The ability of 6- to 8-year-old children to use motor imagery in a goal-directed pointing task

Effect of Motor Imagery Training on Motor Learning in Children and Adolescents: A Systematic Review and Meta-Analysis

Background: There is an urgent need to systematically analyze the growing body of literature on the effect of motor imagery (MI) training in children and adolescents. Methods: Seven databases and clinicaltrials.gov were searched. Two reviewers independently screened references and full texts, and extracted data (studies’ methodology, MI elements, temporal parameters). Two studies were meta-analyzed providing the standard mean difference (SDM). Selected studies were evaluated with the risk of bias (RoB) and GRADE tools. Results: A total of 7238 references were retrieved. The sample size of the 22 included studies, published between 1995 and 2021, ranged from 18 to 136 participants, totaling 934 (nine to 18 years). Studies included healthy pupils, mentally retarded adolescents, children with motor coordination difficulties or with mild mental disabilities. The motor learning tasks focused on upper, lower and whole body movements. SMDs for the primary outcome of pooled studies varied between 0.83 to 1.87 (95% CI, I², T² varied 0.33–3.10; p = 0.001; 0–74%; 0–0.59). RoB varied between some concerns and high risk. GRADE rating was low. Conclusions: MI combined with physical practice (PP) might have a high potential for healthy and impaired children and adolescents. However, important reporting recommendations (PETTLEP, TIDieR, CONSORT) should be followed. The systematic review was registered with PROSPERO: CRD42021237361.

Action representation deficits in adolescents with developmental dyslexia

Developmental dyslexia (DD), a severe and frequent disorder of reading acquisition, is characterized by a diversity of cognitive and motor deficits whose interactions still remain under debate. Although deficits in the automatization of sensorimotor control have been highlighted, internal action representation allowing prediction has never before been investigated. In this study, we considered action representation of 18 adolescents with pure DD and 18 age-matched typical readers. Participants actually and mentally performed a visually guided pointing task involving strong spatiotemporal constraints (speed/accuracy trade-off paradigm). While actual and mental movement times of typical readers were isochronous and both conformed to Fitts' law, the movement times of dyslexics differed between conditions, and only the actual movement times conformed to Fitts' law. Furthermore, the quality of motor imagery correlated with word reading abilities. This suggests that the process of action representation is impaired in pure DD and supports the sensorimotor perspective of DD. Theoretical implications are discussed.

Rehabilitation of patients with cerebral palsy using hand exoskeleton controlled by brain-computer interface

Cerebral palsy (CP) is one of the most severe central nervous system diseases in childhood associated with motor impairment. The study was aimed to assess the efficiency of the complex comprising brain-computer interface (BCI) and hand exoskeleton as an instrument for the motor function recovery in patients with CP complementing the essential therapy. The Fugl-Meyer Assessment scale, ARAT test and Jebsen–Taylor function test were used in 14 children and adolescents for the motor function improvement assessment after the therapy complemented by 7–10 BCI-exoskeleton based procedures. The EEG mu-rhythm sources properties during the motor imagery BCI control were studied. After the procedures completion, the significant improvement of the Fugl-Meyer Assessment scale score (7 (2; 11) for hand active movements; 4.5 (1; 6) for proximal arm and 2.5 (0; 5) for hand), ARAT test score (7.5 (1; 31) for total score, 1.5 (0; 12) for grasp movement and 1.5 (0; 8) for grip movement), as well as significantly different from the zero execution time reduction in three out of seven Jabsen–Taylor function test items (–1 (–4.13; 0.25) for simulated feeding; –1 (–2; 0) for moving light and heavy cans) were identified. The average BCI detection level was 0.51 (0.45; 0.54) (max = 0.70). In most EEG recordings the mu-rhythm sources were detected, both for intact and affected hemispheres. The mu-rhythm desynchronization associated with motor imagery was observed, significantly affecting the BCI accuracy. The results obtained indicate that the use of BCI-exoskeleton complex effectively complements the standard rehabilitation methods for children with CP, and suggest that its clinical effectiveness in individuals with CP may be proven by enrollment of more patients.

Motor Imagery Development in Children: Changes in Speed and Accuracy With Increasing Age

Although motor imagery has been pointed as a promising strategy for the rehabilitation of children with neurological disorders, information on their development throughout childhood and adolescence is still scarce. For instance, it is still unclear at what age they reach a development comparable to the motor imagery performance observed in adults. Herein we used a mental rotation task to assess motor imagery in 164 typically developing children and adolescents, which were divided into four age groups (6-7, 8-9, 10-11, and 12-13 years) and 30 adults. The effects of biomechanical constraints, accuracy, and reaction time of the mental rotation task were considered. ANOVA showed that all groups had the effect of biomechanical restrictions of the mental rotation task. We found a group effect for accuracy [F (4, 180) = 17,560; p < 0.00; η2 = 3.79] and reaction time [F (4, 180) = 17.5; p < 0.001, η2 = 0.615], with the results of children groups 6-7 and 8-9 years being significantly lower than the other groups (p < 0.05). In all the analyses, there were no differences regarding accuracy and reaction time among the participants of the age groups 10-11 and 12-13 years and adults (p > 0.05). Concluding, children aged 6-7 years were able to perform motor imagery, motor imagery ability improved as the participants' ages increased, and children aged 10 and over-performed similarly to adults.

Explicit Motor Imagery for Grasping Actions in Children With Spastic Unilateral Cerebral Palsy

Background: Motor Imagery (MI) refers to mental simulation of a motor action without producing any overt movement. Previous studies showed that children with Unilateral Cerebral Palsy (UCP) are impaired in implicit MI, as demonstrated by the performance of Hand Laterality Judgment tasks. The aim of this study was to examine the specificity of explicit MI deficits in UCP children. Methods: A group of UCP children (n = 10; aged 9-14) performed a mental chronometry task consisting in grasping an object and placing it into a container, or in imagining to perform the same action. As control, a group of typically developing (TD) children, matched by age, performed the same task. Movement durations for executed and imagined trials were recorded. A subgroup of 7 UCP children and 10 TD children also underwent a session of functional MRI to examine the activation of parieto-frontal areas typically associated to MI processes, during the imagination of reaching-grasping actions performed with the paretic hand. Results: Behavioral results revealed the existence of a correlation between executed and imagined movement durations both in TD and UCP groups. Moreover, the regression analysis in TD children showed that higher scores in mental chronometry tasks were positively correlated to increased bilateral activation of the intraparietal sulcus (IPS), superior parietal lobule (SPL), and dorsal premotor (PMd) cortex. A similar analysis revealed in the UCP group a positive correlation between a higher score in the mental chronometry task and bilateral activations of IPS, and to activation of contralesional, right PMd, and putamen during imagination of grasping movements. Conclusions: These results provide new insights on the relationship between MI capacity and motor deficits in UCP children, suggesting the possibility of the use of explicit MI training to improve patient's upper limb motor functions.