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Andrushko JW, Zirk DT, Kurniawan AR, Renshaw DW, Farthing JP. Effects of External Pacing Type on the Cross-Education of Motor Skill. J Mot Behav 2024:1-11. [PMID: 39155837 DOI: 10.1080/00222895.2024.2390032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 07/15/2024] [Accepted: 07/25/2024] [Indexed: 08/20/2024]
Abstract
Cross-education (CE) is a phenomenon whereby motor training of one limb leads to improved performance in the opposite untrained limb. External pacing of a motor task can enhance CE; however, the influence of different pacing methods is poorly understood. This study explored how motor training with auditory (AP) and visual pacing (VP) impacts CE with a visuomotor force target task. Sixty-one participants performed a unimanual motor task. Participants were randomized into a visual (n = 31) or auditory (n = 30) pacing stimuli condition. The primary outcome was cumulative error scores for each hand, before and after visuomotor training. Pacing type did not yield different magnitudes of CE. However, after adjusting for baseline differences, a significant hand (trained vs. untrained) × practice side (dominant or non-dominant) interaction (p = .013, ηp2 = .106) and a group main effect (p = .036, ηp2 = .165) were observed. Visual pacing resulted in greater improvements in task performance compared to auditory pacing regardless of hand or practice side, while training the dominant limb resulting in a greater interlimb asymmetry regardless of pacing stimulus. These findings have implications for applying pacing strategies during rehabilitation from unilateral injury or neurological impairment.
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Affiliation(s)
- Justin W Andrushko
- College of Kinesiology, University of Saskatchewan, Saskatoon, Canada
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Dakota T Zirk
- Department of Psychology, College of Arts and Science, University of Saskatchewan, Saskatoon, Canada
| | - Aryan R Kurniawan
- College of Kinesiology, University of Saskatchewan, Saskatoon, Canada
| | - Doug W Renshaw
- College of Kinesiology, University of Saskatchewan, Saskatoon, Canada
- Department of Kinesiology and Human Performance, Sul Ross State University, Alpine, Texas, USA
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2
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Carson RG, Hayward KS. Using mechanistic knowledge to appraise contemporary approaches to the rehabilitation of upper limb function following stroke. J Physiol 2024. [PMID: 39129269 DOI: 10.1113/jp285559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 07/12/2024] [Indexed: 08/13/2024] Open
Abstract
It is a paradox of neurological rehabilitation that, in an era in which preclinical models have produced significant advances in our mechanistic understanding of neural plasticity, there is inadequate support for many therapies recommended for use in clinical practice. When the goal is to estimate the probability that a specific form of therapy will have a positive clinical effect, the integration of mechanistic knowledge (concerning 'the structure or way of working of the parts in a natural system') may improve the quality of inference. This is illustrated by analysis of three contemporary approaches to the rehabilitation of lateralized dysfunction affecting people living with stroke: constraint-induced movement therapy; mental practice; and mirror therapy. Damage to 'cross-road' regions of the structural (white matter) brain connectome generates deficits that span multiple domains (motor, language, attention and verbal/spatial memory). The structural integrity of these regions determines not only the initial functional status, but also the response to therapy. As structural disconnection constrains the recovery of functional capability, 'disconnectome' modelling provides a basis for personalized prognosis and precision rehabilitation. It is now feasible to refer a lesion delineated using a standard clinical scan to a (dis)connectivity atlas derived from the brains of other stroke survivors. As the individual disconnection pattern thus obtained suggests the functional domains most likely be compromised, a therapeutic regimen can be tailored accordingly. Stroke is a complex disorder that burdens individuals with distinct constellations of brain damage. Mechanistic knowledge is indispensable when seeking to ameliorate the behavioural impairments to which such damage gives rise.
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Affiliation(s)
- Richard G Carson
- Trinity College Institute of Neuroscience and School of Psychology, Trinity College Dublin, Dublin 2, Ireland
- School of Psychology, Queen's University Belfast, Belfast, UK
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Kathryn S Hayward
- Departments of Physiotherapy, University of Melbourne, Melbourne, Australia
- Department of Medicine, University of Melbourne, Melbourne, Australia
- The Florey, University of Melbourne, Melbourne, Australia
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3
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Kitchen NM, Dexheimer B, Yuk J, Maenza C, Ruelos PR, Kim T, Sainburg RL. The complementary dominance hypothesis: a model for remediating the 'good' hand in stroke survivors. J Physiol 2024. [PMID: 38733166 DOI: 10.1113/jp285561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024] Open
Abstract
The complementary dominance hypothesis is a novel model of motor lateralization substantiated by decades of research examining interlimb differences in the control of upper extremity movements in neurotypical adults and hemisphere-specific motor deficits in stroke survivors. In contrast to earlier ideas that attribute handedness to the specialization of one hemisphere, our model proposes complementary motor control specializations in each hemisphere. The dominant hemisphere mediates optimal control of limb dynamics as required for smooth and efficient movements, whereas the non-dominant hemisphere mediates impedance control, important for countering unexpected mechanical conditions and achieving steady-state limb positions. Importantly, this model proposes that each hemisphere contributes its specialization to both arms (though with greater influence from either arm's contralateral hemisphere) and thus predicts that lesions to one hemisphere should produce hemisphere-specific motor deficits in not only the contralesional arm, but also the ipsilesional arm of stroke survivors - a powerful prediction now supported by a growing body of evidence. Such ipsilesional arm motor deficits vary with contralesional arm impairment, and thus individuals with little to no functional use of the contralesional arm experience both the greatest impairments in the ipsilesional arm, as well as the greatest reliance on it to serve as the main or sole manipulator for activities of daily living. Accordingly, we have proposed and tested a novel intervention that reduces hemisphere-specific ipsilesional arm deficits and thereby improves functional independence in stroke survivors with severe contralesional impairment.
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Affiliation(s)
- Nick M Kitchen
- Department of Neurology, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Brooke Dexheimer
- Department of Occupational Therapy, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Jisung Yuk
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Candice Maenza
- Department of Neurology, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
| | - Paul R Ruelos
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Taewon Kim
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
- Department of Physical Medicine and Rehabilitation, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
- Huck Institute of the Life Sciences, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Robert L Sainburg
- Department of Neurology, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
- Huck Institute of the Life Sciences, Pennsylvania State University, University Park, Pennsylvania, USA
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Razian M, Hosseinzadeh M, Behm DG, Sardroodian M. Effect of leg dominance on ipsilateral and contralateral limb training adaptation in middle-aged women after unilateral sensorimotor and resistance exercise training. Res Sports Med 2024; 32:345-362. [PMID: 36036379 DOI: 10.1080/15438627.2022.2113878] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/12/2022] [Indexed: 10/15/2022]
Abstract
The aim was to examine the directionality of global training effects in middle-aged women after unilateral training. Thirty-nine middle-aged female volunteers (59.4 ± 5.4 years) were randomly assigned to one of three groups: 1. Unilateral Dominant Lower Limb Training (UDLT); 2. Unilateral Non-Dominant Lower Limb Training (UNDLT) or 3. Control group. Outcome measures assessing isometric strength, static and dynamic balance were recorded at baseline, and 1 week after 12 weeks (post-test) of training or no-intervention. The net cross education adaptation changes of the contralateral quadriceps isometric maximum voluntary (MVC) force (F2,34 = 4.33; p = 0.022), Stork balance score (F2,34 = 4.26; p = 0.023) and the Star Excursion Balance test score (F2,34 = 11.80; p = 0.001) were asymmetrical in the UNDLT group and on average, exceeded the UDLT group. The results demonstrated asymmetrical cross education training adaptations with unilateral training of non-dominant leg (UNDLT) to contralateral homologous and heterologous muscles, with the exception of knee flexor MVC. The results of this study provide a novel exercise or rehabilitation strategy that can be employed when one of the limbs is affected.
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Affiliation(s)
- Mina Razian
- Department of Sport Science, University of Bojnord, Bojnord, North Khorasan, Iran
| | - Mahdi Hosseinzadeh
- Department of Sport Injuries and Corrective Exercises, Sport Sciences Research Institute, Tehran, Iran
| | - David G Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, Newfoundland and Labrador, St. John's, Canada
| | - Mahta Sardroodian
- Department of Sport Science, University of Bojnord, Bojnord, North Khorasan, Iran
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Carson RG, Morley A. Is a mirror necessary for mirror therapy? Neural Regen Res 2023; 18:2703-2704. [PMID: 37449631 DOI: 10.4103/1673-5374.373701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023] Open
Affiliation(s)
- Richard G Carson
- Trinity College Institute of Neuroscience and School of Psychology, Trinity College Dublin, Dublin, Ireland; School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Alannah Morley
- School of Medicine, Trinity College Dublin, Dublin, Ireland
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Capozio A, Chakrabarty S, Astill S. Acute Effects of Strength and Skill Training on the Cortical and Spinal Circuits of Contralateral Limb. J Mot Behav 2023; 56:119-131. [PMID: 37788807 DOI: 10.1080/00222895.2023.2265316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 09/19/2023] [Indexed: 10/05/2023]
Abstract
Unilateral strength and skill training increase strength and performance in the contralateral untrained limb, a phenomenon known as cross-education. Recent evidence suggests that similar neural mechanisms might be responsible for the increase in strength and skill observed in the untrained hand after unimanual training. The aims of this study were to: investigate whether a single session of unimanual strength and skill (force-tracking) training increased strength and skill in the opposite hand; measure ipsilateral (untrained) brain (via transcranial magnetic stimulation, TMS) and spinal (via the monosynaptic reflex) changes in excitability occurring after training; measure ipsilateral (untrained) pathway-specific changes in neural excitability (via TMS-conditioning of the monosynaptic reflex) occurring after training. Participants (N = 13) completed a session of unimanual strength (ballistic isometric wrist flexions) and skill (force-tracking wrist flexions) training on two separate days. Strength increased after training in the untrained hand (p = 0.025) but not in the trained hand (p = 0.611). Force-tracking performance increased in both the trained (p = 0.007) and untrained (p = 0.010) hand. Corticospinal excitability increased after force-tracking and strength training (p = 0.027), while spinal excitability was not affected (p = 0.214). TMS-conditioned monosynaptic reflex increased after force-tracking (p = 0.001) but not strength training (p = 0.689), suggesting a possible role of polysynaptic pathways in the increase of cortical excitability observed after training. The results suggest that cross-education of strength and skill at the acute stage is supported by increased excitability of the untrained motor cortex.New & Noteworthy: A single session of isometric wrist flexion strength and skill straining increased strength and skill in the untrained limb. The excitability of the untrained motor cortex increased after strength and skill training. TMS-conditioned H-reflexes increased after skill but not strength training in the untrained hand, indicating that polysynaptic pathways in the increase of cortical excitability observed after skill training.
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Affiliation(s)
- Antonio Capozio
- School of Biomedical Sciences, University of Leeds, Leeds, UK
| | | | - Sarah Astill
- School of Biomedical Sciences, University of Leeds, Leeds, UK
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Voskuil CC, Andrushko JW, Huddleston BS, Farthing JP, Carr JC. Exercise prescription and strategies to promote the cross-education of strength: a scoping review. Appl Physiol Nutr Metab 2023; 48:569-582. [PMID: 37156010 DOI: 10.1139/apnm-2023-0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
The cross-education of strength is moderated by exercise design and prescription in clinical and non-clinical populations. This review synthesizes the available evidence regarding exercise design strategies for unilateral resistance training and provides evidence-based recommendations for the prescription of unilateral training to maximize the cross-education of strength. Greater insights regarding the timing and effectiveness of cross-education interventions in clinical scenarios will strengthen the use of unilateral resistance training for individuals who may benefit from its use.
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Affiliation(s)
- Caleb C Voskuil
- Department of Kinesiology, Texas Christian University, Fort Worth TX, USA
| | - Justin W Andrushko
- Faculty of Medicine, Department of Physical Therapy, The University of British Columbia, Vancouver BC, Canada
| | - Boglarka S Huddleston
- Health Sciences Librarian, Mary C. Burnett Library, Texas Christian University, Fort Worth TX, USA
| | | | - Joshua C Carr
- Department of Kinesiology, Texas Christian University, Fort Worth TX, USA
- Department of Medical Education, Texas Christian University School of Medicine, Fort Worth TX, USA
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Yao WX, Ge S, Zhang JQ, Hemmat P, Jiang BY, Liu XJ, Lu X, Yaghi Z, Yue GH. Bilateral transfer of motor performance as a function of motor imagery training: a systematic review and meta-analysis. Front Psychol 2023; 14:1187175. [PMID: 37333595 PMCID: PMC10273842 DOI: 10.3389/fpsyg.2023.1187175] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/16/2023] [Indexed: 06/20/2023] Open
Abstract
Objective The objective of this review was to evaluate the efficacy of mental imagery training (MIT) in promoting bilateral transfer (BT) of motor performance for healthy subjects. Data sources We searched 6 online-databases (Jul-Dec 2022) using terms: "mental practice," "motor imagery training," "motor imagery practice," "mental training," "movement imagery," "cognitive training," "bilateral transfer," "interlimb transfer," "cross education," "motor learning," "strength," "force" and "motor performance." Study selection and data extraction We selected randomized-controlled studies that examined the effect of MIT on BT. Two reviewers independently determined if each study met the inclusion criteria for the review. Disagreements were resolved through discussion and, if necessary, by a third reviewer. A total of 9 articles out of 728 initially identified studies were chosen for the meta-analysis. Data synthesis The meta-analysis included 14 studies for the comparison between MIT and no-exercise control (CTR) and 15 studies for the comparison between MIT and physical training (PT). Results MIT showed significant benefit in inducing BT compared to CTR (ES = 0.78, 95% CI = 0.57-0.98). The effect of MIT on BT was similar to that of PT (ES = -0.02, 95% CI = -0.15-0.17). Subgroup analyses showed that internal MIT (IMIT) was more effective (ES = 2.17, 95% CI = 1.57-2.76) than external MIT (EMIT) (ES = 0.95, 95% CI = 0.74-1.17), and mixed-task (ES = 1.68, 95% CI = 1.26-2.11) was more effective than mirror-task (ES = 0.46, 95% CI = 0.14-0.78) and normal-task (ES = 0.56, 95% CI = 0.23-0.90). No significant difference was found between transfer from dominant limb (DL) to non-dominant limb (NDL) (ES = 0.67, 95% CI = 0.37-0.97) and NDL to DL (ES = 0.87, 95% CI = 0.59-1.15). Conclusion This review concludes that MIT can serve as a valuable alternative or supplement to PT in facilitating BT effects. Notably, IMIT is preferable to EMIT, and interventions incorporating tasks that have access to both intrinsic and extrinsic coordinates (mixed-task) are preferred over those that involve only one of the two coordinates (mirror-task or normal-task). These findings have implications for rehabilitation of patients such as stroke survivors.
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Affiliation(s)
- Wan X. Yao
- Department of Kinesiology, College for Health, Community, and Policy, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Sha Ge
- College of Sports Science, Tianjin Normal University, Tianjin, China
| | - John Q. Zhang
- Department of Kinesiology, College for Health, Community, and Policy, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Parisa Hemmat
- Department of Kinesiology, College for Health, Community, and Policy, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Bo Y. Jiang
- School of Public Health, Jilin Medical University, Jilin, China
| | - Xiao J. Liu
- College of Art, Beijing Sport University, Beijing, China
| | - Xing Lu
- College of Art, Beijing Sport University, Beijing, China
| | - Zayd Yaghi
- Department of Kinesiology, College for Health, Community, and Policy, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Guang H. Yue
- Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, United States
- Rutgers New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, United States
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Kaur J, Proksch S, Balasubramaniam R. The effect of elastic and viscous force fields on bimanual coordination. Exp Brain Res 2023; 241:1117-1130. [PMID: 36914895 PMCID: PMC10081978 DOI: 10.1007/s00221-023-06589-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 02/28/2023] [Indexed: 03/16/2023]
Abstract
Bimanual in-phase and anti-phase coordination modes represent two basic movement patterns with distinct characteristics-homologous muscle contraction and non-homologous muscle contraction, respectively. A method to understand the contribution of each limb to the overall coordination pattern involves detuning (Δω) the natural eigenfrequency of each limb. In the present experiment, we experimentally broke the symmetry between the two upper limbs by adding elastic and viscous force fields using a Kinarm robot exoskeleton. We measured the effect of this symmetry breaking on coordination stability as participants performed bimanual in-phase and anti-phase movements using their left and right hand in 1:1 frequency locking mode. Differences between uncoupled frequencies were manipulated via the application of viscous & elastic force fields and using fast and slow oscillation frequencies with a custom task developed using the Kinarm robotic exoskeleton. The effects of manipulating the asymmetry between the limbs were measured through the mean and variability of relative phase (ϕ) from the intended modes of 0 ° or 180 °. In general, participants deviated less from intended phase irrespective of coordination mode in all matched conditions, except for when elastic loads are applied to both arms in the anti-phase coordination. Second, we found that when force fields were mismatched participants exhibited a larger deviation from the intended phase. Overall, there was increased phase deviation during anti-phase coordination. Finally, participants exhibited higher variability in relative phase in mismatched force conditions compared to matched force conditions, with overall higher variability during anti-phase coordination mode. We extend previous research by demonstrating that symmetry breaking caused by force differences between the limbs disrupts stability in each coordination mode.
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Affiliation(s)
- Jaskanwaljeet Kaur
- Sensorimotor Neuroscience Laboratory, Cognitive and Information Sciences, University of California, 5200 N Lake Road Merced, Merced, CA, 95343, USA.
| | - Shannon Proksch
- Sensorimotor Neuroscience Laboratory, Cognitive and Information Sciences, University of California, 5200 N Lake Road Merced, Merced, CA, 95343, USA.,Department of Psychology, Augustana University, Sioux Falls, SD, 57197, USA
| | - Ramesh Balasubramaniam
- Sensorimotor Neuroscience Laboratory, Cognitive and Information Sciences, University of California, 5200 N Lake Road Merced, Merced, CA, 95343, USA
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Woldeamanuel GG, Frazer AK, Lee A, Avela J, Tallent J, Ahtiainen JP, Pearce AJ, Kidgell DJ. Determining the Corticospinal Responses and Cross-Transfer of Ballistic Motor Performance in Young and Older Adults: A Systematic Review and Meta-Analysis. J Mot Behav 2022; 54:763-786. [PMID: 35437124 DOI: 10.1080/00222895.2022.2061409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Ballistic motor training induces plasticity changes and imparts a cross-transfer effect. However, whether there are age-related differences in these changes remain unclear. Thus, the purpose of this study was to perform a meta-analysis to determine the corticospinal responses and cross-transfer of motor performance following ballistic motor training in young and older adults. Meta-analysis was performed using a random-effects model. A best evidence synthesis was performed for variables that had insufficient data for meta-analysis. There was strong evidence to suggest that young participants exhibited greater cross-transfer of ballistic motor performance than their older counterparts. This meta-analysis showed no significant age-related differences in motor-evoked potentials (MEPs), short-interval intracortical inhibition (SICI) and surface electromyography (sEMG) for both hands following ballistic motor training.
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Affiliation(s)
- Gashaw Garedew Woldeamanuel
- Faculty of Medicine, Nursing and Health Science, Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - Ashlyn K Frazer
- Faculty of Medicine, Nursing and Health Science, Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - Annemarie Lee
- Faculty of Medicine, Nursing and Health Science, Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - Janne Avela
- Faculty of Sport and Health Sciences, NeuroMuscular Research Center, University of Jyväskylä, Finland
| | - Jamie Tallent
- Faculty of Medicine, Nursing and Health Science, Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, Australia.,Faculty of Sport, Health and Applied Sciences, St Mary's University, Twickenham, UK
| | - Juha P Ahtiainen
- Faculty of Sport and Health Sciences, NeuroMuscular Research Center, University of Jyväskylä, Finland
| | - Alan J Pearce
- College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | - Dawson J Kidgell
- Faculty of Medicine, Nursing and Health Science, Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, Australia
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