Variations in cognitive demand affect heart rate in typically developing children and children at risk for developmental coordination disorder

Development and feasibility of a virtual reality-based exergaming program to enhance cardiopulmonary fitness in children with developmental coordination disorder

Introduction

Developmental coordination disorder (DCD) is a neurodevelopmental disorder characterized by motor skill deficits. Such deficits often limit children's participation in physical activities, further affecting their overall health, including through reduced cardiopulmonary fitness. Because virtual reality (VR) devices offer interactive games and activities that require various movements and coordination, they can serve as motivating and enjoyable means for children to perform physical exercise. In this study, we developed a VR-based exergaming system and tested its ability to enhance the cardiopulmonary fitness of children with DCD.

Materials and methods

A total of 13 children with DCD and 10 young adults were recruited in phase I to examine the test-retest reliability and concurrent validity of our system (including a custom-made heart rate monitor) with a commercial heart rate device. In phase II, we included an additional 13 children with DCD to test the feasibility of the system. We tested the outcomes using the enjoyment rating scale, intrinsic motivation inventory (IMI), and 20-m shuttle run test (20mSRT).

Results

In phase I, test-retest reliability was good to excellent in the static task and moderate to good in the dynamic task. Concurrent validity was excellent in both tasks. In phase II, more than half of the children (18 out of 26) assigned the maximum rating for their enjoyment of the game; they also had high average scores on the IMI. Furthermore, after the 8-week training using the VR program, the average running distance of the 26 children in the 20mSRT had increased significantly from 129.23 m to 176.92 m (p < 0.001).

Conclusion

Our VR-based exergaming program can serve as an alternative intervention for enhancing cardiopulmonary fitness in children with DCD.

Baseline heart rate variability (HRV) and performance during a set-shifting visuospatial learning task: The moderating effect of trait negative affectivity (NA) on behavioral flexibility✰

Higher negative affectivity (NA) has an association with decreased executive function and cognitive control. Heart rate variability (HRV) may index cardiac vagal regulation differences in the autonomic nervous system (ANS) for both cognition and emotion. The current study investigates this association using a set-shifting variant of the Virtual Morris Water Task (VMWT) to study discrimination learning, spatial learning, reversal learning, and attentional set-shifting in a virtual environment. 73 participants completed affective questionnaires (Beck Depression Inventory-II, Beck Anxiety Inventory, Positive and Negative Affective Scale), a 5-minute baseline electrocardiogram, and the VMWT. Individuals who failed to complete the task exhibited significantly lower baseline RMSSD then those who completed the task. There was no direct effect between affective measures and task performance. Higher baseline HRV was predictive of better performance during set-shifting. Trait NA moderated the effect of baseline HRV, as well as trait positive affectivity (PA), on performance during the extradimensional shift condition. Increased behavioral flexibility performance was only predicted by higher HRV and PA in low NA individuals. High trait NA negates the positive effects of HRV and PA on behavioral flexibility.

Autonomous nervous system modulation in supine and standing postures in children with probable developmental coordination disorder

Background

Children with Developmental Coordination Disorder (DCD) are known to have poor physical fitness and psychosocial problems. The autonomous nervous system (ANS) plays an essential role in the regulation of human neurophysiological processes. Inadequate ANS modulation has been associated with harmful health conditions such as poor aerobic power, high body mass index, and symptoms of stress and anxiety. Modulation of ANS in children with DCD needs to be further investigated taking into consideration variables that may influence its function. For instance, would the level of physical fitness or the symptoms of stress and anxiety affect the ANS modulation of children with DCD?

Aims

To examine the ANS modulation during supine and standing postures, and stress/anxiety with questionnaire data from children with probable-DCD (p-DCD).

Methods

and procedures: Thirty children, 8–12 years old, composed two groups paired by age, gender, peak volume of oxygen uptake (aerobic power), and body mass index (BMI): p-DCD (9 boys, mean age 10.8 y) and typically developing (TD). Both groups were compared for stress/anxiety assessment by questionnaire and spectral, symbolic, and complexity heart rate variability (HRV) analyses during posture changes.

Outcomes and results

p-DCD group showed higher stress symptoms than TD group for stress/anxiety assessment in the questionnaire's data, but HRV analyses showed no differences between the two groups. Both groups showed parasympathetic prevalence during supine posture and sympathetic prevalence during standing posture.

Conclusions and implications

Children with p-DCD had similar autonomic control function as TD children during posture change (supine to standing). Symptoms of stress and anxiety demonstrated by p-DCD did not impact their ANS modulation. These results indicate that aerobic power and BMI are probable protective factors of ANS modulation for these children.

Linear and Nonlinear Analyses of the Cardiac Autonomic Control in Children With Developmental Coordination Disorder: A Case-Control Study

Children with Developmental Coordination Disorder (DCD) and children at risk for DCD (r-DCD) present motor impairments interfering in their school, leisure and daily activities. In addition, these children may have abnormalities in their cardiac autonomic control, which together with their motor impairments, restrict their health and functionality. Therefore, this study aimed to assess the cardiac autonomic control, by linear and nonlinear analysis, at supine and during an orthostatic stimulus in DCD, r-DCD and typically developed children. Thirteen DCD children (11 boys and 2 girls, aged 8.08 ± 0.79 years), 19 children at risk for DCD (13 boys and 6 girls, aged 8.10 ± 0.96 years) and 18 typically developed children, who constituted the control group (CG) (10 boys and 8 girls, aged 8.50 ± 0.96 years) underwent a heart rate variability (HRV) examination. R-R intervals were recorded in order to assess the cardiac autonomic control using a validated HR monitor. HRV was analyzed by linear and nonlinear methods and compared between r-DCD, DCD, and CG. The DCD group presented blunted cardiac autonomic adjustment to the orthostatic stimulus, which was not observed in r-DCD and CG. Regarding nonlinear analysis of HRV, the DCD group presented lower parasympathetic modulation in the supine position compared to the r-DCD and CG groups. In the within group analysis, only the DCD group did not increase HR from supine to standing posture. Symbolic analysis revealed a significant decrease in 2LV (p < 0.0001) and 2UV (p < 0.0001) indices from supine to orthostatic posture only in the CG. In conclusion, r-DCD and DCD children present cardiac autonomic dysfunction characterized by higher sympathetic, lower parasympathetic and lower complexity of cardiac autonomic control in the supine position, as well as a blunted autonomic adjustment to the orthostatic stimulus. Therefore, cardiovascular health improvement should be part of DCD children's management, even in cases of less severe motor impairment.

Cognitive and neuroimaging findings in developmental coordination disorder: new insights from a systematic review of recent research

AIM

To better understand the neural and performance factors that may underlie developmental coordination disorder (DCD), and implications for a multi-component account.

METHOD

A systematic review of the experimental literature published between June 2011 and September 2016 was conducted using a modified PICOS (population, intervention, comparison, outcomes, and study type) framework. A total of 106 studies were included.

RESULTS

Behavioural data from 91 studies showed a broad cluster of deficits in the anticipatory control of movement, basic processes of motor learning, and cognitive control. Importantly, however, performance issues in DCD were often shown to be moderated by task type and difficulty. As well, we saw new evidence of compensatory processes and strategies in several studies. Neuroimaging data (15 studies, including electroencephalography) showed reduced cortical thickness in the right medial orbitofrontal cortex and altered brain activation patterns across functional networks involving prefrontal, parietal, and cerebellar regions in children with DCD than those in comparison groups. Data from diffusion-weighted magnetic resonance imaging suggested reduced white matter organization involving sensorimotor structures and altered structural connectivity across the whole brain network.

INTERPRETATION

Taken together, results support the hypothesis that children with DCD show differences in brain structure and function compared with typically developing children. Behaviourally, these differences may affect anticipatory planning and reduce automatization of movement skill, prompting greater reliance on slower feedback-based control and compensatory strategies. Implications for future research, theory development, and clinical practice are discussed.

Heart rate variability and cognitive processing: The autonomic response to task demands

This study investigated variations in heart rate variability (HRV) as a function of cognitive demands. Participants completed an execution condition including the psychomotor vigilance task, a working memory task and a duration discrimination task. The control condition consisted of oddball versions (participants had to detect the rare event) of the tasks from the execution condition, designed to control for the effect of the task parameters (stimulus duration and stimulus rate) on HRV. The NASA-TLX questionnaire was used as a subjective measure of cognitive workload across tasks and conditions. Three major findings emerged from this study. First, HRV varied as a function of task demands (with the lowest values in the working memory task). Second, and crucially, we found similar HRV values when comparing each of the tasks with its oddball control equivalent, and a significant decrement in HRV as a function of time-on-task. Finally, the NASA-TLX results showed larger cognitive workload in the execution condition than in the oddball control condition, and scores variations as a function of task. Taken together, our results suggest that HRV is highly sensitive to overall demands of sustained attention over and above the influence of other cognitive processes suggested by previous literature. In addition, our study highlights a potential dissociation between objective and subjective measures of mental workload, with important implications in applied settings.