The role of working memory in motor learning and performance

Kinematic and Kinetic Differences Between Ball Rotational Exercises and the Throwing Motion in Collegiate Baseball Athletes

ABSTRACT

Mylott, JA, Potts, EM, Wolf, JH, Bullock, GS, and Nicholson, KF. Kinematic and kinetic differences between ball rotational exercises and the throwing motion in collegiate baseball athletes. J Strength Cond Res XX(X): 000-000, 2024-The purpose of this study was to observe the associations that medicine ball pushes and chops have on the lower extremities regarding ground reaction forces (GRF) and lead knee flexion angles and to compare these values with a regular baseball overhead throw. Lower extremity kinetics and kinematics were obtained via force plates and marker motion capture. Subjects (n = 35) included baseball players (age 19.7 ± 1.5 years). Five medicine ball movements of each type along with at least 3 pitches or 5 throws off the mound were recorded for data collection. Statistical parametric mapping, including analysis of variance and 2-way t-tests, was used to compare the variables of interest between the movements for continuous time data. All kinematic and kinetic variables were significantly different (p < 0.05) for some time during the motion between the different trial types of medicine ball exercises and throws. A medicine ball chop can increase peak drive leg GRF, whereas a push can help an athlete keep greater driver leg GRF and maintain ground connection into foot plant. A push helps train lead leg deficiencies in the delivery. Both the medicine ball chop and push have benefits for training lead leg stabilization and extension.

Implicit Versus Explicit Learning a Novel Skill for High School Students

The aim of the study was to compare the effects of implicit learning using dual task-paradigm, with explicit learning on learning a novel skill, and if the performance is maintained over a prolonged period of time. Twenty-six high school adolescents (n = 26, boys n = 15, girls n = 11, age: 16 ± 0.66 years) performed a four-week front-flip learning program, where participants underwent two hours front flip practice in total between the pre- and post-test session followed by two tests; three and six months after the post-test, in which the front-flip was not practiced. Performance was evaluated by two independent gymnastics judges. Both groups increased performance at the post test, with significantly higher scores in the explicit group compared with the implicit group. Probably benefiting from error correction to select positive action outcomes and avoid negative ones consciously. However, the explicit group was also the only group that significantly decreased performance again at first retention test, suggesting that their reliance on the retrieval of declarative knowledge from working memory was subject to decay. While it seems that performance learned via implicit learning may deteriorate more slowly, but also continuously throughout six months suggesting that the directly accumulated procedural knowledge may need for proper reinforcement and practice.

Some pressures are more equal than others: Effects of isolated pressure on performance

It is commonly assumed that performance is impaired by pressure and that different types of individual situational factors can produce equivalent pressure. Our aim was to explore the psychophysiological effects of pressure to test this assumption. Eighty-one novices completed a golf putting task under control and eight individual pressure conditions: time, difficulty, video, team, goal, fame, shame, and distraction. Performance was measured by the number of holed putts and ball-hole distance. Psychological, physiological and kinematic measures were collected. Performance was impaired by time and difficulty conditions but improved by team, goal and shame conditions compared to control. Perceived pressure and effort were higher than control in all conditions except distraction. Conscious processing was greater than control in all conditions except distraction and time constraint. Heart rate was faster with time, team, fame and shame. Heart rate variability and muscle activity were largely unaffected. Putter kinematics provided evidence of swing profiles slowing and/or becoming constrained in conditions where conscious processing increased, while the swing became faster in the time-pressure condition where conscious processing was decreased. Taken together, these results reveal heterogenous effects of pressure on performance, with performance impaired, unaffected, and improved by individual pressure situations. Similarly, heterogeneity characterized the effects of pressure on psychological, physiological and kinematic responses associated with task performance. In sum, the evidence challenges the standard tacit assumptions about the pressure-performance relationship in sport.

Implicit motor learning in children with autism spectrum disorder: current approaches and future directions

Motor dysfunction is increasingly being viewed as a core characteristic of autism spectrum disorder (ASD) in children. In particular, children with ASD have difficulty in learning new motor skills and there is a need to develop effective methods to improve this. Previous research has found that children with ASD may retain the ability to implicitly learn motor skills in comparison to their explicit learning of motor skills, which is typically impaired. This literature mini review focuses on summarizing the study of implicit learning in the acquisition of motor skills in children with ASD. First, we briefly introduce several common implicit learning methods in children's motor skill learning. Second, we focus on the role of two important implicit learning approaches in motor skill learning, namely, an external focus of attention and analogy learning. Finally, based on our review of the existing studies, we present an outlook for future research and the areas that need to be improved in the practical teaching of implicit learning in the acquisition of motor skills in children with ASD.

Transcranial alternating current stimulation does not affect microscale learning

A theory has been posited that microscale learning, which involves short intervals of a few seconds during explicit motor skill learning, considerably enhances performance. This phenomenon correlates with diminished beta-band activity in the frontal and parietal regions. However, there is a lack of neurophysiological studies regarding the relationship between microscale learning and implicit motor skill learning. In the present study, we aimed to determine the effects of transcranial alternating current stimulation (tACS) during short rest periods on microscale learning in an implicit motor task. We investigated the effects of 20-Hz β-tACS delivered during short rest periods while participants performed an implicit motor task. In Experiments 1 and 2, β-tACS targeted the right dorsolateral prefrontal cortex and the right frontoparietal network, respectively. The participants performed a finger-tapping task using their nondominant left hand, and microscale learning was separately analyzed for micro-online gains (MOnGs) and micro-offline gains (MOffGs). Contrary to our expectations, β-tACS exhibited no statistically significant effects on MOnGs or MOffGs in either Experiment 1 or Experiment 2. In addition, microscale learning during the performance of the implicit motor task was improved by MOffGs in the early learning phase and by MOnGs in the late learning phase. These results revealed that the stimulation protocol employed in this study did not affect microscale learning, indicating a novel aspect of microscale learning in implicit motor tasks. This is the first study to examine microscale learning in implicit motor tasks and may provide baseline information that will be useful in future studies.

Effects of task difficulty on performance and event-related bradycardia during preparation for action

The slowing of heart rate prior to movement onset has been presented as a marker of task-related cognitive processing and linked with performance accuracy. Here we examined this event-related bradycardia and task performance as a function of task difficulty. Forty experienced golfers completed a series of golf putting conditions that manipulated task difficulty by varying target distance, target size, and surface contour. Performance was measured by the number of holed putts and finishing distance from the hole. Physiological activity was recorded throughout. Analyses confirmed that performance varied as a function of task difficulty, worsening with longer distances to target, smaller targets, and sloping paths to target. Task difficulty also impacted the cardiac response, including the rate of heart rate deceleration, change in heart rate, and heart rate at impact. These heart rate metrics were found to correlate with performance strongly, moderately, and weakly, respectively. In conclusion, heart rate deceleration in the moments preceding movement onset was affected by task difficulty. Features of this cardiac deceleration pattern were characteristic of successful performance. Our findings are discussed in terms of the role of cognitive and motor processes during the execution of complex motor skills.

Energetic and Cognitive Demands of Treading Water: Effects of Technique and Expertise

Being able to tread water effectively can improve the likelihood of survival following accidental immersion. People tread water in various ways, ranging from rudimentary 'doggy-paddle' to more elaborate techniques like the eggbeater, but little is known about the energetic and cognitive requirements of treading water. We therefore aimed to measure the demands of treading water techniques for people of different experience levels. Three cohorts, comprising 21 adult water treading experts (water polo players), 15 intermediate swimmers and 16 inexperienced swimmers, treaded water for 3 min each using four different techniques while cognitive and energetic economy measures were taken. For inexperienced swimmers, the flutter kick and breaststroke patterns produced the lowest self-reported physical and task load (rating of perceived exertion, NASA task load index), while cognitive (probe reaction time), cardiac (heart rate) and metabolic (oxygen consumption) load did not differ between techniques. In contrast, for expert water treaders, both breaststroke and eggbeater patterns produced lower cognitive, cardiac and metabolic loads. For intermediate swimmers, breaststroke resulted in the lowest cardiac and metabolic loads, as well as self-reported task load. Probe reaction time was highest while performing the eggbeater technique, indicating that this technique was challenging to coordinate and cognitively demanding. While the energetic demands of antiphase kicking patterns (such as eggbeater in experts or flutter kick in beginners) may be similarly low, the symmetric coordination of upright breaststroke may explain why this pattern's cognitive economy was favourable for all groups. As the eggbeater can be challenging to perform for many people, an upright breaststroke technique is an adequate alternative to adopt in survival situations.

Proprioceptive short-term memory in passive motor learning

A physical trainer often physically guides a learner's limbs to teach an ideal movement, giving the learner proprioceptive information about the movement to be reproduced later. This instruction requires the learner to perceive kinesthetic information and store the instructed information temporarily. Therefore, (1) proprioceptive acuity to accurately perceive the taught kinesthetics and (2) short-term memory to store the perceived information are two critical functions for reproducing the taught movement. While the importance of proprioceptive acuity and short-term memory has been suggested for active motor learning, little is known about passive motor learning. Twenty-one healthy adults (mean age 25.6 years, range 19-38 years) participated in this study to investigate whether individual learning efficiency in passively guided learning is related to these two functions. Consequently, learning efficiency was significantly associated with short-term memory capacity. In particular, individuals who could recall older sensory stimuli showed better learning efficiency. However, no significant relationship was observed between learning efficiency and proprioceptive acuity. A causal graph model found a direct influence of memory on learning and an indirect effect of proprioceptive acuity on learning via memory. Our findings suggest the importance of a learner's short-term memory for effective passive motor learning.

Sensorimotor Adaptation to Formant-Shifted Auditory Feedback Is Predicted by Language-Specific Factors in L1 and L2 Speech Production

Auditory feedback plays an important role in the long-term updating and maintenance of speech motor control; thus, the current study explored the unresolved question of how sensorimotor adaptation is predicted by language-specific and domain-general factors in first-language (L1) and second-language (L2) production. Eighteen English-L1 speakers and 22 English-L2 speakers performed the same sensorimotor adaptation experiments and tasks, which measured language-specific and domain-general abilities. The experiment manipulated the language groups (English-L1 and English-L2) and experimental conditions (baseline, early adaptation, late adaptation, and end). Linear mixed-effects model analyses indicated that auditory acuity was significantly associated with sensorimotor adaptation in L1 and L2 speakers. Analysis of vocal responses showed that L1 speakers exhibited significant sensorimotor adaptation under the early adaptation, late adaptation, and end conditions, whereas L2 speakers exhibited significant sensorimotor adaptation only under the late adaptation condition. Furthermore, the domain-general factors of working memory and executive control were not associated with adaptation/aftereffects in either L1 or L2 production, except for the role of working memory in aftereffects in L2 production. Overall, the study empirically supported the hypothesis that sensorimotor adaptation is predicted by language-specific factors such as auditory acuity and language experience, whereas general cognitive abilities do not play a major role in this process.

Not according to plan: Cognitive failures in marksmanship due to effects of expertise, unknown environments, and the likelihood of shooting unintended targets

Shooting errors have multi-faceted causes with contributing factors that include sensorimotor activity and cognitive failures. Empirical investigations often assess mental errors through threat identification, yet other cognitive failures could contribute to poor outcomes. The current study explored several possible sources of cognitive failures unrelated to threat identification with live fire exercises. Experiment 1 examined a national shooting competition to compare marksmanship accuracy, expertise, and planning in the likelihood of hitting no-shoot or unintended targets. Experts demonstrated an inverse speed/accuracy trade-off and fired upon fewer no-shoot targets than lesser skilled shooters, yet overall, greater opportunity to plan produced more no-shoot errors, thereby demonstrating an increase in cognitive errors. Experiment 2 replicated and extended this finding under conditions accounting for target type, location, and number. These findings further dissociate the roles of marksmanship and cognition in shooting errors while suggesting that marksmanship evaluations should be re-designed to better incorporate cognitive variables.

Transcranial direct current stimulation to the left dorsolateral prefrontal cortex enhances early dexterity skills with the left non-dominant hand: a randomized controlled trial

BACKGROUND

The left dorsolateral prefrontal cortex (DLPFC) is involved in early-phase manual dexterity skill acquisition when cognitive control processes, such as integration and complexity demands, are required. However, the effectiveness of left DLPFC transcranial direct current stimulation (tDCS) on early-phase motor learning and whether its effectiveness depends on the cognitive demand of the target task are unclear. This study aimed to investigate whether tDCS over the left DLPFC improves non-dominant hand dexterity performance and determine if its efficacy depends on the cognitive demand of the target task.

METHODS

In this randomized, double-blind, sham-controlled trial, 70 healthy, right-handed, young adult participants were recruited. They were randomly allocated to the active tDCS (2 mA for 20 min) or sham groups and repeatedly performed the Purdue Pegboard Test (PPT) left-handed peg task and left-handed assembly task three times: pre-tDCS, during tDCS, and post tDCS.

RESULTS

The final sample comprised 66 healthy young adults (mean age, 22.73 ± 1.57 years). There were significant interactions between group and time in both PPT tasks, indicating significantly higher performance of those in the active tDCS group than those in the sham group post tDCS (p < 0.001). Moreover, a greater benefit was observed in the left-handed assembly task performance than in the peg task performance (p < 0.001). No significant correlation between baseline performance and benefits from tDCS was observed in either task.

CONCLUSIONS

These results demonstrated that prefrontal tDCS significantly improved early-phase manual dexterity skill acquisition, and its benefits were greater for the task with high cognitive demands. These findings contribute to a deeper understanding of the underlying neurophysiological mechanisms of the left DLPFC in the modulation of early-phase dexterity skill acquisition.

TRIAL REGISTRATION

This study was registered in the University Hospital Medical Information Network Clinical Trial Registry in Japan (UMIN000046868), Registered February 8, 2022 https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000053467.

A Novel Neurorehabilitation Approach for Neural Plasticity Overstimulation and Reorganization in Patients with Neurological Disorders

Neurological disorders are those that are associated with impairments in the nervous system. These impairments affect the patient’s activities of daily living. Recently, many advanced modalities have been used in the rehabilitation field to treat various neurological impairments. However, many of these modalities are available only in clinics, and some are expensive. Most patients with neurological disorders have difficulty reaching clinics. This review was designed to establish a new neurorehabilitation approach based on the scientific way to improve patients’ functional recovery following neurological disorders in clinics or at home. The human brain is a network, an intricate, integrated system that coordinates operations among billions of units. In fact, grey matter contains most of the neuronal cell bodies. It includes the brain and the spinal cord areas involved in muscle control, sensory perception, memory, emotions, decision-making, and self-control. Consequently, patients’ functional ability results from complex interactions among various brain and spinal cord areas and neuromuscular systems. While white matter fibers connect numerous brain areas, stimulating or improving non-motor symptoms, such as motivation, cognitive, and sensory symptoms besides motor symptoms may enhance functional recovery in patients with neurological disorders. The basic principles of the current treatment approach are established based on brain connectivity. Using motor, sensory, motivation, and cognitive (MSMC) interventions during rehabilitation may promote neural plasticity and maximize functional recovery in patients with neurological disorders. Experimental studies are strongly needed to verify our theories and hypothesis.

Individual differences in attentional control predict working memory capacity in adults who stutter

PURPOSE

Prior research has suggested that people who stutter exhibit differences in some working memory tasks, particularly when more phonologically complex stimuli are used. This study aimed to further specify working memory differences in adults who stutter by not only accounting for linguistic demands of the stimuli but also individual differences in attentional control and experimental influences, such as concomitant processing requirements.

METHOD

This study included 40 adults who stutter and 42 adults who do not stutter who completed the Attention Network Test (ANT; Fan et al., 2002) and three complex span working memory tasks: the Operation Span (OSPAN), Rotation Span, and Symmetry Span (Draheim et al., 2018; Foster et al., 2015; Unsworth et al., 2005, 2009). All complex span tasks were dual-tasks and varied in linguistic content in task stimuli.

RESULTS

Working memory capacities demonstrated by adults who stutter paralleled the hierarchy of linguistic content across the three complex span tasks, with statistically significant between-group differences in working memory capacity apparent in the task with the highest linguistic demand (i.e., OSPAN). Individual differences in attentional control in adults who stutter also significantly predicted working memory capacity on the OSPAN.

DISCUSSION

Findings from this study extend existing working memory research in stuttering by showing that: (1) significant working memory differences are present between adults who stutter and adults who do not stutter even using relatively simple linguistic stimuli in dual-task working memory conditions; (2) adults who stutter with stronger executive control of attention demonstrate working memory capacity more comparable to adults who do not stutter on the OSPAN compared to adults who stutter with lower executive control of attention.

Assessment of water safety competencies: Benefits and caveats of testing in open water

Drowning has been the cause of over 2.5 million preventable deaths in the past decade. Despite the fact that the majority of drownings occur in open water, assessment of water safety competency typically occurs in swimming pools. The assessment of water safety competency in open water environments brings with it a few difficulties, but also promises tremendous benefits. The aim of this position paper is to discuss the benefits and caveats of conducting assessments in open water environments as opposed to closed and controlled environments, and to provide recommendations for evidence-based practice. The first theoretical section discusses the effects of the environment and key variables (such as temperature and water movement) on various factors of assessment. These discussions are linked to the two perspectives of representative learning design (based on ecological dynamics) and information processing theory. The second section presents two pilot studies of relevance and provides practical implications for assessment of water safety competency. It seems that a combination of pool-based practice and open water education may be ideal in assessing aquatic skills competency. Assessment in open water presents clear benefits regarding validity, but often poses seemingly unsurmountable barriers, which providers may have reservations about in the absence of clear evidence. Hence this article provides a robust discussion about competency assessment and signals the practical importance of faithfully reproducing the environment in which skilled behavior is most relevant.

An Examination of the Contextual Interference Effect and the Errorless Learning Model during Motor Learning

The purpose of this study was to investigate the combined effects of random and block practice, with errorless and errorful conditions, on motor learning. One hundred-twenty participants (all male, Mage = 21.19 ± 1.4 years) were randomly assigned to one of eight groups. Participants completed a dart throwing task across the experimental phases. In the retention test, evidence supporting the CI effect was found in the 'errorless' conditions, but not in the 'errorful' conditions. In the transfer tests, the findings indicated that the impact of errorless and errorful conditions on participants' automation levels depends on the structure of practice. Participants in the Random-Errorless group performed better in the transfer tests than those in the Random group and the Random-Errorful group, suggesting greater automation levels following errorless practice.

Consistency of children's hemodynamic responses during spontaneous speech

Significance: Hemodynamic responses (HRs) are typically averaged across experimental sessions based on the assumption that brain activation is consistent over multiple trials. This may not be a safe assumption, especially in pediatric populations, due to unaccounted effects of inattention, fatigue, or habituation. Aim: The purpose of this study was to quantify the consistency of the HR over speech and language brain regions during speech production in typically developing school-aged children. Approach: Brain activity over speech and language regions of interest (ROIs) was recorded with functional near-infrared spectroscopy during a picture description paradigm with 37 children (aged 7 to 12 years). We divided the 30 experimental trials, each 5 s long, into three segments of 10 trials each corresponding with early (trials 1 to 10), middle (trials 11 to 20), and late (trials 21 to 30) trials. We then compared oxygenated (HbO) and deoxygenated (HbR) hemoglobin concentrations averaged across each 10 trial segment to overall concentrations averaged across all 30 trials. We also compared differential hemoglobin (HbD) across ROIs. Results: HbO and HbR averaged across all experimental trials most strongly correlated with HbO and HbR from early trials. HbD values from channels over most speech and language regions did not appreciably change throughout the experimental session. The exception was HbD values from channels over the dorsal inferior frontal gyrus (dIFG). This region showed significantly higher activation over the left hemisphere during the first segment of the experiment. Conclusions: Our findings suggest that brain activity from speech and language ROIs was relatively consistent over the experimental session. The exception was increased activation of left dIFG during earlier experimental trials. We suggest that researchers critically evaluate the consistency of HRs from different brain regions to determine the reliability of HRs recorded during experimental sessions. This step is instrumental in ensuring that uncontrolled effects do not mask patterns of task-related activation.

Implications of Optimal Feedback Control Theory for Sport Coaching and Motor Learning: A Systematic Review

Best practice in skill acquisition has been informed by motor control theories. The main aim of this study is to screen existing literature on a relatively novel theory, Optimal Feedback Control Theory (OFCT), and to assess how OFCT concepts can be applied in sports and motor learning research. Based on 51 included studies with on average a high methodological quality, we found that different types of training seem to appeal to different control processes within OFCT. The minimum intervention principle (founded in OFCT) was used in many of the reviewed studies, and further investigation might lead to further improvements in sport skill acquisition. However, considering the homogenous nature of the tasks included in the reviewed studies, these ideas and their generalizability should be tested in future studies.

Optimizing Motor Learning: Difficulty Manipulation Combined with Feedback- Frequency Enhance Under-Time-Pressure Fine-Motor-Coordination Skill Acquisition and Retention

Improving acquisition and retention of new motor skills is of great importance. This study investigated the effects of progressive task difficulty manipulation (TD), combined with varying knowledge of results frequencies (KR) on performance accuracy and consistency when learning novel fine motor coordination tasks, and examined relationships between novel fine motor task performance and executive function (EF), working memory (WM), and perceived difficulty (PD). Thirty-six, right-handed, novice physical-education students (age = 10.72 ± 0.89 years) participated; participants were separated into three groups, receiving varying KR frequency (100%KR, 50%KR, and 33%KR). For each group, distance to the target was increased progressively (2 m, 2.37 m, and 3.56 m) to obtain three difficulty levels. We assessed performance during test sessions (pretest, post-test, Retention1 and Retention2) under free (FC) and time pressure (TPC) conditions. Results revealed that under FC, 100%KR improved significantly. Results revealed significant linear improvements in accuracy for 50%KR and 33%KR under TPC. New findings indicate that the association between TD and KR (50%KR) may provide more appropriate cognitive loads compared to 33%KR and 100%KR groups. These have implications for practitioners because, while strategies are clearly necessary for improving learning, the efficacy of the process appears to be based on the characteristics of the learners.

Additive and interaction effects of working memory and motor sequence training on brain functional connectivity

Although shared behavioral and neural mechanisms between working memory (WM) and motor sequence learning (MSL) have been suggested, the additive and interactive effects of training have not been studied. This study aimed at investigating changes in brain functional connectivity (FC) induced by sequential (WM + MSL and MSL + WM) and combined (WM × MSL) training programs. 54 healthy subjects (27 women; mean age: 30.2 ± 8.6 years) allocated to three training groups underwent twenty-four 40-min training sessions over 6 weeks and four cognitive assessments including functional MRI. A double-baseline approach was applied to account for practice effects. Test performances were compared using linear mixed-effects models and t-tests. Resting state fMRI data were analysed using FSL. Processing speed, verbal WM and manual dexterity increased following training in all groups. MSL + WM training led to additive effects in processing speed and verbal WM. Increased FC was found after training in a network including the right angular gyrus, left superior temporal sulcus, right superior parietal gyrus, bilateral middle temporal gyri and left precentral gyrus. No difference in FC was found between double baselines. Results indicate distinct patterns of resting state FC modulation related to sequential and combined WM and MSL training suggesting a relevance of the order of training performance. These observations could provide new insight for the planning of effective training/rehabilitation.

A Multidisciplinary Comparison of Different Techniques Among Skilled Water Treaders

In an immersion incident, a person may be required to tread water for extended periods of time in order to survive. Treading water, or maintaining a stable head position above the water surface, can be achieved in several different ways. Determining which treading water techniques are economic (energetically and cognitively) is an important first step in approaching evidence-based water safety instruction. The present study investigated the cognitive and metabolic demands associated with four main techniques for treading water in experienced water treaders. Skilled water treaders (n=21) performed four common treading techniques for 3min each: "running" in the water, "flutter kick" with hands sculling, "upright breaststroke," and "egg-beater." Self-reported rate of perceived exertion (RPE) and task load index (TLX) score, as well as objective measures of probe reaction time (PRT; i.e., response to auditory cues while treading), oxygen consumption and heart rate were assessed. The "egg-beater" technique and the "upright breaststroke" technique were linked to significantly lower cognitive and energetic demands compared to the other techniques (VO₂: p<0.001 - "Running" M=29.02, SD=7.40/"Flutter kick" M=29.37, SD=8.56, "Breaststroke" M=23.47, SD=7.28, and "Eggbeater" M=23.18, SD=6.31). This study lays the groundwork for future research that may establish the ideal movement behavior in drowning situations and investigate movement instruction to less experienced treaders.

Development of lower limb training interventions that promote an external focus of attention in people with stroke: a modified Delphi survey

Objective

To produce guidance and validated examples of tasks that promote an external focus of attention, for use in lower limb rehabilitation in an inpatient stroke care setting.

Design

Electronic survey, using e-Delphi methodology.

Participants

A multi-professional expert panel of 14 clinicians and researchers, with expertise in stroke rehabilitation and/or motor learning.

Method

Each survey round consisted of two parts: 1) classification of specific exercise examples, shown using video and 2) the categorization of specific tratement adjuncts. The panel was asked to comment on: likely focus of attention of the performer; instructions that would promote an external focus of attention; and how the task set-up could be modified to promote an external focus of attention. Rounds 2 and 3 included a summary of results from the previous round, and revised/new examples. The panel were also asked to state their level of agreement with a series of statements that arose from the free text. Three rounds of survey were completed and the a priori threshold for agreement was set at 80%.

Results

Eighteen iterations of exercises were presented, and 12 were accepted as promoting an external focus of attention. In addition, six additional statements were generated based on open responses, leading to further specific guidance on facilitating an external focus of attention in clinical practice.

Conclusions

Commonly used rehabilitation exercises can be adapted to promote an external focus of attention, by altering the therapist’s use of instructions and/or altering the task set up. Treatment principles and examples of tasks that promote an external focus have been produced.

Heart rate variability, postural sway and electrodermal activity in competitive golf putting

BACKGROUND

Stressful conditions during competitive golf putting may result in impaired performance, producing physiological changes. Nevertheless, simultaneous measurements of postural sway (PS), heart rate variability (HRV) and electrodermal activity (EDA) during a competitive golf putting have not yet been examined. This study aims at describing if changes in PS, HRV and EDA during golf putting, might affect the golfer's performance.

METHODS

Based on EGA-handicap, 40 amateur golfers were divided in 2 groups. They competed in an indoor round of golf putting. PS, EDA, HRV and putting performance (SCORE) were recorded at basal and during competition.

RESULTS

During the putting round, a significant increase in low-frequency power (LF) and decrease in high-frequency power (HF) was found in Group A, leading to an increased LF/HF ratio. The heart rate increased significantly more in Group A than in Group B, but the stress index (SI) remained lower in this group. EDA significantly increased in both groups, with no statistical difference between groups. No statistical difference in SCORE was observed.

CONCLUSIONS

Despite the significant differences observed between the two groups, both at baseline and in response to competition, no variation of the studied variables was associated with a better putting performance.

Implicit motor learning in primary school children: A systematic review

The aim of this study was to assess the current state of evidence and methodological quality of studies on implicit and explicit motor learning in both typically developing children and children with developmental disorders. A systematic literature review was conducted on the experimental literature published up to April 2020. A total of 25 studies were included. Studies were evaluated on methodological quality, paradigm used, and level of evidence. The results showed that implicit paradigms are as effective as explicit paradigms in both groups of children. Studies are predominantly experimental in nature involving mostly upper limb aiming tasks. The few studies that were performed outside the lab (n = 5) suggest superior efficacy of the implicit paradigm. Methodological quality varied between studies and was not always of sufficient standard to allow conclusions. In particular, manipulation checks were only performed in 13 studies (52% of all studies), limiting conclusions. Further progress can be made by focussing on improving methodological quality through retention testing by the inclusion of a control group, by the inclusion of a manipulation check, and via assessment of relevant co-variables, such as working memory, age, and motor competence.

Measuring implicit sequence learning and dual task ability in mild to moderate Parkinson´s disease: A feasibility study

We investigated the feasibility aspects of two choice reaction time tasks designed to assess implicit sequence learning and dual task ability in individuals with mild to moderate Parkinson’s disease in comparison to healthy individuals. Twelve individuals with mild to moderate Parkinson’s disease and 12 healthy individuals, all ≥ 60 years of age, were included. A serial reaction time task was used as a measure of implicit sequence learning and a similar task but with the addition of a simple counting task, was used as a measure of dual task ability. We have present thorough descriptive statistics of the data but we have refrained from any inferential statistics due to the small sample size. All participants understood the task instructions and the difficulty level of both tasks was deemed acceptable. There were indications of task fatigue that demand careful choices for how best to analyse the data from such tasks in future trials. Ceiling effects were present in several accuracy outcomes, but not in the reaction time outcomes. Overall, we found both tasks to be feasible to use in samples of individuals with mild to moderate Parkinson’s disease and healthy older individuals.

A Preliminary Investigation of Attention-Deficit/Hyperactivity Disorder Characteristics in Adults Who Stutter

Purpose Recent studies have shown that many children who stutter may have elevated characteristics of attention-deficit/hyperactivity disorder (ADHD). Although childhood ADHD commonly persists into adulthood, it is unclear how many adults who stutter experience aspects of ADHD (e.g., inattention or hyperactivity/impulsivity). This study sought to increase understanding of how ADHD characteristics might affect individuals who stutter by evaluating (a) whether elevated ADHD characteristics are common in adults who stutter, (b) whether elevated ADHD characteristics in adults who stutter were significantly associated with greater adverse impact related to stuttering, and (c) whether individual differences in Repetitive Negative Thinking (RNT) and Effortful Control influenced this relationship. Method Two hundred fifty-four adults who stutter completed the Adult ADHD Self-Report Scale, the Perseverative Thinking Questionnaire, the Adult Temperament Questionnaire short form, and the Overall Assessment of the Speaker's Experience of Stuttering. Data were analyzed via multiple linear regression to determine whether the number of inattention or hyperactivity/impulsivity characteristics was significantly associated with RNT, Effortful Control, or Adverse Impact related to stuttering. Results Almost one quarter of participants (23.2%; 60/254) self-reported experiencing six or more inattention characteristics, while fewer participants (8.3%; 21/254) self-reported experiencing six or more hyperactivity/impulsivity characteristics. Participants with lower Effortful Control and higher levels of both RNT and Adverse Impact were significantly more likely to self-report experiencing more inattention characteristics. Discussion Many adults who stutter may exhibit previously unaccounted for characteristics of ADHD, especially inattention. Results highlight the value of continued research on the intersectionality of stuttering, ADHD, and attention, and the importance of individualizing therapy to the needs of each unique person who stutters.

Effects of attentional focus on upper extremity motor performance in post stroke patients: A randomized pilot study

INTRODUCTION

To facilitate the command to the learner, therapist can use verbal cues for guidance: internal focus (own body) and external focus (consequence of movement in the environment).

OBJECTIVE

To examine the effects of different attentional focus on upper limb motor performance in post-stroke.

METHODS

Randomized controlled trial with 2 groups. Study realized at Integrated Clinic of the Faculty of Health Science at Trairi (Santa Cruz, Rio Grande do Norte, Brazil). Twelve participants allocated into 2 groups. Two motor tasks were used: task 1, reach-point; task 2, reach-grasp-fit, with the paretic extremity, using verbal commands directed by a trained therapist. In the first phase, Group 1 received commands with internal focus, while Group 2 was instructed with commands with external focus. After 1 week, the command type was changed between groups. The variables collected was movement time, velocity and number of peaks velocity.

RESULTS

Both attentional focus promoted significant differences in movement time and velocity, however, only Internal Focus provided significant results in both tasks of the same variables.

DISCUSSION

The benefits of 1 attentional focus on the other are not fully confirmed. However, not receiving any kind of attention guidance compromises motor performance. The results support the hypothesis that the benefits of the External Focus are accentuated when preceded by the Internal Focus.

CLINICAL TRIAL REGISTRATION

Research Ethics Committee of the Faculty of Helth Science at Trairi (Facisa - UFRN)- Number CAAE 2.625.609, approved on April 13, 2018; Brazilian Registry of Clinical Trials - RBR-4995cr approved on July 4, 2019 retrospectively registered (http://www.ensaiosclinicos.gov.br/rg/RBR-4995cr/).

How to Improve Fine Motor Skill Learning in Dentistry

Introduction

Restorative dental treatment is a complex task involving various procedures which require the development and integration of both theoretical knowledge and fine motor skills. It aims to provide the theoretical background and role of key factors in learning these skills.

Materials and Methods

The following electronic databases were searched to identify relevant articles to our topic: PubMed, Medline, Google Scholar, and Scopus. Generic keywords, that is, factors, fine, performance, and dentistry, and MeSH terms, that is, "learning," "instruction," "patient simulation," "motor skills," "perception," "tactile," "neurophysiology," and "working memory" were used to conduct our comprehensive search. Results and Conclusions. Several techniques are used in performing different restorative procedures in dentistry, that is, root canal preparation, root planning, and minor oral surgery procedures. Mastering these techniques requires a good understanding of the underpinning cognitive, sensory, and neuromuscular processes. Factors including the amount and timing of instructions provided, cognitive abilities, and practice schedule of learning trials may have significant implications on the design of fine motor skill learning exercises.

Ways to Improve Multitasking: Effects of Predictability after Single- and Dual-Task Training

In this study we investigated the effect of predictability on dual-task performance in two experiments. In the first experiment 33 participants separately practiced a continuous tracking task and an auditory reaction time task. Both tasks had a repeating element that made them predictable; in the tracking task this was a repeating segment, and in the auditory task this was an auditory sequence. In addition, one group obtained explicit knowledge about the repeating sequence in the tracking task while the other group trained implicitly. After training, single- and dual-task performance was tested at a post test and retention test. Results showed that predictability only improved performance in the predictable tasks themselves and dual-task costs disappeared for the tracking task. To see whether the task-specific effect of predictability was the results of task prioritization, or because task representations did not have much chance to interact with each other, we conducted a second experiment. Using the same tasks as in Experiment 1, 39 participants now trained both tasks simultaneously. Results largely mirrored those of the first experiment, demonstrating that freed-up resources due to predictability in one task could not be re-invested to improve in the other task. We conclude that predictability has a positive but task-specific effect on dual-task performance.

Use of Acoustic Feedback to Change Gait Patterns: Implementation and Transfer to Motor Learning Theory—A Scoping Review

Changing gait parameters through acoustic feedback is a promising approach in gait therapy. The question remains to what extent, if any, the theories and concepts of motor learning have been taken into account for acoustic feedback systems development. Fifteen studies were identified for further analysis using a scoping review framework, among which seven had individuals with disordered gait as their population and eight incorporated healthy individuals. It was found that most studies used error feedback and did not test for long-term effects on gait parameters. It can be concluded that future studies should apply motor learning theories and concepts to the development of acoustic feedback devices for gait therapy.

Towards a reliable measure of motor working memory: revisiting Wu and Coulson's (2014) movement span task

Some researchers have argued that motor working memory is relatively independent from visuospatial working memory and underlies the learning and processing of motor tasks, like gesture comprehension. To allow systematic testing of these claims, Wu & Coulson 2014 Psychol. Sci. 26, 1717-1727. (doi:10.1177/0956797615597671) proposed a novel measure of motor working memory, the movement span task. Some studies have reported that the movement span task has a high degree of validity. The purpose of the present study was to attempt to replicate Wu & Coulson 2014 Psychol. Sci. 26, 1717-1727. (doi:10.1177/0956797615597671) in the following ways: (1) the high correlation between movement span and movement recall scores and (2) the lack of correlation between the movement span task on the one hand and visuospatial and verbal working memory on the other. In the present study, we found a high correlation between the movement span and recall scores as well as most measures of visuospatial memory. However, the size of these correlations was similar to that reported by Wu and Coulson, suggesting that the significance may be related to sample size. In other words, motor working memory may be weakly related to visuospatial memory. By contrast, there were weak correlations between the movement span task and verbal memory. In sum, we found the same pattern of results observed by Wu & Coulson 2014, 1717-1727. (doi:10.1177/0956797615597671).

Expert Event Segmentation of Dance Is Genre-Specific and Primes Verbal Memory

By chunking continuous streams of action into ordered, discrete, and meaningful units, event segmentation facilitates motor learning. While expertise in the observed repertoire reduces the frequency of event borders, generalization of this effect to unfamiliar genres of dance and among other sensorimotor experts (musicians, athletes) remains unknown, and was the first aim of this study. Due to significant overlap in visuomotor, language, and memory processing brain networks, the second aim of this study was to investigate whether visually priming expert motor schemas improves memory for words related to one’s expertise. A total of 112 participants in six groups (ballet, Bharatanatyam, and “other” dancers, athletes, musicians, and non-experts) segmented a ballet dance, a Bharatanatyam dance, and a non-dance control sequence. To test verbal memory, participants performed a retrieval-induced forgetting task between segmentation blocks. Dance, instrument, and sport word categories were included to probe the second study aim. Results of the event segmentation paradigm clarify that previously-established expert segmentation effects are specific to familiar genres of dance, and do not transfer between different types of experts or to non-dance sequences. Greater recall of dance category words among ballet and Bharatanatyam dancers provides novel evidence for improved verbal memory primed by activating familiar sensorimotor representations.

Effects of Transcranial Direct Current Stimulation Over the Dorsolateral Prefrontal Cortex (PFC) on Cognitive-Motor Dual Control Skills

This randomized crossover study investigated whether anodal transcranial direct current stimulation (tDCS) over the dorsolateral prefontal cortex (dlPFC) modulates memory-guided finger isometric maintenance during single motor and dual cognitive-motor tasks, based on electroencephalogram (EEG) signals. Twenty-three healthy participants (14 female; M age = 29.130 years, SD = 10.918) underwent both sham and 2-mA stimulation sessions over the dlPFC for 20 minutes, with a minimum washout period of seven days. We analyzed finger-force isometric maintenance and event-related spectral perturbation (ERSP) of the EEG during early and later phases of both tasks. We observed a significant motor accuracy improvement (p = .014) and significant variation of force output (p = .027) with significant decrease in ERSP on the dorsomedial prefrontal cortex (dmPFC) (early phase, p = .027; later phase, p = .023) only after 2 mA stimulation. Thus, anodal tDCS over the dlPFC may improve memory-guided force control during cognitive-motor dual tasks.

Distinguishing Two Types of Variability in a Sit-to-Stand Task

Variability is commonly observed in complex behavior, such as the maintenance of upright posture. The current study examines the value added by using nonlinear measures of variability to identify dynamic stability instead of linear measures that reflect average fluctuations about a mean state. The largest Lyapunov exponent (λ1) and SD were calculated on mediolateral movement as participants performed a sit-to-stand task on a stable and unstable platform. Both measures identified changes in movement across postures, but results diverged when participants stood on the unstable platform. Large SD indicated an increase in movement variability, but small λ1 identified those movements as stable and controlled. The results suggest that a combination of linear and nonlinear analyses is useful in identifying the proportion of observed variability that may be attributed to structured, controlled sources. Nonlinear measures of variability, like λ1, can further be used to make predictions about transitions between stable postures and to identify a system’s resistance to disruption from external perturbations. Those features make nonlinear analyses highly applicable to both human movement research and clinical practice.

Fluid intelligence and working memory support dissociable aspects of learning by physical but not observational practice

Humans have a remarkable ability to learn by watching others, whether learning to tie an elaborate knot or play the piano. However, the mechanisms that translate visual input into motor skill execution remain unclear. It has been proposed that common cognitive and neural mechanisms underpin learning motor skills by physical and observational practice. Here we provide a novel test of the common mechanism hypothesis by testing the extent to which certain individual differences predict observational as well as physical learning. Participants (N = 92 per group) either physically practiced a five-element key-press sequence or watched videos of similar sequences before physically performing trained and untrained sequences in a test phase. We also measured cognitive abilities across participants that have previously been associated with rates of learning, including working memory and fluid intelligence. Our findings show that individual differences in working memory and fluid intelligence predict improvements in dissociable aspects of motor learning following physical practice, but not observational practice. Working memory predicts general learning gains from pre- to post-test that generalise to untrained sequences, whereas fluid intelligence predicts sequence-specific gains that are tied to trained sequences. However, neither working memory nor fluid intelligence predict training gains following observational learning. Therefore, these results suggest limits to the shared mechanism hypothesis of physical and observational learning. Indeed, models of observational learning need updating to reflect the extent to which such learning is based on shared as well as distinct processes compared to physical learning. We suggest that such differences could reflect the more intentional nature of learning during physical compared to observational practice, which relies to a greater extent on higher-order cognitive resources such as working memory and fluid intelligence.

The Cognitive Status of Older Adults: Do Reduced Time Constraints Enhance Sequence Learning?

Research has indicated that older adults perform movement sequences more slowly than young adults. The purpose of the present experiment was to compare movement sequence learning in young and older adults when the time to perform the sequence was extended, and how the elderly's cognitive status (Montreal Cognitive Assessment [MoCA]) interacted with sequence learning. The task was to minimize the difference between a target sequence pattern and the sequence produced by elbow extension-flexion movements. On Day 1, participants (28 young adults; 28 older adults) practiced the sequence under two time windows: 1300 ms or 2000 ms. On Day 2, retention performance and the cognitive status were assessed. The results demonstrated that young adults performed superior compared to older adults. Additional time to perform the sequence did not improve retention performance for the older adults. The correlation between the error score and the MoCA score of r = -.38 (p < .05) in older adults indicated that a better cognitive status was associated with performance advantages in sequence learning.

Application of Analogy in Learning Badminton Among Older Adults: Implications for Rehabilitation

This study aimed to investigate the effect of applying analogy instruction for older adults in learning the badminton high serve. It was hypothesized that acquiring this motor skill by analogy instruction would bring the benefits of more robust and durable motor performance under stress and over time. A group of older adults learned badminton high serves by either a set of explicit instructions or an analogy instruction that represented the biomechanical metaphor of the badminton high serve. They were then invited to perform the motor task in two testing conditions: a stress transfer test and a retention test. It was found that the analogy instruction group improved the motor performance in badminton high serves during the learning blocks and maintained high levels of performance in the stress transfer test and retention test, whereas the explicit instruction group did not show any improvement. The analogy instruction group had better motor performance than the explicit instruction group during the stress transfer test. The results showed that analogy instruction facilitated the acquisition of new motor skills in older adults, and the benefit of stress resistance was also evidenced.

Visual attention, EEG alpha power and T7-Fz connectivity are implicated in prosthetic hand control and can be optimized through gaze training

Background

Prosthetic hands impose a high cognitive burden on the user that often results in fatigue, frustration and prosthesis rejection. However, efforts to directly measure this burden are sparse and little is known about the mechanisms behind it. There is also a lack of evidence-based training interventions designed to improve prosthesis hand control and reduce the mental effort required to use them. In two experiments, we provide the first direct evaluation of this cognitive burden using measurements of EEG and eye-tracking (Experiment 1), and then explore how a novel visuomotor intervention (gaze training; GT) might alleviate it (Experiment 2).

Methods

In Experiment 1, able-bodied participants (n = 20) lifted and moved a jar, first using their anatomical hand and then using a myoelectric prosthetic hand simulator. In experiment 2, a GT group (n = 12) and a movement training (MT) group (n = 12) trained with the prosthetic hand simulator over three one hour sessions in a picking up coins task, before returning for retention, delayed retention and transfer tests. The GT group received instruction regarding how to use their eyes effectively, while the MT group received movement-related instruction typical in rehabilitation.

Results

Experiment 1 revealed that when using the prosthetic hand, participants performed worse, exhibited spatial and temporal disruptions to visual attention, and exhibited a global decrease in EEG alpha power (8-12 Hz), suggesting increased cognitive effort. Experiment 2 showed that GT was the more effective method for expediting prosthesis learning, optimising visual attention, and lowering conscious control – as indexed by reduced T7-Fz connectivity. Whilst the MT group improved performance, they did not reduce hand-focused visual attention and showed increased conscious movement control. The superior benefits of GT transferred to a more complex tea-making task.

Conclusions

These experiments quantify the visual and cortical mechanisms relating to the cognitive burden experienced during prosthetic hand control. They also evidence the efficacy of a GT intervention that alleviated this burden and promoted better learning and transfer, compared to typical rehabilitation instructions. These findings have theoretical and practical implications for prosthesis rehabilitation, the development of emerging prosthesis technologies and for the general understanding of human-tool interactions.

Electronic supplementary material

The online version of this article (10.1186/s12984-019-0524-x) contains supplementary material, which is available to authorized users.

The immediate influence of implicit motor learning strategies on spatiotemporal gait parameters in stroke patients: a randomized within-subjects design

OBJECTIVES:

To investigate immediate changes in walking performance associated with three implicit motor learning strategies and to explore patient experiences of each strategy.

DESIGN:

Participants were randomly allocated to one of three implicit motor learning strategies. Within-group comparisons of spatiotemporal parameters at baseline and post strategy were performed.

SETTING:

Laboratory setting.

SUBJECTS:

A total of 56 community-dwelling post-stroke individuals.

INTERVENTIONS:

Implicit learning strategies were analogy instructions, environmental constraints and action observation. Different analogy instructions and environmental constraints were used to facilitate specific gait parameters. Within action observation, only videotaped gait was shown.

MAIN MEASURES:

Spatiotemporal measures (speed, step length, step width, step height) were recorded using Vicon 3D motion analysis. Patient experiences were assessed by questionnaire.

RESULTS:

At a group level, three of the four analogy instructions ( n = 19) led to small but significant changes in speed ( d = 0.088 m/s), step height (affected side d = 0.006 m) and step width ( d = -0.019 m), and one environmental constraint ( n = 17) led to significant changes in step width ( d = -0.040 m). At an individual level, results showed wide variation in the magnitude of changes. Within action observation ( n = 20), no significant changes were found. Overall, participants found it easy to use the different strategies and experienced some changes in their walking performance.

CONCLUSION:

Analogy instructions and environmental constraints can lead to specific, immediate changes in the walking performance and were in general experienced as feasible by the participants. However, the response of an individual patient may vary quite considerably.

Implicit learning increases shot accuracy of football players when making strategic decisions during penalty kicking

Implicit learning has been proposed to improve athletes' performance in dual-task situations. Yet, only a few studies tested this with a sports-relevant dual-task. Hence, the current study aimed to compare the effects of implicit and explicit training methods on penalty kicking performance. Twenty skilled football players were divided in two training groups and took part in a practice phase to improve kicking accuracy (i.e., without a goalkeeper) and in a post-test in order to check penalty kick performance (i.e., accuracy including a decision to kick to the side opposite the goalkeeper's dive). Results found that the implicit and explicit training method resulted in similar levels of decision-making, but after implicit training this was achieved with higher kicking accuracy. Additionally, applications for football players and coaches are discussed.

Application of motor learning in neurorehabilitation: a framework for health-care professionals

Learning motor skills is an essential part of most rehabilitation processes. Facilitating and supporting motor learning is particularly challenging in neurological rehabilitation: patients who suffer from neurological diseases experience both physical limitations and difficulties of cognition and communication that affect and/or complicate the motor learning process. Therapists (e.g. physiotherapists and occupational therapists) who work in neurorehabilitation are therefore continuously searching for the best way to facilitate patients during these intensive learning processes. To support therapists in the application of motor learning, a framework was developed, integrating knowledge from the literature and the opinions and experiences of international experts. This article presents the framework, illustrated by cases from daily practice. The framework may assist therapists working in neurorehabilitation in making choices, implementing motor learning in routine practice, and supporting communication of knowledge and experiences about motor learning with colleagues and students. The article discusses the framework and offers suggestions and conditions given for its use in daily practice.

Technical and tactical skills related to performance levels in tennis: A systematic review

The aim of this systematic review is to provide an overview of outcome measures and instruments identified in the literature for examining technical and tactical skills in tennis related to performance levels. Such instruments can be used to identify talent or the specific skill development training needs of particular players. Searches for this review were conducted using the PubMed, Web of Science, and PsycInfo databases. Out of 733 publications identified through these searches, 40 articles were considered relevant and included in this study. They were divided into three categories: (1) technical skills, (2) tactical skills and (3) integrated technical and tactical skills. There was strong evidence that technical skills (ball velocity and to a lesser extent ball accuracy) and tactical skills (decision making, anticipation, tactical knowledge and visual search strategies) differed among players according to their performance levels. However, integrated measurement of these skills is required, because winning a point largely hinges on a tactical decision to perform a particular stroke (i.e., technical execution). Therefore, future research should focus on examining the relationship between these skills and tennis performance and on the development of integrated methods for measuring these skills.