Perception as a Route for Motor Skill Learning: Perspectives from Neuroscience

Exploring the Therapeutic Effects and Mechanisms of Transcranial Alternating Current Stimulation on Improving Walking Ability in Stroke Patients via Modulating Cerebellar Gamma Frequency Band-a Narrative Review

The cerebellum plays an important role in maintaining balance, posture control, muscle tone, and lower limb coordination in healthy individuals and stroke patients. At the same time, the relationship between cerebellum and motor learning has been widely concerned in recent years. Due to the relatively intact structure preservation and high plasticity after supratentorial stroke, non-invasive neuromodulation targeting the cerebellum is increasingly used to treat abnormal gait in stroke patients. The gamma frequency of transcranial alternating current stimulation (tACS) is commonly used to improve motor learning. It is an essential endogenous EEG oscillation in the gamma range during the swing phase, and rhythmic movement changes in the gait cycle. However, the effect of cerebellar tACS in the gamma frequency band on balance and walking after stroke remains unknown and requires further investigation.

Oromotor Nonverbal Performance and Speech Motor Control: Theory and Review of Empirical Evidence

This position paper offers a perspective on the long-standing debate concerning the role of oromotor, nonverbal gestures in understanding typical and disordered speech motor control secondary to neurological disease. Oromotor nonverbal tasks are employed routinely in clinical and research settings, but a coherent rationale for their use is needed. The use of oromotor nonverbal performance to diagnose disease or dysarthria type, versus specific aspects of speech production deficits that contribute to loss of speech intelligibility, is argued to be an important part of the debate. Framing these issues are two models of speech motor control, the Integrative Model (IM) and Task-Dependent Model (TDM), which yield contrasting predictions of the relationship between oromotor nonverbal performance and speech motor control. Theoretical and empirical literature on task specificity in limb, hand, and eye motor control is reviewed to demonstrate its relevance to speech motor control. The IM rejects task specificity in speech motor control, whereas the TDM is defined by it. The theoretical claim of the IM proponents that the TDM requires a special, dedicated neural mechanism for speech production is rejected. Based on theoretical and empirical information, the utility of oromotor nonverbal tasks as a window into speech motor control is questionable.

Effects of virtual body-representation on motor skill learning

Motor learning is often hindered or facilitated by visual information from one's body and its movement. However, it is unclear whether visual representation of the body itself facilitates motor learning. Thus, we tested the effects of virtual body-representation on motor learning through a virtual reality rotary pursuit task. In the task, visual feedback on participants' movements was identical, but virtual body-representation differed by dividing the experimental conditions into three conditions: non-avatar, non-hand avatar, and hand-shaped avatar. We measured the differences in the rate of motor learning, body-ownership, and sense of agency in the three conditions. Although there were no differences in body-ownership and sense of agency between the conditions, the hand-shaped avatar condition was significantly superior to the other conditions in the rate of learning. These findings suggest that visually recognizing one's body shape facilitates motor learning.

The effects of physical training versus combined action observation and motor imagery in conjunction with physical training on upper-extremity performance

INTRODUCTION

Combined action observation and motor imagery training (AO+MI training), which involves motor imagery during action observation and physical training, has been attracting attention as an effective strategy for learning motor skills. However, little has been reported on the effects of AO+MI training. In the present study, we compared the effects of AO+MI training to the effects of physical training on upper-extremity performance.

MATERIALS AND METHODS

Ninety-six healthy participants were randomly assigned to either the control group or the experimental group. Sport stacking, which is often used to evaluate upper-extremity performance, was adopted for the task. The experiment was scheduled for three days. The training was 20 min per day. The control group performed only physical training, while the experimental group performed four 5-min AO+MI training sessions. Time taken to complete a sport stacking try (task completion time) was defined as the index of speed of upper-extremity performance and number of fallen cups as the index of its accuracy. The outcomes within each group and between the two groups were compared.

RESULTS

Both AO+MI training and physical training showed reduced task completion time and increased number of fallen cups. There were no significant differences in the degree of changes between the groups.

CONCLUSION

Results from the present study showed that AO+MI training and physical training had almost the same influence on upper-extremity performance in the early stages of learning sport stacking. This result suggests that AO+MI training may be an effective and low-burden training method for participants.

Children do not distinguish efficient from inefficient actions during observation

Observation is a powerful way to learn efficient actions from others. However, the role of observers' motor skill in assessing efficiency of others is unknown. Preschoolers are notoriously poor at performing multi-step actions like grasping the handle of a tool. Preschoolers (N = 22) and adults (N = 22) watched video-recorded actors perform efficient and inefficient tool use. Eye tracking showed that preschoolers and adults looked equally long at the videos, but adults looked longer than children at how actors grasped the tool. Deep learning analyses of participants' eye gaze distinguished efficient from inefficient grasps for adults, but not for children. Moreover, only adults showed differential action-related pupil dilation and neural activity (suppressed oscillation power in the mu frequency) while observing efficient vs. inefficient grasps. Thus, children observe multi-step actions without "seeing" whether the initial step is efficient. Findings suggest that observer's own motor efficiency determines whether they can perceive action efficiency in others.

Comparing the Effects of Stroke-Appearing and Stroke-Disappearing on Learning the Order of Strokes in Chinese Characters

Different approaches to stimulating perceptions in learning can be easily designed with technology-enhanced learning systems. This study aimed to explore how different approaches can influence learners' perceptions that may negatively or positively affect their learning performance of writing Chinese characters using the correct Chinese order of strokes (COS). We therefore designed an e-learning system which was subdivided into two modes: stroke-appearing (i.e., using red to mark incorrect strokes) and stroke-disappearing (i.e., using blanks to mark incorrect strokes) to indicate strokes written in the incorrect order. We then investigated the modes that would facilitate a higher level of attention and better learning outcomes. A total of 10 third-grade elementary school students participated in the experiment, divided into two test groups. Their EEG data were collected, and time series analysis and t-tests were utilized to analyze the differences. The results indicated that: (1) there was a significant difference in the attention levels of the students practicing with the stroke-appearing and stroke-disappearing modes when learning COS, and (2) there was a significant difference in the learning outcomes of the students practicing with the stroke-appearing and stroke-disappearing modes when learning COS. These findings support the specific role of stroke order knowledge in learning Chinese characters and the need for the design of an effective method for teaching children to learn Chinese characters.

Changes in attentional resources during the acquisition of laparoscopic surgical skills

Background

Increasing familiarity and practice might free up mental resources during laparoscopic surgical skills training. The aim of the study was to track changes in mental resource allocation during acquisition of laparoscopic surgical skills.

Methods

Medical students with no previous experience in laparoscopic surgery took part in a 5-week laparoscopic training curriculum. At the beginning and end of the training period, one of the training tasks was combined with a secondary auditory detection task that required pressing a foot switch for defined target tones, creating a dual-task situation. During execution of the two concurrent tasks, continuous electroencephalographic measurements were made, with special attention to the P300 component, an index of mental resources. Accuracy and reaction times of the secondary task were determined.

Results

All 14 participants successfully completed the training curriculum. Target times for successful completion of individual tasks decreased significantly during training sessions (P  <0.001 for all tasks). Comparing results before and after training showed a significant decrease in event-related brain potential amplitude at the parietal electrode cluster (P300 component, W = 67, P = 0.026), but there were no differences in accuracy (percentage correct responses: W = 48, P = 0.518) or reaction times (W = 42, P = 0.850) in the auditory detection task.

Conclusion

The P300 decrease in the secondary task over training demonstrated a shift of mental resources to the primary task: the surgical exercise. This indicates that, with more practice, mental resources are freed up for additional tasks.

A Review on Upper Limb Rehabilitation Robots

Rehabilitation is the process of treating post-stroke consequences. Impaired limbs are considered the common outcomes of stroke, which require a professional therapist to rehabilitate the impaired limbs and restore fully or partially its function. Due to the shortage in the number of therapists and other considerations, researchers have been working on developing robots that have the ability to perform the rehabilitation process. During the last two decades, different robots were invented to help in rehabilitation procedures. This paper explains the types of rehabilitation treatments and robot classifications. In addition, a few examples of well-known rehabilitation robots will be explained in terms of their efficiency and controlling mechanisms.

Superimposed Skilled Performance in a Virtual Mirror Improves Motor Performance and Cognitive Representation of a Full Body Motor Action

Feedback is essential for skill acquisition as it helps identifying and correcting performance errors. Nowadays, Virtual Reality can be used as a tool to guide motor learning, and to provide innovative types of augmented feedback that exceed real world opportunities. Concurrent feedback has shown to be especially beneficial for novices. Moreover, watching skilled performances helps novices to acquire a motor skill, and this effect depends on the perspective taken by the observer. To date, however, the impact of watching one's own performance together with full body superimposition of a skilled performance, either from the front or from the side, remains to be explored. Here we used an immersive, state-of-the-art, low-latency cave automatic virtual environment (CAVE), and we asked novices to perform squat movements in front of a virtual mirror. Participants were assigned to one of three concurrent visual feedback groups: participants either watched their own avatar performing full body movements or were presented with the movement of a skilled individual superimposed on their own performance during movement execution, either from a frontal or from a side view. Motor performance and cognitive representation were measured in order to track changes in movement quality as well as motor memory across time. Consistent with our hypotheses, results showed an advantage of the groups that observed their own avatar performing the squat together with the superimposed skilled performance for some of the investigated parameters, depending on perspective. Specifically, for the deepest point of the squat, participants watching the squat from the front adapted their height, while those watching from the side adapted their backward movement. In a control experiment, we ruled out the possibility that the observed improvements were due to the mere fact of performing the squat movements—irrespective of the type of visual feedback. The present findings indicate that it can be beneficial for novices to watch themselves together with a skilled performance during execution, and that improvement depends on the perspective chosen.