain) involving unperturbed pointing movements were also conducted. The results indicated that the timing of the nociceptive stimulus differently affected baseline movement performance. Pain during motor preparation shortened reaction time, while pain during movement execution decreased task performance. However, when these baseline effects were accounted for, no impact of pain on motor adaptation or retention was observed. All groups showed significant improvements in all motor variables for both adaptation and retention. In conclusion, while acute phasic pain during motor preparation or execution can affect the movement itself, it does not interfere with motor acquisition or retention during a motor adaptation task.

Observe, Practice, and Improve? Enhancing Sidestep Cutting Execution in Talented Female Soccer Players: A Four-Week Intervention Program With Video Instruction

ABSTRACT

Nijmeijer, EM, Kempe, M, Elferink-Gemser, MT, and Benjaminse A. Observe, practice and improve? Enhancing sidestep cutting (SSC) execution in talented female soccer players: A four-week intervention program with video instruction. J Strength Cond Res 38(8): e430-e439, 2024-Implicit learning has the potential to improve movement execution and reduce injury risk. Previous research showed beneficial effects of short-term interventions with implicit learning in male athletes. However, research on long-term interventions in female athletes is lacking. The aim of this study was to examine the effects of a 4-week intervention with video instruction on movement execution of SSC, a task that is highly related with anterior cruciate ligament (ACL) injury risk, in female athletes. Twenty talented adolescent female soccer players were part of the control (CTRL, n = 10) or video instruction (VIDEO, n = 10) group. All subjects practiced 4 weeks and received general task instructions. In addition, the VIDEO group received expert video instruction during practice. Lower extremity kinematics and kinetics and vertical ground reaction force of SSC were examined during baseline, immediate post, and 1-week retention tests. After nonlinear registration, differences between each subject and the expert she had seen were determined. These differences were analyzed with SPM1D 2-way ANOVA. No interaction effects between time and group were found ( p > 0.05). Main effects of time were found in the frontal plane. In particular, smaller deviations of subjects compared with the seen expert of the knee adduction ( p = 0.005, 97.9-100% stance phase [SP]) and hip abduction ( p = 0.005, 11.5-13.8% SP) and adduction ( p < 0.001, 33.4-87.7% SP) moments were found in immediate post compared with baseline. These frontal plane short-term improvements, replicating earlier findings in both sexes, may lower ACL injury risk. The large observed interindividual differences over time may have concealed the long-term effects of video instruction at the group level.

Structural Learning Benefits in a Visuomotor Adaptation Task Generalize to a Contralateral Effector

Structural learning is characterized by facilitated adaptation following training on a set of sensory perturbations all belonging to the same structure (e.g., 'visuomotor rotations'). This generalization of learning is a core feature of the motor system and is often studied in the context of interlimb transfer. However, such transfer has only been demonstrated when participants learn to counter a specific perturbation in the sensory feedback of their movements; we determined whether structural learning in one limb generalized to the contralateral limb. We trained 13 participants to counter random visual feedback rotations between +/-90 degrees with the right hand and subsequently tested the left hand on a fixed rotation. The structural training group showed faster adaptation in the left hand in both feedforward and feedback components of reaching compared to 13 participants who trained with veridical reaching, with lower initial reaching error, and straighter, faster, and smoother movements than in the control group. The transfer was ephemeral - benefits were confined to roughly the first 20 trials. The results demonstrate that the motor system can extract invariant properties of seemingly random environments in one limb, and that this information can be accessed by the contralateral limb.

Online Anticipatory Cues During Practice Disrupt Intentional and Incidental Sequence Learning

In the Serial Reaction Time Task, participants respond to several stimuli usually being unaware that the stimuli follow a predefined sequence while still learning the sequence. In the present study, we aimed to clearly separate explicit intentional learning from implicit incidental learning by either informing participants about all details of the sequence or not informing participants about the existence of the sequence. Further, we explored the influence of anticipatory cues during practice while anticipatory cues were either presented (extrinsically triggered anticipation) or not presented (self-reliant intrinsic anticipation). Participants were tested before and after practice in the Practice Sequence and a Control Sequence. To test automatization, tests were performed in Single-Task and Dual-Task Blocks. Results showed that after learning with explicit instructions, participants memorized the sequence more deeply and executed the sequence faster than after learning without explicit instructions. Further, by learning with anticipatory cues, participants memorized the sequence less deeply and executed the sequence slower than by learning without anticipatory cues. Unexpectedly, automatization was sequence-unspecific and independent of the practice conditions. In conclusion, detailed explicit prior information about the sequence facilitates sequence learning while anticipatory online cues during practice hamper sequence learning.

Motor competence is related to acquisition of error-based but not reinforcement learning in children ages 6 to 12

Background

An essential component of childhood development is increasing motor competence. Poor motor learning is often thought to underlie impaired motor competence, but this link is unclear in previous studies.

Aims

Our aim was to test the relationship between motor competence and motor learning in the acquisition phase. Both reinforcement learning (RL) and error-based learning (EBL) were tested. We hypothesized that slower RL and slower EBL acquisition rates would relate to lower motor competence.

Methods and procedures

Eighty-six participants ages 6-12 performed a target throwing task under RL and EBL conditions. The Movement Assessment Battery for Children - 2nd edition (MABC-2) provided a measure of motor competence. We assessed EBL and RL acquisition rates, baseline variability, and baseline bias from the throwing task.

Outcomes and results

In a multiple linear regression model, baseline variability (β = -0.49, p = <0.001) and the EBL acquisition rate (β = -0.24, p = 0.018) significantly explained the MABC-2 score. Participants with higher baseline variability and slower EBL acquisition had lower motor competence scores. The RL acquisition rate was independent of MABC-2 score suggesting that RL may be less of a contributor to poor motor competence.

Conclusions and implications

Children with slower EBL acquisition had lower motor competence scores but RL acquisition was unrelated to the level of motor competence. Emphasizing the unrelated reinforcement mechanisms over error-based mechanisms during motor skill interventions may help children with poor motor competence better acquire new motor skills.

Haptic Feedback, Performance and Arousal: A Comparison Study in an Immersive VR Motor Skill Training Task

This article investigates the relationship between fine motor skill training in VR, haptic feedback, and physiological arousal. To do so, we present the design and development of a motor skill task (buzzwire), along with a custom vibrotactile feedback attachment for the Geomagic Touch haptic device. A controlled experiment following a between-subjects design was conducted with 73 participants, studying the role of three feedback conditions - visual/kinesthetic, visual/vibrotactile and visual only - on the learning and performance of the considered task and the arousal levels of the participants. Results indicate that performance improved in all three feedback conditions after the considered training session. However, participants reported no change in self-efficacy and in terms of presence and task load (NASA-TLX). All three feedback conditions also showed similar arousal levels. Further analysis revealed that positive changes in performance were linked to higher arousal levels. These results suggest the potential of haptic feedback to affect arousal levels and encourage further research into using this relationship to improve motor skill training in VR.

Dyad motor learning in a wrist-robotic environment: Learning together is better than learning alone

OBJECTIVE

Dyad motor practice is characterized by two learners alternating between physical and observational practice, which can lead to better motor outcomes and reduce practice time compared to physical practice alone. Robot-assisted therapy has become an established neurorehabilitation tool but is limited by high therapy cost and access. Implementing dyad practice in robot-assisted rehabilitation has the potential to improve therapeutic outcomes and/or to achieve them faster. This study aims to determine the effects of dyad practice on motor performance in a wrist-robotic environment to evaluate its potential use in robotic rehabilitation settings.

METHODS

Forty-two healthy participants (18-35 years) were randomized into three groups (n = 14): Dyad practice, physical practice with rest and physical practice without rest. Participants practiced a 2 degree-of-freedom gamified wrist movement task for 20 trials using a custom-made wrist robotic device. A motor performance score (MPS) that captured temporal and spatial time-series kinematics was computed at baseline, the end of training and 24 h later to assess retention.

RESULTS

MPS did not differ between groups at baseline. All groups revealed significant performance gains by the end of training. However, dyads outperformed the other groups at the end of training (p < 0.001) and showed higher retention after 24-h (p = 0.02). Median MPS improved by 46.5% in dyads, 25.3% in physical practice-rest, and 33.6% in physical practice-no rest at the end of training compared to baseline.

CONCLUSION

Compared to physical practice alone, dyad practice leads to superior motor outcomes in a robot-assisted motor learning task. Dyads still outperformed their counterparts 24-h after practice.

IMPACT STATEMENT

Improving motor function in complex motor tasks without increasing required practice time, dyad practice can optimize therapeutic resources. This is particularly impactful in robot-assisted rehabilitation regimens as it would help to improve patients' outcomes and increase care efficiency.

Afferents to Action: Cortical Proprioceptive Processing Assessed with Corticokinematic Coherence Specifically Relates to Gross Motor Skills

Voluntary motor control is thought to be predicated on the ability to efficiently integrate and process somatosensory afferent information. However, current approaches in the field of motor control have not factored in objective markers of how the brain tracks incoming somatosensory information. Here, we asked whether motor performance relates to such markers obtained with an analysis of the coupling between peripheral kinematics and cortical oscillations during continuous movements, best known as corticokinematic coherence (CKC). Motor performance was evaluated by measuring both gross and fine motor skills using the Box and Blocks Test (BBT) and the Purdue Pegboard Test (PPT), respectively, and with a biomechanics measure of coordination. A total of 61 participants completed the BBT, while equipped with electroencephalography and electromyography, and the PPT. We evaluated CKC, from the signals collected during the BBT, as the coherence between movement rhythmicity and brain activity, and coordination as the cross-correlation between muscle activity. CKC at movements' first harmonic was positively associated with BBT scores (r = 0.41, p = 0.001), and alone showed no relationship with PPT scores (r = 0.07, p = 0.60), but in synergy with BBT scores, participants with lower PPT scores had higher CKC than expected based on their BBT score. Coordination was not associated with motor performance or CKC (p > 0.05). These findings demonstrate that cortical somatosensory processing in the form of strengthened brain-peripheral coupling is specifically associated with better gross motor skills and thus may be considered as a valuable addition to classical tests of proprioception acuity.

Pediatric endoscopy: how can we improve patient outcomes and ensure best practices?

INTRODUCTION

Strategies to promote high-quality endoscopy in children require consensus around pediatric-specific quality standards and indicators. Using a rigorous guideline development process, the international Pediatric Endoscopy Quality Improvement Network (PEnQuIN) was developed to support continuous quality improvement efforts within and across pediatric endoscopy services.

AREAS COVERED

This review presents a framework, informed by the PEnQuIN guidelines, for assessing endoscopist competence, granting procedural privileges, audit and feedback, and for skill remediation, when required. As is critical for promoting quality, PEnQuIN indicators can be benchmarked at the individual endoscopist, endoscopy facility, and endoscopy community levels. Furthermore, efforts to incorporate technologies, including electronic medical records and artificial intelligence, into endoscopic quality improvement processes can aid in creation of large-scale networks to facilitate comparison and standardization of quality indicator reporting across sites.

EXPERT OPINION

PEnQuIN quality standards and indicators provide a framework for continuous quality improvement in pediatric endoscopy, benefiting individual endoscopists, endoscopy facilities, and the broader endoscopy community. Routine and reliable measurement of data, facilitated by technology, is required to identify and drive improvements in care. Engaging all stakeholders in endoscopy quality improvement processes is crucial to enhancing patient outcomes and establishing best practices for safe, efficient, and effective pediatric endoscopic care.

Behavioral and physiological fatigue-related factors influencing timing and force control learning in pianists

Optimizing the training regimen depending on neuromuscular fatigue is crucial for the well-being of professionals intensively practicing motor skills, such as athletes and musicians, as persistent fatigue can hinder learning and cause neuromuscular injuries. However, accurate assessment of fatigue is challenging because of the dissociation between subjective perception and its impact on motor and cognitive performance. To address this issue, we investigated the interplay between fatigue and learning development in 28 pianists during three hours of auditory-motor training, dividing them into two groups subjected to different resting conditions. Changes in behavior and muscle activity during training were measured to identify potential indicators capable of detecting fatigue before subjective awareness. Our results indicate that motor learning and fatigue development are independent of resting frequency and timing. Learning indices, such as reduction in force and timing errors throughout training, did not differ between the groups. No discernible distinctions emerged in fatigue-related behavioral and physiological indicators between the groups. Regression analysis revealed that several fatigue-related indicators, such as tapping speed variability and electromyogram amplitude per unit force, could explain the learning of timing and force control. Our findings suggest the absence of a universal resting schedule for optimizing auditory-motor learning.

Examining Learner-Controlled Role-Switching in Dyad Practice for the Learning of a Speed Cup-Stacking Task

Dyad practice has proven to be an efficient, and in some cases, a more effective method of promoting motor learning compared to individual practice. Further, providing individuals control over their own or another learner's practice environment has also been shown to be superior for skill learning relative to individuals without control. The purpose of the experiment was to assess learner-controlled role-switching in dyad practice conditions. In dyads, partners either alternated actor and observer roles on a trial-to-trial basis, or under novel learner-controlled conditions wherein either the actor or the observer was given control over when the partners should switch roles. Participants practiced a speed cup-stacking task and learning was assessed in 24-h retention and transfer tests. Although there were no learning differences between dyad conditions, paired learners effectively chose when to switch roles with their partner, without undermining learning. The results also highlight the dynamic nature of dyad practice as the observers chose to switch roles more frequently than the actors, yet both dyad groups adopted comparable switching strategies by alternating roles following relatively 'good' and 'bad' trials. This experiment provides further support for dyad practice as an efficient and effective method of skill learning.

Acute exercise performed before and after motor practice enhances the positive effects on motor memory consolidation

Performing a single bout of exercise can enhance motor learning and long-term retention of motor skills. Parameters such as the intensity and when the exercise bout is performed in relation to skill practice (i.e., timing) likely influence the effectiveness. However, it is still not fully understood how exercise should be administered to maximize its effects and how exercise interacts with distinct components of skill learning. Here, we expand this knowledge by investigating the potential synergistic effects of performing acute exercise both prior to and following motor practice. Sixty-four, able-bodied, young adult male participants practiced a sequential visuomotor accuracy tracking (SVAT) task requiring rapid and accurate force modulation and high levels of precision control using intrinsic hand muscles. The task also contained a repeated pattern of targets that allowed sequence-specific skill improvements. Sequential and non-sequential motor performance was assessed at baseline, immediately after motor practice, and again seven days later. One group performed moderate-intensity exercise before practice (PREMO), a second group performed high-intensity exercise after practice (POSTHI), a third group exercised both before and after practice (PREMO + POSTHI), and a fourth group did not exercise during these periods (CON). Regardless of the exercise condition, acute exercise improved long-term retention of the skill by countering performance decay between experimental sessions (i.e., a 7-day interval). Furthermore, exercising both before and after motor practice led to the greatest improvements in skilled performance over time. We found that the effects of exercise were not specific to the practiced sequence. Namely, the effects of exercise generalized across sequential and non-sequential target positions and orders. This suggests that acute exercise works through mechanisms that promote general aspects of motor memory (e.g., lasting improvements in fast and accurate motor execution). The results demonstrate that various exercise protocols can promote the stabilization and long-term retention of motor skills. This effect can be enhanced when exercise is performed both before and after practice.

Effect of transcranial direct current stimulation on learning in older adults with and without Parkinson's disease: A systematic review with meta-analysis

Older adults with and without Parkinson's disease show impaired retention after training of motor or cognitive skills. This systematic review with meta-analysis aims to investigate whether adding transcranial direct current stimulation (tDCS) to motor or cognitive training versus placebo boosts motor sequence and working memory training. The effects of interest were estimated between three time points, i.e. pre-training, post-training and follow-up. This review was conducted according to the PRISMA guidelines (PROSPERO: CRD42022348885). Electronic databases were searched from conception to March 2023. Following initial screening, 24 studies were eligible for inclusion in the qualitative synthesis and 20 could be included in the meta-analysis, of which 5 studies concerned motor sequence learning (total n = 186) and 15 working memory training (total n = 650). Results were pooled using an inverse variance random effects meta-analysis. The findings showed no statistically significant additional effects of tDCS over placebo on motor sequence learning outcomes. However, there was a strong trend showing that tDCS boosted working memory training, although methodological limitations and some heterogeneity were also apparent. In conclusion, the present findings do not support wide implementation of tDCS as an add-on to motor sequence training at the moment, but the promising results on cognitive training warrant further investigations.

Does Cognitive Impairment Impact Motor Learning? A Scoping Review of Elderly Individuals With Alzheimer's Disease and Mild Cognitive Impairment

Individuals with cognitive impairment may have motor learning deficits due to the high engagement of cognitive mechanisms during motor skill acquisition. We conducted a scoping review to address the quality of current research on the relationship between cognitive impairments (i.e., deficits in attention, memory, planning and executive functions) and motor learning among older adults with Alzheimer's Disease or Mild Cognitive Impairment. After screening thousands of articles, we selected 15 studies describing cognitive assessment tools, experimental designs, and the severity of cognitive impairment. Although seven studies reported that cognitive impairment impaired motor learning, most studies included a high risk of bias. We identified multiple assessment tools across these studies that make comparisons among findings difficult. Future research in this area should focus on the influence of increased practice days during motor learning acquisition and incorporate both retention and transfer tests. Cognitive assessments should target the specific cognitive skills or deficits most closely related to the motor learning process.

Placebo effects of transcranial direct current stimulation on motor skill acquisition

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique used in neurorehabilitation to enhance motor training. However, its benefits to motor training can be difficult to reproduce across research studies. It is possible that the observed benefits of tDCS are not directly related to the intervention itself but rather to the brain-mind responses elicited by the treatment context, commonly known as a placebo effect. This study investigated the presence of a placebo effect of tDCS on motor training and explored potential underlying factors. Sixty-eight participants who were right-handed were randomly assigned to active tDCS, sham tDCS, or a no-stimulation control group. Double-blind active or sham tDCS was applied to the right primary motor cortex, while the unblinded control group received no stimulation. All participants completed 30 training trials of a functional upper-extremity motor task. Participants' beliefs of tDCS, along with their prior knowledge of tDCS, were also collected. There was no significant difference in the amount of improvement on the motor task between the active and sham tDCS groups; however, both active and sham tDCS groups improved more than the control group, indicating a placebo effect. More motor task improvement was also associated with higher beliefs of tDCS (regardless of whether active or sham tDCS was received). This demonstrates a measurable placebo effect of tDCS on motor training, driven at least in part by treatment expectations or beliefs. Future tDCS studies should control for beliefs and other placebo-related factors.

Conscious awareness of others' actions during observational learning does not benefit motor skill performance

The conscious awareness of motor success during motor learning has recently been revealed as a learning factor. In these studies, participants had to learn a motor sequence and to detect when they assumed the execution had reached a maximal fluidity. The consciousness groups showed better motor performance during a delayed post-training test than the non-consciousness control groups. Based on the "similar mechanism" hypothesis between observational and physical practice, we tested this beneficial effect of the conscious awareness of action in an observational learning context. In the present study, two groups learned a motor sequence task by observing a videotaped human model performing the task. However, only the consciousness group had to detect the maximal fluidity of the learning human model during observational practice. Unpredictably, no difference was detected between groups during the post-training test. However, the consciousness group outperformed the non-consciousness control group for tests that assessed the motor knowledges.

Moderate-intensity cardiovascular exercise performed before motor practice attenuates offline implicit motor learning in stroke survivors but not age-matched neurotypical adults

The acute impact of cardiovascular exercise on implicit motor learning of stroke survivors is still unknown. We investigated the effects of cardiovascular exercise on implicit motor learning of mild-moderately impaired chronic stroke survivors and neurotypical adults. We addressed whether exercise priming effects are time-dependent (e.g., exercise before or after practice) in the encoding (acquisition) and recall (retention) phases. Forty-five stroke survivors and 45 age-matched neurotypical adults were randomized into three sub-groups: BEFORE (exercise, then motor practice), AFTER (motor practice, then exercise), and No-EX (motor practice alone). All sub-groups practiced a serial reaction time task (five repeated and two pseudorandom sequences per day) on three consecutive days, followed 7 days later by a retention test (one repeated sequence). Exercise was performed on a stationary bike, (one 20-min bout per day) at 50% to 70% heart rate reserve. Implicit motor learning was measured as a difference score (repeated-pseudorandom sequence response time) during practice (acquisition) and recall (delayed retention). Separate analyses were performed on the stroke and neurotypical groups using linear mixed-effects models (participant ID was a random effect). There was no exercise-induced benefit on implicit motor learning for any sub-group. However, exercise performed before practice impaired encoding in neurotypical adults and attenuated retention performance of stroke survivors. There is no benefit to implicit motor learning of moderately intense cardiovascular exercise for stroke survivors or age-matched neurotypical adults, regardless of timing. Practice under a high arousal state and exercise-induced fatigue may have attenuated offline learning in stroke survivors.

Effects of dynamic and isometric motor practice on position control, force control and corticomuscular coherence in preadolescent children

In this study, we investigated the effects of motor practice with an emphasis on either position or force control on motor performance, motor accuracy and variability in preadolescent children. Furthermore, we investigated corticomuscular coherence and potential changes following motor practice. We designed a setup allowing discrete wrist flexions of the non-dominant hand and tested motor accuracy and variability when the task was to generate specific movement endpoints (15-75 deg) or force levels (5-25% MVC). All participants were tested in both tasks at baseline and post motor practice without augmented feedback on performance. Following baseline assessment, participants (44 children aged 9-11 years) were randomly assigned to either position (PC) or force control (FC) motor practice or a resting control group (CON). The PC and FC groups performed four blocks of 40 trials motor practice with augmented feedback on performance. Following practice, improvements in movement accuracy were significantly greater in the PC group compared to the FC and CON groups (p < 0.001). None of the groups displayed changes in force task performance indicating no benefits of force control motor practice and low transfer between tasks (p-values:0.08-0.45). Corticomuscular coherence (C4-FCR) was demonstrated during the hold phase in both tasks with no difference between tasks. Corticomuscular coherence did not change from baseline to post practice in any group. Our findings demonstrate that preadolescent children improve position control following dynamic accuracy motor practice. Contrary to previous findings in adults, preadolescent children displayed smaller or no improvements in force control following isometric motor practice, low transfer between tasks and no changes in corticomuscular coherence.

How to improve movement execution in sidestep cutting? Involve me and I will learn

Providing choices, i.e., autonomy, to athletes during practice increases intrinsic motivation and positively influences the motor learning process. The effects of autonomy on the timing of feedback (self-controlled timing of feedback) when optimizing the movement execution of sidestep cutting (SSC), a task that is highly related with ACL injury risk, are unknown. The aim of this study was to investigate the effect of self-controlled timing of video and EF-feedback on movement execution of SSC in team sport athletes. Thirty healthy ball team sport athletes (22.9 ± 1.7 years, 185.5 ± 7.2 cm, 79.3 ± 9.2 kg) were recruited from local sports clubs. Participants were alternately assigned to the self-control (SC) or the yoked (YK) group based on arrival and performed five anticipated and five unanticipated 45° SSC trials as pre-, immediate-post and one-week retention test. Movement execution was measured with the Cutting Movement Assessment Score (CMAS). Training consisted of three randomized 45° SSC conditions: one anticipated and two unanticipated conditions. All participants received expert video instructions and were instructed to 'try to do your best in copying the movement of the expert'. The SC group was allowed to request feedback whenever they wanted during training. The feedback consisted of 1) CMAS score, 2) posterior and sagittal videos of the last trial and 3) an external focus verbal cue on how to improve their execution. The participants were told to lower their score and they knew the lower the score, the better. The YK group received feedback after the same trial on which their matched participant in the SC group had requested feedback. Data of twenty-two participants (50% in SC group) was analyzed. Pre-test and training CMAS scores between groups were equal (p > 0.05). In the anticipated condition, the SC group (1.7 ± 0.9) had better CMAS scores than the YK group (2.4 ± 1.1) at the retention test (p < 0.001). Additionally, in the anticipated condition, the SC group showed improved movement execution during immediate-post (2.0 ± 1.1) compared to pre-test (3.0 ± 1.0), which was maintained during retention (p < 0.001). The YK group also improved in the anticipated condition during immediate-post (1.8 ± 1.1) compared to pre-test (2.6 ± 1.0) (p < 0.001) but showed decreased movement execution during retention compared to immediate-post test (p = 0.001). In conclusion, self-controlled timing of feedback resulted in better learning and greater improvements in movement execution compared to the control group in the anticipated condition. Self-controlled timing of feedback seems beneficial in optimizing movement execution in SSC and is advised to be implemented in ACL injury prevention programs.

Effective practice and instruction: A skill acquisition framework for excellence

We revisit an agenda that was outlined in a previous paper in this journal focusing on the importance of skill acquisition research in enhancing practice and instruction in sport. In this current narrative review, we reflect on progress made since our original attempt to highlight several potential myths that appeared to exist in coaching, implying the existence of a theory-practice divide. Most notably, we present five action points that would impact positively on coaches and practitioners working to improve skill learning across sports, as well as suggesting directions for research. We discuss the importance of practice quality in enhancing learning and relate this concept to notions of optimising challenge. We discuss how best to assess learning, the right balance between repetition and practice that is specific to competition, the relationship between practice conditions, instructions, and individual differences, and why a more "hands-off" approach to instruction may have advantages over more "hands-on" methods. These action points are considered as a broad framework for advancing skill acquisition for excellence (SAFE) in applied practice. We conclude by arguing the need for increased collaboration between researchers, coaches, and other sport practitioners.

Visuomotor skill learning in young adults with Down syndrome

BACKGROUND

Individuals with Down syndrome (DS) have impaired general motor skills compared to typically developed (TD) individuals.

AIMS

To gain knowledge on how young adults with DS learn and retain new motor skills.

METHODS AND PROCEDURES

A DS-group (mean age = 23.9 ± 3 years, N = 11), and an age-matched TD-group (mean age 22.8 ± 1.8, N = 14) were recruited. The participants practiced a visuomotor accuracy tracking task (VATT) in seven blocks (10.6 min). Online and offline effects of practice were assessed based on tests of motor performance at baseline immediate and 7-day retention.

OUTCOMES AND RESULTS

The TD-group performed better than the DS-group on all blocks (all P < 0.001). Both groups improved VATT-performance online from baseline to immediate retention, (all P < 0.001) with no difference in online effect between groups. A significant between-group difference was observed in the offline effect (∆TD - ∆DS, P = 0.04), as the DS-group's performance at 7-day retention was equal to their performance at immediate retention (∆DS, P > 0.05), whereas an offline decrease in performance was found in the TD-group (∆TD, P < 0.001).

CONCLUSIONS AND IMPLICATIONS

Visuomotor pinch force accuracy is lower for adults with DS compared to TD. However, adults with DS display significant online improvements in performance with motor practice similar to changes observed for TD. Additionally, adults with DS demonstrate offline consolidation following motor learning leading to significant retention effects.

Involvement of the prefrontal cortex in motor sequence learning: A functional near-infrared spectroscopy (fNIRS) study

Our previous functional near-infrared spectroscopy (fNIRS) study on motor sequence learning (Polskaia et al., 2020) did not detect the same decrease in activity in the left dorsolateral prefrontal cortex (DLPFC) associated with movement automaticity, as reported by Wu et al. (2004). This was partly attributed to insufficient practice time to reach neural efficiency. Therefore, we sought to expand on our previous work to better understand the contribution of the prefrontal cortex (PFC) to motor sequence learning by examining learning across a longer period of time. Participants were randomly assigned to one of two groups: control or trained. fNIRS was acquired at three time points: pre-test, post-test, and retention. Participants performed four sequences (S1, S2, S3, and S4) of right-hand finger tapping. The trained group also underwent four days of practice of S1 and S2. No group differences in the left DLPFC and ventrolateral (VLPFC) were found between sessions for S1 and S2. Our findings revealed increased contribution from the right VLPFC in post-test for the trained group, which may reflect the active retrieval of explicit information from long-term memory. Our results suggest that despite additional practice time, explicit motor sequence learning requires the continued involvement of the PFC.

Nurses sustain manual handling risk assessment behaviours six-months after a training program to move patients safely: a pre-post study

PURPOSE

To determine if a patient manual handling training program focused on dynamic manual handling risk assessment for staff and patient safety, together with the patient's need for physical rehabilitation, can be transferred and sustained in clinical practice.

MATERIALS AND METHODS

Using a pre-post design, nurses (n = 72) from acute and rehabilitation wards participated in a 4-hour training session teaching dynamic manual handling risk assessment to safely move patients. Clinical observations audits of patient transfers were conducted prior to, and at 1-month and 6-months post training. Surveys determined experiences of training. Nurse musculoskeletal injuries and patient falls were measured 6-months after training.

RESULTS

Program patient handling skills were competently implemented 89% of the time 1-month following training and were sustained 6-months following training. There was no change in falls rates and staff injury rates were very low pre- and post-training. Training was well received and all nurses passed the competency assessment.

CONCLUSION

The patient handling training program taught nurses to better identify factors associated with risk to themselves and their patients and gave them improved skills to help patients move. Skills were incorporated safely into clinical practice and sustained at 6-months. It is uncertain whether training impacted musculoskeletal injuries.Implications for rehabilitationA dynamic manual handling risk assessment program for safely transferring and moving patients balances staff safety with the patient's need for physical rehabilitation.Nurses can be taught risk assessment skills to better identify factors associated with risk to themselves and their patients that can be translated to clinical practice.Thorough risk assessment at the point of the nurse-patient interaction can enable a patient to move at their highest level of function thus providing patients with opportunities to progress their rehabilitation at every interaction.

Accuracy and feasibility of a novel fine hand motor skill assessment using computer vision object tracking

We developed a computer vision-based three-dimension (3D) motion capture system employing two action cameras to examine fine hand motor skill by tracking an object manipulated by a hand. This study aimed to examine the accuracy and feasibility of this approach for detecting changes in a fine hand motor skill. We conducted three distinct experiments to assess the system's accuracy and feasibility. We employed two high-resolution, high-frame-rate action cameras. We evaluated the accuracy of our system in calculating the 3D locations of moving object in various directions. We also examined the system's feasibility in identifying improvement in fine hand motor skill after practice in eleven non-disabled young adults. We utilized color-based object detection and tracking to estimate the object's 3D location, and then we computed the object's kinematics, representing the endpoint goal-directed arm reaching movement. Compared to ground truth measurements, the findings demonstrated that our system can adequately estimate the 3D locations of a moving object. We also showed that the system can be used to measure the endpoint kinematics of goal-directed arm reaching movements to detect changes in fine hand motor skill after practice. Future research is needed to confirm the system's reliability and validity in assessing fine hand motor skills in patient populations.

Dynamic motor practice improves movement accuracy, force control and leads to increased corticospinal excitability compared to isometric motor practice

The central nervous system has a remarkable ability to plan motor actions, to predict and monitor the sensory consequences during and following motor actions and integrate these into future actions. Numerous studies investigating human motor learning have employed tasks involving either force control during isometric contractions or position control during dynamic tasks. To our knowledge, it remains to be elucidated how motor practice with an emphasis on position control influences force control and vice versa. Furthermore, it remains unexplored whether these distinct types of motor practice are accompanied by differential effects on corticospinal excitability. In this study, we tested motor accuracy and effects of motor practice in a force or position control task allowing wrist flexions of the non-dominant hand in the absence of online visual feedback. For each trial, motor performance was quantified as errors (pixels) between the displayed target and the movement endpoint. In the main experiment, 46 young adults were randomized into three groups: position control motor practice (PC), force control motor practice (FC), and a resting control group (CON). Following assessment of baseline motor performance in the position and force control tasks, intervention groups performed motor practice with, augmented visual feedback on performance. Motor performance in both tasks was assessed following motor practice. In a supplementary experiment, measures of corticospinal excitability were obtained in twenty additional participants by application of transcranial magnetic stimulation to the primary motor cortex hot spot of the flexor carpi radialis muscle before and following either position or force control motor practice. Following motor practice, accuracy in the position task improved significantly more for PC compared to FC and CON. For the force control task, both the PC and FC group improved more compared to CON. The two types of motor practice thus led to distinct effects including positive between-task transfer accompanying dynamic motor practice The results of the supplementary study demonstrated an increase in corticospinal excitability following dynamic motor practice compared to isometric motor practice. In conclusion, dynamic motor practice improves movement accuracy, and force control and leads to increased corticospinal excitability compared to isometric motor practice.

Exploring the activities and outcomes of digital teaching and learning of practical skills in higher education for the social and health care professions: a scoping review

Higher education for health care professionals faces numerous challenges. It is important to develop and apply methods supporting education, especially the practical skills. This scoping review aimed to explore the activities and learning outcomes of digital technology in practical skills teaching and learning in higher education for the social and health professions. Scoping review recommendations and the PRISMA-ScR checklist were applied. Randomized controlled trials published between 2016 and 2021 involving students in higher education who were taking courses in the social sciences and health care and reported interventions with digital technology activities and practices in practical teaching and learning were included. The CINAHL Plus, PubMed, Scopus, ERIC, and Sociological Abstracts/Social Services Abstracts databases were searched. Teaching methods were blended, e-learning or other online-based, and digital simulation-based activities. Teaching and learning environments, methods, resources, and activity characteristics varied, making a summary difficult. Interventions were developed in a face-to-face format prior to digitalization. The outcomes were measured at the knowledge level, not at the performance level. One-third of the studies showed a significant improvement in practical skills in the intervention group in comparison to the control conditions. The use of digital technology in the learning and teaching process have potential to develop of students' skills, knowledge, motivation, and attitudes. The pedagogy of technology use is decisive. The development of new digital methods for teaching and learning practical skills requires the engagement of students and teachers, in addition the researchers.

Sequence representations after action-imagery practice of one-finger movements are effector-independent

Action-imagery practice (AIP) is often less effective than action-execution practice (AEP). We investigated whether this is due to a different time course of learning of different types of sequence representations in AIP and AEP. Participants learned to sequentially move with one finger to ten targets, which were visible the whole time. All six sessions started with a test. In the first four sessions, participants performed AIP, AEP, or control-practice (CP). Tests involved the practice sequence, a mirror sequence, and a different sequence, which were performed both with the practice hand and the other (transfer) hand. In AIP and AEP, movement times (MTs) in both hands were significantly shorter in the practice sequence than in the other sequences, indicating sequence-specific learning. In the transfer hand, this indicates effector-independent visual-spatial representations. The time course of the acquisition of effector-independent visual-spatial representations did not significantly differ between AEP and AIP. In AEP (but not in AIP), MTs in the practice sequence were significantly shorter in the practice hand than in the transfer hand, indicating effector-dependent representations. In conclusion, effector-dependent representations were not acquired after extensive AIP, which may be due to the lack of actual feedback. Therefore, AIP may replace AEP to acquire effector-independent visual-spatial representations, but not to acquire effector-dependent representations.

The Effect of Different Combinations of Practice Schedules on Motor Response Stability during Practice

Many results in motor learning have indicated that relative and absolute timing dimensions are modulated by factors that modify response stability among trials. One of these factors is the combination of constant and variable practices. Although many researchers have investigated the combination of practice schedules, these researchers have used measurements that do not assess performance and motor response separately. This study aimed to investigate the effect of different combinations of practice schedules on motor response stability during practice. Participants performed a sequential key-pressing task with two goals: (1) to learn the relative timing dimension and (2) the absolute timing dimension. Participants were assigned to one of two groups: constant-variable or variable-constant. Our findings indicate an influence of the increase in variability over the practice in the constant-variable group. Precisely, the increase in variability of total time in the second half (constant-variable group) of practice was followed by the maintenance of the same level of cross-correlate between absolute timing error and variability of total time. Finally, our findings support the hypothesis that practicing in a constant schedule favors the relative timing dimension of learning regardless of the order in which the constant practice is provided.

Motor Memory Consolidation Deficits in Parkinson's Disease: A Systematic Review with Meta-Analysis

BACKGROUND

The ability to encode and consolidate motor memories is essential for persons with Parkinson's disease (PD), who usually experience a progressive loss of motor function. Deficits in memory encoding, usually expressed as poorer rates of skill improvement during motor practice, have been reported in these patients. Whether motor memory consolidation (i.e., motor skill retention) is also impaired is unknown.

OBJECTIVE

To determine whether motor memory consolidation is impaired in PD compared to neurologically intact individuals.

METHODS

We conducted a pre-registered systematic review (PROSPERO: CRD42020222433) following PRISMA guidelines that included 46 studies.

RESULTS

Meta-analyses revealed that persons with PD have deficits in retaining motor skills (SMD = -0.17; 95% CI = -0.32, -0.02; p = 0.0225). However, these deficits are task-specific, affecting sensory motor (SMD = -0.31; 95% CI -0.47, -0.15; p = 0.0002) and visuomotor adaptation (SMD = -1.55; 95% CI = -2.32, -0.79; p = 0.0001) tasks, but not sequential fine motor (SMD = 0.17; 95% CI = -0.05, 0.39; p = 0.1292) and gross motor tasks (SMD = 0.04; 95% CI = -0.25, 0.33; p = 0.7771). Importantly, deficits became non-significant when augmented feedback during practice was provided, and additional motor practice sessions reduced deficits in sensory motor tasks. Meta-regression analyses confirmed that deficits were independent of performance during encoding, as well as disease duration and severity.

CONCLUSION

Our results align with the neurodegenerative models of PD progression and motor learning frameworks and emphasize the importance of developing targeted interventions to enhance motor memory consolidation in PD.

An external focus of attention enhances table tennis backhand stroke accuracy in low-skilled players

The aim of the study was to determine the impact of internal and external (proximal and distal) attentional focus on table tennis backhand stroke accuracy in low-skilled players. Fifty-one undergraduate physical education (PE) students were randomly assigned to 3 groups: Group G1 (IF) was instructed to focus on the hand holding the paddle, Group G2 (EFP) was instructed to focus on the ball, while Group G3 (EFD) was instructed to focus on targets marked on the tennis table. The experimental groups followed identical instructions except for the instruction about the focus of attention. Participants were asked to score as many points as possible by hitting the ball inside the three smallest targets marked on the tennis table. They were required to do so using a backhand stroke. The practice session consisted of 45 trials in three blocks of backhand (15 trials at each target). A special scoring system was used to determine the accuracy of the strokes. One of the most important findings from the current research was that groups with an external focus of attention revealed significant improvements in accuracy in the post-test, while the group with an internal focus of attention achieved low training effects. No significant difference was observed between G2 (EFP) and G3 (EFD) in the delayed retention test, which indicates that proximal and distal attentional focus had similar effects on table tennis backhand stroke accuracy in low-skilled players.

Do temporal factors affect whether our performance accurately reflects our underlying knowledge? The effects of stimulus presentation rates on the performance versus competence dissociation

Ample evidence shows that the momentary performance can dissociate from the underlying knowledge (competence). Under what circumstances such dissociation occurs, however, remains unclear. Here we tested how temporal factors, and more specifically, the elapsed time between subsequent events affects the dissociation between performance and competence by systematically manipulating the stimulus presentation rates during and after learning. Participants completed a probabilistic sequence learning task with a fast (120 msec) or a slow (850 msec) response-to-stimulus-interval (RSI) during the Learning phase and they were tested with both RSIs 24 h later (Testing phase). We also tested whether they gained explicit knowledge about the sequence or their knowledge remained implicit. Our results revealed higher reaction time learning scores when tested with the fast RSI, irrespective of the RSI during learning, suggesting that faster presentation rates can help better express the acquired knowledge, leading to increased performance measures. For accuracy, participants showed higher learning scores when tested with the same presentation rate as the one that they encountered during learning. The acquired knowledge remained implicit in both groups, suggesting that the observed findings were not confounded by differences in awareness gained in the two groups. Overall, our study highlights that the momentary performance does not always accurately reflect the underlying knowledge, and temporal factors seem to influence this dissociation. Our findings have theoretical, methodological, and translational implications that likely extend beyond learning and memory to other functions and domains as well, including aspects of decision-making, perception, theory of mind, and language.

Rey-Osterrieth complex figure recall scores and motor skill learning in older adults: A non-linear mixed effect model-based analysis

Age-related declines in motor learning are well documented. Visuospatial memory has been proposed as a key factor explaining age-related declines in sensorimotor adaptation, but most studies have not used standardized visuospatial memory tests nor controlled for age-related visuospatial memory declines. The present study explores the relationship between visuospatial memory and motor learning in older adults while also controlling for age and utilizing a standardized visuospatial memory test. Forty-nine nondemented older adults repetitively practiced a functional upper-extremity motor task and were re-assessed one week later. Training data were modeled with mixed-effect exponential decay functions, with parameters representing amount of performance change, rate of improvement, and final performance. Age and visuospatial memory were included as possible covariates for the parameter measuring rate of improvement (τ). After controlling for age, higher visuospatial memory scores were associated with faster rates of skill acquisition and better short-term retention one week later. These associations with visuospatial memory were dependent, however, on the level of initial skill. These findings suggest that the extent of re-learning motor skills in geriatric physical rehabilitation may depend on intact visuospatial memory.

Effects of short-term arm immobilization on motor skill acquisition

Learning to sequence movements is necessary for skillful interaction with the environment. Neuroplasticity, particularly long-term potentiation (LTP), within sensorimotor networks underlies the acquisition of motor skill. Short-term immobilization of the arm, even less than 12 hours, can reduce corticospinal excitability and increase the capacity for LTP-like plasticity within the contralateral primary motor cortex. However, it is still unclear whether short-term immobilization influences motor skill acquisition. The current study aimed to evaluate the effect of short-term arm immobilization on implicit, sequence-specific motor skill acquisition using a modified Serial Reaction Time Task (SRTT). Twenty young, neurotypical adults underwent a single SRTT training session after six hours of immobilization of the non-dominant arm or an equivalent period of no immobilization. Our results demonstrated that participants improved SRTT performance overall after training, but there was no evidence of an effect of immobilization prior to task training on performance improvement. Further, improvements on the SRTT were not sequence-specific. Taken together, motor skill acquisition for sequential, individuated finger movements improved following training but the effect of six hours of immobilization was difficult to discern.

Influence of Heat Exposure on Motor Control Performance and Learning as Well as Physiological Responses to Visuomotor Accuracy Tracking Task

This study aimed to determine whether heat exposure attenuates motor control performance and learning, and blunts cardiovascular and thermoregulatory responses to visuomotor accuracy tracking (VAT) tasks. Twenty-nine healthy young adults (22 males) were divided into two groups performing VAT tasks (5 trials × 10 blocks) in thermoneutral (NEUT: 25 °C, 45% RH, n = 14) and hot (HOT: 35 °C, 45% RH, n = 15) environments (acquisition phase). One block of the VAT task was repeated at 1, 2, and 4 h after the acquisition phase (retention phase). Heat exposure elevated skin temperature to ~3 °C with a marginally increased core body temperature. VAT performance (error distance of curve tracking) was more attenuated overall in HOT than in NEUT in the acquisition phase without improvement in magnitude alteration. Heat exposure did not affect VAT performance in the retention phase. The mean arterial blood pressure and heart rate, but not for sweating and cutaneous vascular responses to VAT acquisition trials, were more attenuated in HOT than in NEUT without any retention phase alternations. We conclude that skin temperature elevation exacerbates motor control performance and blunts cardiovascular response during the motor skill acquisition period. However, these alternations are not sustainable thereafter.

Transcranial direct current stimulation leads to faster acquisition of motor skills, but effects are not maintained at retention

Practice is required to improve one’s shooting technique in basketball or to play a musical instrument well. Learning these motor skills may be further enhanced by transcranial direct current stimulation (tDCS). We aimed to investigate whether tDCS leads to faster attainment of a motor skill, and to confirm prior work showing it improves skill acquisition and retention performance. Fifty-two participants were tested; half received tDCS with the anode on primary motor cortex and cathode on the contralateral forehead while concurrently practicing a sequential visuomotor isometric pinch force task on Day 1, while the other half received sham tDCS during practice. On Day 2, retention of the skill was tested. Results from a Kaplan-Meier survival analysis showed that participants in the anodal group attained a pre-defined target level of skill faster than participants in the sham group (χ2 = 9.117, p = 0.003). Results from a nonparametric rank-based regression analysis showed that the rate of improvement was greater in the anodal versus sham group during skill acquisition (F(1,249) = 5.90, p = 0.016), but there was no main effect of group or time. There was no main effect of group or time, or group by time interaction when comparing performance at the end of acquisition to retention. These findings suggest anodal tDCS improves performance more quickly during skill acquisition but does not have additional benefits on motor learning after a period of rest.

Predicting individual differences in motor learning: a critical review

The ability to predict individual differences in motor learning has significant implications from both theoretical and applied perspectives. However, there is high variability in the methodological and analytical strategies employed as evidence for such predictions. Here, we critically examine the evidence for predictions of individual differences in motor learning by reviewing the literature from a 20-year period (2000-2020). Specifically, we examined four factors: (i) the predictor and predicted variables used, (ii) the strength of the prediction and associated sample size, (iii) the timescale over which the prediction was made, and (iv) the type of motor task used. Overall, the results highlight several issues that raise concerns about the quality of the evidence for such predictions. First, there was a large variation in both predictor and predicted variables, suggesting the presence of a large number of researcher degrees of freedom. Second, sample sizes tended to be small, and the strength of the correlation showed an inverse relation with sample size. Third, the timescale of most predictions was very short, mostly constrained to a single day. Last, most studies were largely restricted to two experimental paradigms - adaptation and sequence learning. Based on these issues, we highlight recommendations for future studies to improve the quality of evidence for predicting individual differences in motor learning.

The Immediate and Long-Term Effects of Tube and Mask+Tube Phonation in Water Exercises and Their Duration as Measured by Electroglottographic and Nasometric Parameters

OBJECTIVE

This study investigated the immediate effects and their persistence (at 15 minutes) of various durations of semi-occluded vocal tract exercise (SOVTE) (standard tube into water and modified mask+tube into water exercises) as measured by electroglottographic (EGG) and nasometric parameters.

METHODS

The study included 30 women aged 19 through 28 years with healthy voices, and it comprised five randomly implemented procedures (Ps): P1-tube phonation into water for 5 minutes; P2-tube phonation into water for 10 minutes; P3-tube+ventilation mask phonation into water for 5 minutes; P4-tube+ventilation mask phonation into water for 10 minutes; P5-phonation with ventilation mask for 5 minutes. Fifteen-minute voice rest breaks were provided between each procedure. Nasometric and electroglottographic measurements were taken before, during, immediately after and at 5, 10, and 15 minutes after the exercises, and the recorded measurements were analyzed.

RESULTS

The immediate effects of P3 and P4 on voice quality showed better performance than the other procedures. Among all the procedures, P1 had the smallest effect on voice quality in terms of nasometric and EGG parameters and the least degree of effect permanence. In all the fluctuating SOVTE procedures except P1, the nasalance scores decreased (P1, P2, P3, and P4: fluctuating SOVTE; P5: steady SOVTE).

CONCLUSION

The tube phonation exercises modified by the addition of a ventilation mask were highly advantageous in terms of EGG parameters. In addition to this, regardless of the mode of application of the retention time, it was observed that the positive effect (ie, lower vertical laryngeal position) of the exercises applied for 10 minutes was higher than the exercises applied for 5 minutes.

Providing choice of feedback affects perceived choice but does not affect performance

Background

Autonomy or choice can lead to improved learning in various educational domains. The purpose of this online study was to examine whether giving participants a choice regarding the frequency of their received feedback (either after each individual trial or after a block of trials) in a computerized alternate task-switching task, will affect their performance.

Methods

Participants (n = 148) were randomly assigned to three groups: choice group (n = 49), online feedback group (n = 51), and summary feedback group (n = 48). From those three groups we created two groups: a choice group and a no-choice group (n = 49 in each group). All participants performed eight familiarization trials, a pre-test of 24 trials, five blocks of 24 trials for practice, and a post-test of 24 trials. After completing the task, the participants were asked about their perceived feeling of choice and completed the short form of the International Positive and Negative Affect Schedule.

Results

The participants in the choice group had higher perceived choice compared with the participants in the no-choice group (8.41 vs 5.47 out of 10, respectively). However, this higher perceived choice did not materialize into better performance during practice or in the post-test.

Different Patterns of Neural Activity Characterize Motor Skill Performance During Acquisition and Retention

Motor performance and learning have distinct behavioral and neural signatures and can be uniquely modulated by various informational and motivational factors. Contemporary frameworks describe four different motor learning mechanisms mapped onto specific neural regions which are key for motor skill acquisition: error-based learning (cerebellum), reinforcement learning (basal ganglia), cognitive strategies (prefrontal cortex), and use-dependent learning (motor cortex). However, little is known about the neural circuits engaged during skill acquisition that are modulated specifically by practice-based performance improvement and those that predict recall performance. Based on previous work, we hypothesize that brain activity during practice in primary motor cortex and basal ganglia (1) is associated with trial-by-trial practice performance and (2) is predictive of immediate recall performance. Leveraging the contemporary framework, we use a well-known task paradigm that primarily relies upon cognitive strategy, reinforcement, and use-based learning mechanisms to test our hypotheses. Forty neurotypical young adults were asked to practice a pinch force tracking task. Participants received performance feedback after each trial during practice. We used whole brain analysis of functional magnetic resonance imaging (fMRI) and behavioral performance measures (i.e., time-on-target and self-efficacy) during the practice phase to determine which brain activation patterns are (1) associated with trial-by-trial tracking performance and (2) predictive of immediate no-feedback retention performance. We observed brain activations in the frontal orbital cortex, putamen, amygdala, and insula correlated with tracking performance improvement during practice. In contrast, a different set of performance-related activated regions were observed that were associated with immediate retention performance that included the primary motor cortex, superior frontal gyrus, somatosensory cortex, angular gyrus, and parietal gyrus. Our findings demonstrate that improved practice performance and recall of a sensorimotor skill are correlated with distinct neural activity patterns during acquisition, drawing on different motor learning mechanisms during encoding. While motor performance improvements depend on both cortical and subcortical regions, motor skill recall depends primarily on prefrontal and motor cortices. We discuss possible interpretations for why our hypothesis regarding basal ganglia activity and retention performance was not supported. Understanding the different neural mechanisms engaged in motor performance and learning may inform novel interventions to enhance motor skill learning.

Three days of beam walking practice improves dynamic balance control regardless of the use of haptic anchors in older adults

Balance deficits during walking increase the risk of falls in older adults. Providing haptic information through anchors improves dynamic balance control, but the benefits of practicing with anchors during walking need to be evaluated. We investigated the effect of practice with haptic anchors in the beam walking task in older adults. Twenty-five older adults participated in this study divided into 0% (G0, practice without the anchors) and 50% (G50, practice with the haptic anchors in 50% of the trials) groups. With the anchors, participants held in each hand a cable with a mass of 0.125 kg affixed to the end of the cable that contacted the ground. They walked and kept the anchors in contact with the ground such that they dragged them. Participants increased the distance walked on the beam and reduced the trunk angular acceleration after training, but this effect was independent of the anchors. The use of haptic anchors during beam walking training did not significantly affect older adults' performance and dynamic balance control. Both groups showed improvements in the post-test and 24-hr retention conditions, indicating that older adults can learn to adapt their gait to more challenging contexts.

Random Practice Enhances Retention and Spatial Transfer in Force Field Adaptation

The contextual-interference effect is a frequently examined phenomenon in motor skill learning but has not been extensively investigated in motor adaptation. Here, we first tested experimentally if the contextual-interference effect is detectable in force field adaptation regarding retention and spatial transfer, and then fitted state-space models to the data to relate the findings to the “forgetting-and-reconstruction hypothesis”. Thirty-two participants were divided into two groups with either a random or a blocked practice schedule. They practiced reaching to four targets and were tested 10 min and 24 h afterward for motor retention and spatial transfer on an interpolation and an extrapolation target, and on targets which were shifted 10 cm away. The adaptation progress was participant-specifically fitted with 4-slow-1-fast state-space models accounting for generalization and set breaks. The blocked group adapted faster (p = 0.007) but did not reach a better adaptation at practice end. We found better retention (10 min), interpolation transfer (10 min), and transfer to shifted targets (10 min and 24 h) for the random group (each p < 0.05). However, no differences were found for retention or for the interpolation target after 24 h. Neither group showed transfer to the extrapolation target. The extended state-space model could replicate the behavioral results with some exceptions. The study shows that the contextual-interference effect is partially detectable in practice, short-term retention, and spatial transfer in force field adaptation; and that state-space models provide explanatory descriptions for the contextual-interference effect in force field adaptation.

Participants with mildly-disabling chronic neck pain perform differently during explicit compared to implicit motor learning of a reaching task

Chronic musculoskeletal (CMSK) pain associated with musculoskeletal disorders like low back pain or neck pain are the leading causes of disability. While CMSK pain has the potential to negatively influence motor learning, there is limited research to understand the impact of CMSK on motor learning. In order to examine differences in motor learning between individuals with and without CMSK we modified a serial reaction time task to assess motor learning of a repetitive reaching task. The paradigm was used to assess both explicit and implicit motor learning. In a cross-sectional study design, seventeen participants with chronic neck pain (CNP) (5 males) and 21 controls (8 males) were recruited. In addition, physical, cognitive, sensorimotor, disability and pain assessments were used to examine differences between individuals with and without CNP. All participants with CNP were categorized as having mild disability. There was no difference in cognitive assessments and minimal differences in physical measures between groups. Examining motor learning, groups with and without CNP demonstrated similar outcomes in both explicit and implicit motor learning. There was one notable performance difference between groups in the reaching task, the group with CNP demonstrated slower reaching movements outward and inward during blocks without explicit information. This may suggest a cautious approach to movement with reduced explicit information. Findings from this study provide insight on motor learning in individuals with mildly-disabling CNP, further research is necessary to examine how instruction can impact peak performance in people with CMSK pain.

Visuo-spatial learning and memory impairments in the 5xFAD mouse model of Alzheimer's disease: Effects of age, sex, albinism, and motor impairments

The 5xFAD mouse model of Alzheimer's disease (AD) rapidly develops AD-related neuro-behavioral pathology. Learning and memory impairments in 5xFAD mice, however, are not always replicated and the size of impairments varies considerably across studies. To examine possible sources of this variability, we analyzed the effects of age, sex, albinism due to background genes (Tyrc , Oca2p ) and motor impairment on learning and memory performance of wild type and 5xFAD mice on the Morris water maze, from 3 to 15 months of age. The 5xFAD mice showed impaired learning at 6-9 months of age, but memory impairments were not detected with the test procedure used in this study. Performance of 5xFAD mice was profoundly impaired at 12-15 months of age, but was accompanied by slower swim speeds than wild-type mice and a frequent failure to locate the escape platform. Overall female mice performed worse than males, and reversal learning impairments in 5xFAD mice were more pronounced in females than males. Albino mice performed worse than pigmented mice, confirming that albinism can impair performance of 5xFAD mice independently of AD-related transgenes. Overall, these results show that 5xFAD mice have impaired learning performance at 6-9 months of age, but learning and memory performance at 12-15 months is confounded with motor impairments. Furthermore, sex and albinism should be controlled to provide an accurate assessment of AD-related transgenes on learning and memory. These results will help reduce variability across pre-clinical experiments with 5xFAD mice, and thus enhance the reliability of studies developing new therapeutics for AD.