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Scotto CR, Blandin Y, Crolan R, Eon A, Laguillaumie P, Decatoire A. Visual feedbacks influence short-term learning of torque versus motion profile with robotic guidance among young adults. Hum Mov Sci 2024; 95:103221. [PMID: 38696914 DOI: 10.1016/j.humov.2024.103221] [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: 02/08/2024] [Revised: 03/27/2024] [Accepted: 04/24/2024] [Indexed: 05/04/2024]
Abstract
Robotic assistance can improve the learning of complex motor skills. However, the assistance designed and used up to now mainly guides motor commands for trajectory learning, not dynamics learning. The present study explored how a complex motor skill involving the right arm can be learned without suppressing task dynamics, by means of an innovative device with robotic guidance that allows a torque versus motion profile to be learned with admittance control. In addition, we assessed how concurrent visual feedback on this profile can enhance learning without creating dependency, by means of a fading procedure (i.e., feedback reduction across trials). On Day 1, a Control group performed an acquisition session (6 blocks) featuring concurrent visual feedback, while a Fading group performed the session with a gradual reduction in feedback (from 100% to 0% over the 6 blocks). On Day 2, both groups performed a block first without feedback (i.e., Transfer test), then with feedback (i.e., Retention test). Results revealed that on Day 1, movement rehearsal induced a significant improvement in spatiotemporal parameters for the Control group, compared with the Fading group. On Day 2, the opposite was found when this visual feedback was removed, as the Fading group performed significantly better than the Control group on the Transfer test. Vision allows a relationship to be established between the required torque and the motion profile. Its suppression then forces the processing of more intrinsic information, leading to the development of a stable internal representation of the task.
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Affiliation(s)
- C R Scotto
- Université de Poitiers, Université de Tours, Centre National de la Recherche Scientifique, Centre de Recherches sur la Cognition et l'Apprentissage (UMR 7295), Poitiers, France.
| | - Y Blandin
- Université de Poitiers, Université de Tours, Centre National de la Recherche Scientifique, Centre de Recherches sur la Cognition et l'Apprentissage (UMR 7295), Poitiers, France
| | - R Crolan
- Université de Poitiers, ISAE-ENSMA, CNRS, PPRIME, Poitiers, France
| | - A Eon
- Université de Poitiers, ISAE-ENSMA, CNRS, PPRIME, Poitiers, France
| | - P Laguillaumie
- Université de Poitiers, ISAE-ENSMA, CNRS, PPRIME, Poitiers, France
| | - A Decatoire
- Université de Poitiers, ISAE-ENSMA, CNRS, PPRIME, Poitiers, France
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2
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Han Y, Sung H, Kim G, Ryu Y, Yoon J, Kim YS. Effects of a Web-based Weight Management Education Program on Various Factors for Overweight and Obese Women: Randomized Controlled Trial. JMIR Cardio 2024; 8:e42402. [PMID: 38635975 PMCID: PMC11066746 DOI: 10.2196/42402] [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: 10/11/2022] [Revised: 05/22/2023] [Accepted: 03/23/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Mediated diet and exercise methods yield effective short-term weight loss but are costly and hard to manage. However, web-based programs can serve many participants, offering ease of access and cost-efficiency. OBJECTIVE This study aimed to compare the effectiveness of a web-based weight management program through web-based education alone (MINE) or combined with tailored video feedback (MINE Plus) with a control (CO) group. METHODS This intervention included 60 Korean women with overweight and obesity (BMI≥23 kg/m2) aged 19 years to 39 years old. We randomly allocated 60 participants to each of 3 groups: (1) MINE group (web-based education video and self-monitoring app), (2) MINE Plus group (web-based education video, self-monitoring app, and 1:1 tailored video feedback), and (3) CO group (only self-monitoring app). Web-based education included nutrition, physical activity, psychological factors, medical knowledge for weight loss, goal setting, and cognitive and behavioral strategies. Tailored feedback aimed to motivate and provide solutions via weekly 10-minute real-time video sessions. The intervention lasted 6 weeks, followed by a 6-week observation period to assess the education's lasting effects, with evaluations at baseline, 6 weeks, and 12 weeks. A generalized linear mixed model was used to evaluate time and group interactions. RESULTS In the intention-to-treat analysis including all 60 participants, there were significant differences in weight change at 6 weeks in the MINE and MINE Plus groups, with mean weight changes of -0.74 (SD 1.96) kg (P=.03) and -1.87 (SD 1.8) kg (P<.001), respectively, while no significant change was observed in the CO group, who had a mean weight increase of 0.03 (SD 1.68) kg (P=.91). After 12 weeks, changes in body weight were -1.65 (SD 2.64) kg in the MINE group, -1.59 (SD 2.79) kg in the MINE Plus group, and 0.43 (SD 1.42) kg in the CO group. There was a significant difference between the MINE and MINE Plus groups (P<.001). Significant group × time effects were found for body weight in the MINE and CO groups (P<.001) and in the MINE Plus and CO groups (P<.001), comparing baseline and 12 weeks. Regarding physical activity and psychological factors, only body shape satisfaction and health self-efficacy were associated with improvements in the MINE and MINE Plus groups (P<.001). CONCLUSIONS This study found that the group receiving education and tailored feedback showed significant weight loss and improvements in several psychological factors, though there were differences in the sustainability of the effects. TRIAL REGISTRATION Korea Disease Control and Prevention Agency (KDCA) KCT0007780: https://cris.nih.go.kr/cris/search/detailSearch.do/22861.
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Affiliation(s)
- Yunmin Han
- Department of Physical Education, Seoul National University, Seoul, Republic of Korea
| | - Hoyong Sung
- Department of Military Kinesiology, Korea Military Academy, Seoul, Republic of Korea
| | - Geonhui Kim
- Department of Aviation Sports, Korea Air Force Academy, Cheongju, Republic of Korea
| | - Yeun Ryu
- Department of Physical Education, Seoul National University, Seoul, Republic of Korea
| | - Jiyeon Yoon
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Yeon Soo Kim
- Department of Physical Education, Seoul National University, Seoul, Republic of Korea
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Han Z, Sanchez D, Levitan CA, Sherman A. Stimulus-locked auditory information facilitates real-time visuo-motor sequence learning. Psychon Bull Rev 2024; 31:828-838. [PMID: 37735341 PMCID: PMC11061001 DOI: 10.3758/s13423-023-02378-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2023] [Indexed: 09/23/2023]
Abstract
Prior research investigating whether and how multisensory information facilitates skill learning is quite mixed; whereas some research points to congruent information improving learning, other work suggests that people become reliant on the redundant information, such that its removal ultimately detracts from the ability to perform a unisensory task. We examined this question using the Serial Interception Sequence Learning (SISL) task, a visuo-motor paradigm in which participants implicitly learn a sequence embedded in noise. We investigated whether adding auditory information in different ways would enhance real time sequence learning and whether any benefits of multisensory learning would persist with visual-only testing. Auditory information was used either as feedback on the visuo-motor task (Experiments 1 and 2) or was presented synchronously with visual information during learning (Experiment 3). Robust sequence-specific performance advantages occurred across conditions and experiments; however, auditory information enhanced real-time performance only when it was synchronized with visual information. Participants were significantly more accurate, faster, and more precise with stimulus-locked auditory information during training. Notably, these benefits did not generalize to the visual-only context, suggesting that the benefits of stimulus-locked auditory information are primarily useful only when the perceptual information is present.
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Affiliation(s)
- Ziyan Han
- Department of Cognitive Science, Occidental College, Los Angeles, CA, USA
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | | | - Carmel A Levitan
- Department of Cognitive Science, Occidental College, Los Angeles, CA, USA
| | - Aleksandra Sherman
- Department of Cognitive Science, Occidental College, Los Angeles, CA, USA.
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Stuttaford SA, Dyson M, Nazarpour K, Dupan SSG. Reducing Motor Variability Enhances Myoelectric Control Robustness Across Untrained Limb Positions. IEEE Trans Neural Syst Rehabil Eng 2024; 32:23-32. [PMID: 38100346 DOI: 10.1109/tnsre.2023.3343621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
The limb position effect is a multi-faceted problem, associated with decreased upper-limb prosthesis control acuity following a change in arm position. Factors contributing to this problem can arise from distinct environmental or physiological sources. Despite their differences in origin, the effect of each factor manifests similarly as increased input data variability. This variability can cause incorrect decoding of user intent. Previous research has attempted to address this by better capturing input data variability with data abundance. In this paper, we take an alternative approach and investigate the effect of reducing trial-to-trial variability by improving the consistency of muscle activity through user training. Ten participants underwent 4 days of myoelectric training with either concurrent or delayed feedback in a single arm position. At the end of training participants experienced a zero-feedback retention test in multiple limb positions. In doing so, we tested how well the skill learned in a single limb position generalized to untrained positions. We found that delayed feedback training led to more consistent muscle activity across both the trained and untrained limb positions. Analysis of patterns of activations in the delayed feedback group suggest a structured change in muscle activity occurs across arm positions. Our results demonstrate that myoelectric user-training can lead to the retention of motor skills that bring about more robust decoding across untrained limb positions. This work highlights the importance of reducing motor variability with practice, prior to examining the underlying structure of muscle changes associated with limb position.
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Ghai S, Ghai I, Narciss S. Influence of taping on force sense accuracy: a systematic review with between and within group meta-analysis. BMC Sports Sci Med Rehabil 2023; 15:138. [PMID: 37864268 PMCID: PMC10588111 DOI: 10.1186/s13102-023-00740-1] [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: 06/21/2023] [Accepted: 09/20/2023] [Indexed: 10/22/2023]
Abstract
Taping is a common technique used to address proprioceptive deficits in both healthy and patient population groups. Although there is increasing interest in taping to address proprioceptive deficits, little is known about its effects on the kinetic aspects of proprioception as measured by force sense accuracy. To address this gap in the literature, the present systematic review and meta-analysis was conducted to evaluate the impact of taping on force sense accuracy. A search for relevant literature was conducted following PRISMA guidelines across seven databases and one register. Eleven studies with 279 participants were included in the review out of 7362 records. In the between-group analyses, we found a significant improvement in absolute (p < 0.01) and relative (p = 0.01) force sense accuracy with taping compared to no comparator. Likewise, a significant improvement in absolute (p = 0.01) force sense accuracy was also observed with taping compared to placebo tape. In the within group analysis, this reduction in the absolute (p = 0.11) force sense accuracy was not significant. Additional exploratory subgroup analyses revealed between group improvement in force sense accuracy in both healthy individuals and individuals affected by medial epicondylitis. The findings of this meta-analysis should be interpreted with caution due to the limited number of studies and a lack of blinded randomized controlled trials, which may impact the generalizability of the results. More high-quality research is needed to confirm the overall effect of taping on force sense accuracy.
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Affiliation(s)
- Shashank Ghai
- Department of Political, Historical, Religious and Cultural Studies, Karlstad University, Karlstad, Sweden.
- Centre for Societal Risk Research, Karlstad University, Karlstad, Sweden.
- Psychology of Learning and Instruction, Department of Psychology, School of Science, Technische Universität Dresden, Dresden, Germany.
- Centre for Tactile Internet With Human-in-the-Loop (CeTI), Technische Universität Dresden, Dresden, Germany.
| | - Ishan Ghai
- School of Life Sciences, Jacobs University Bremen, Bremen, Germany
| | - Susanne Narciss
- Psychology of Learning and Instruction, Department of Psychology, School of Science, Technische Universität Dresden, Dresden, Germany
- Centre for Tactile Internet With Human-in-the-Loop (CeTI), Technische Universität Dresden, Dresden, Germany
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Akbaş A, Marszałek W, Król H. Presence of an Overhead Goal Does Not Improve the Effectiveness of Jump Training. J Strength Cond Res 2023; 37:e280-e288. [PMID: 36165994 DOI: 10.1519/jsc.0000000000004336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Akbaş, A, Marszałek, W, and Król, H. Presence of an overhead goal does not improve the effectiveness of jump training. J Strength Cond Res 37(4): e280-e288, 2023-This study investigated the effectiveness of jump training with and without an overhead goal (OG) on a modified countermovement jump (CMJ) tested in a similar manner, with and without OG. Fifty-two men divided into 3 groups-trained with OG, trained without OG, and untrained-were examined: before the commencement of training; after 2, 4, and 6 weeks of training; and 2 weeks after the discontinuation of training. Each session consisted of 50 modified CMJ and was performed 3 times per week. Countermovement jump height, mean power, peak power, countermovement depth, and take-off phase time were quantified, and the statistical level was set at p < 0.05. Although the results showed the beneficial effect of OG on jump height ( p < 0.01), the training with OG did not bring significantly better results than training without OG. In addition, the group trained without OG improved after 2 weeks in both testing conditions (with and without OG), whereas the group trained with OG improved after 2 weeks when tested with OG and only after 6 weeks when tested without OG. We believe the use of OG in jump training may be detrimental when the OG is withdrawn from the testing procedure because of its strong motivational and feedback features. Consequently, athletes in disciplines which require them to jump toward an object located over their head during a game, e.g., a ball or crossbar, should be tested with the presence of OG. Despite this, OG is still an important factor in maximizing jump performance.
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Affiliation(s)
- Anna Akbaş
- Department of Human Motor Behavior, Institute of Sport Sciences, Academy of Physical Education, Katowice, Poland
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Johnson L, Burridge J, Ewings S, Westcott E, Gayton M, Demain S. Principles into Practice: An Observational Study of Physiotherapists use of Motor Learning Principles in Stroke Rehabilitation. Physiotherapy 2023; 118:20-30. [PMID: 36306569 PMCID: PMC9907222 DOI: 10.1016/j.physio.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 03/21/2022] [Accepted: 06/14/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE(S) To describe a) how motor learning principles are applied during post stroke physiotherapy, with a focus on lower limb rehabilitation; and b) the context in which these principles are used, in relation to patient and/or task characteristics. DESIGN Direct non-participation observation of routine physiotherapy sessions, with data collected via video recording. A structured analysis matrix and pre-agreed definitions were used to identify, count and record: type of activity; repetitions; instructional and feedback statements (frequency and type); strategies such as observational learning and augmented feedback. Data was visualised using scatter plots, and analysed descriptively. SETTING 6 UK Stroke Units PARTICIPANTS: 89 therapy sessions were observed, involving 55 clinicians and 57 patients. RESULTS Proportion of time spent active within each session ranged from 26% to 98% (mean 85, SD 19). The frequency of task repetition varied widely, with a median of 3.7 repetitions per minute (IQR 2.1-8.6). Coaching statements were common (mean 6.46 per minute), with 52% categorised as instructions, 14% as feedback, and 34% as verbal cues/motivational statements. 13% of instructions and 6% of feedback statements were externally focussed. Examining the use of different coaching behaviours in relation to patient characteristics found no associations. Overall, practice varied widely across the dataset. CONCLUSIONS To optimise the potential for motor skill learning, therapists must manipulate features of their coaching language (what they say, how much and when) and practice design (type, number, difficulty and variability of task). There is an opportunity to implement motor learning principles more consistently, to benefit motor skill recovery following stroke. TRIAL REGISTRATION NUMBER Clinicaltrials.gov (NCT03792126). CONTRIBUTION OF THE PAPER.
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Affiliation(s)
- Louise Johnson
- University Hospitals Dorset NHS Foundation Trust, Castle Lane East, Bournemouth, Dorset, UK; School of Health Sciences, Faculty of Environmental and Life Sciences, Building 45, University of Southampton, Southampton SO17 1BJ.
| | - Jane Burridge
- School of Health Sciences, Faculty of Environmental and Life Sciences, Building 45, University of Southampton, Southampton SO17 1BJ
| | - Sean Ewings
- Southampton Clinical Trials Unit, University of Southampton, University Road, Southampton, SO17 1BJ
| | - Ellie Westcott
- University Hospitals Dorset NHS Foundation Trust, Castle Lane East, Bournemouth, Dorset, UK
| | - Marianne Gayton
- University Hospitals Dorset NHS Foundation Trust, Castle Lane East, Bournemouth, Dorset, UK
| | - Sara Demain
- School of Health Sciences, Faculty of Environmental and Life Sciences, Building 45, University of Southampton, Southampton SO17 1BJ
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8
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Knowledge and use of extrinsic feedback characteristics: A survey of current practice among Brazilian physical therapists. Physiother Theory Pract 2023; 39:384-394. [PMID: 34872426 DOI: 10.1080/09593985.2021.2010246] [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: 01/19/2023]
Abstract
OBJECTIVES This study aimed to identify the knowledge about the different characteristics of and the use of extrinsic feedback (EF) by Brazilian physical therapists. METHODS This is a cross-sectional study, and we used an internet-based survey with questions about knowledge and application of extrinsic feedback in clinical practice. We analyzed the responses in relation to the best available evidence on motor control and learning. We recruited Brazilian registered physical therapists from different regions in Brazil. Participants' demographics and survey responses were analyzed using descriptive statistics. RESULTS Two hundred and forty-six Brazilian physical therapists participated in the study. Most participants affirmed not knowing the definition of EF (55.69%), confirmed using some form of EF in their clinical practice (86.59%), and reported using it in 50% to 90% of their patients (26.42%). Brazilian physical therapists reported using mainly summary feedback (69.10%) with external focus of attention (63.41%). Participants reported using concurrent feedback (82.83%) and delivered it after every exercise repetition (63.82%). Most participants (43.09%) did not assess learning retention. Answers were similar regardless of education level or time from graduation. CONCLUSIONS The results of this survey suggest that Brazilian physical therapists do not have sufficient knowledge about the different characteristics of EF; however, they do consider EF useful and use it for most of their patients. Brazilian physical therapists adopted adequate content characteristics of EF but not adequate use of timing characteristics of EF.
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Haeri F, Torre D. Application of Feedback Type on Performance of Abdominal Drawing-In Maneuver in Healthy Adults: A Quasi-Experimental Study of Motor Control and Motor Learning. J Manipulative Physiol Ther 2022; 45:671-680. [PMID: 37306649 DOI: 10.1016/j.jmpt.2023.04.004] [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: 08/07/2022] [Revised: 04/07/2023] [Accepted: 04/08/2023] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The aim of this study was to compare the effects of verbal, tactile-verbal, and visual feedback on muscle activation of the lumbar stabilizers relative to extremity movers during an abdominal drawing-in maneuver when feedback is withheld. METHODS This quasi-experimental study equally divided 54 healthy adults into 3 feedback groups (verbal, tactile-verbal, and visual) who trained twice per week over a 4-week period to perform supine abdominal drawing-in maneuvers. The percentage of maximum voluntary isometric contraction of rectus abdominis, multifidus (MF), erector spinae, and hamstrings (HS) as an outcome measure was acquired using surface electromyography. A 2-way factorial analysis of variance with bootstrapping allowed for comparison of post-pre difference scores across the interaction of feedback and muscle groups. RESULTS Hamstring activation decreased in those receiving tactile-verbal feedback relative to an increase in participants given visual feedback. Furthermore, when using verbal feedback, HS activity increased relative to a decline in rectus abdominis, and when presenting visual feedback, HS activity increased relative to a decrease in MF. However, no post-pre changes were seen across muscles with tactile-verbal feedback. CONCLUSION Although tactile-verbal feedback did not increase MF recruitment, it produced less HS activity than visual feedback. Undesirable HS recruitment may reflect boredom or feedback dependency.
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Affiliation(s)
- Farhad Haeri
- Physical Therapy Program, School of Health Professions, SUNY Downstate Health Sciences University, Brooklyn, New York.
| | - Dennis Torre
- Physical Therapy Program, School of Health Professions, SUNY Downstate Health Sciences University, Brooklyn, New York
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The Role of Verbal Feedback in the Motor Learning of Gymnastic Skills: A Systematic Review. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12125940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The main purpose of this study was to systematically review the effects of feedback on motor skill acquisition in gymnastic skills. A systematic literature search was conducted in the electronic databases MEDLINE (EBSCO), Scopus, SPORTDiscus (EBSCO), and Web of Science. Of the initial 743 search articles, 13 studies were included in the quantitative analysis. Studies were included if they met the following criteria: (a) healthy subjects, (b) studies with gymnastic, artistic gymnastic, or trampoline elements in the study protocol, (c) verbal feedback intervention, (d) the study compared verbal feedback intervention with other forms of feedback, instructional intervention, or with a control intervention, and (e) task performance evaluation. Methodological quality was identified using the PEDro scale. Combining verbal instructions with different forms of feedback is beneficial when learning complex gymnastic skills. Verbal feedback may be useful to improve the technical performance of a gymnastic element; in particular, information regarding the errors committed in a key element of the performance seems to be effective in the motor learning process.
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Elghoul Y, Bahri F, Trabelsi K, Chtourou H, Frikha M, Clark CCT, Glenn JM, Bragazzi N, Souissi N. Optimizing Motor Learning: Difficulty Manipulation Combined with Feedback- Frequency Enhance Under-Time-Pressure Fine-Motor-Coordination Skill Acquisition and Retention. J Mot Behav 2021; 54:490-502. [PMID: 34913851 DOI: 10.1080/00222895.2021.2016573] [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: 10/19/2022]
Abstract
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.
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Affiliation(s)
- Yousri Elghoul
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia.,Education, Motor Skills, Sports and Health (EM2S), LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
| | - Fatma Bahri
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia.,Education, Motor Skills, Sports and Health (EM2S), LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
| | - Khaled Trabelsi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia.,Education, Motor Skills, Sports and Health (EM2S), LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
| | - Hamdi Chtourou
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia.,Education, Motor Skills, Sports and Health (EM2S), LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
| | - Mohamed Frikha
- Department of Physical Education, College of Education, King Faisal University, Al-Hufŭf, Saudi Arabia
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | - Jordan M Glenn
- Exercise Science Research Center, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, Arkansas, USA
| | - Nicola Bragazzi
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada
| | - Nizar Souissi
- Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis, Tunisia
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Effects of Concurrent and Terminal Visual Feedback on Ankle Co-Contraction in Older Adults during Standing Balance. SENSORS 2021; 21:s21217305. [PMID: 34770611 PMCID: PMC8588392 DOI: 10.3390/s21217305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/22/2021] [Accepted: 10/26/2021] [Indexed: 01/13/2023]
Abstract
This preliminary investigation studied the effects of concurrent and terminal visual feedback during a standing balance task on ankle co-contraction, which was accomplished via surface electromyography of an agonist–antagonist muscle pair (medial gastrocnemius and tibialis anterior muscles). Two complementary mathematical definitions of co-contraction indices captured changes in ankle muscle recruitment and modulation strategies. Nineteen healthy older adults received both feedback types in a randomized order. Following an analysis of co-contraction index reliability as a function of surface electromyography normalization technique, linear mixed-effects regression analyses revealed participants learned or utilized different ankle co-contraction recruitment (i.e., relative muscle pair activity magnitudes) and modulation (i.e., absolute muscle pair activity magnitudes) strategies depending on feedback type and following the cessation of feedback use. Ankle co-contraction modulation increased when concurrent feedback was used and significantly decreased when concurrent feedback was removed. Ankle co-contraction recruitment and modulation did not significantly change when terminal feedback was used or when it was removed. Neither ankle co-contraction recruitment nor modulation was significantly different when concurrent feedback was used compared to when terminal feedback was used. The changes in ankle co-contraction recruitment and modulation were significantly different when concurrent feedback was removed as compared to when terminal feedback was removed. Finally, this study found a significant interaction between feedback type, removal of feedback, and order of use of feedback type. These results have implications for the design of balance training technologies using visual feedback.
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Automated summative feedback improves performance and retention in simulation training of mastoidectomy: a randomised controlled trial. The Journal of Laryngology & Otology 2021; 136:29-36. [PMID: 34709147 DOI: 10.1017/s0022215121003352] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE This study aimed to investigate the effects of automated metrics-based summative feedback on performance, retention and cognitive load in distributed virtual reality simulation training of mastoidectomy. METHOD Twenty-four medical students were randomised in two groups and performed 15 mastoidectomies on a distributed virtual reality simulator as practice. The intervention group received additional summative metrics-based feedback; the control group followed standard instructions. Two to three months after training, participants performed a retention test without learning supports. RESULTS The intervention group had a better final-product score (mean difference = 1.0 points; p = 0.001) and metrics-based score (mean difference = 12.7; p < 0.001). At retention, the metrics-based score for the intervention group remained superior (mean difference = 6.9 per cent; p = 0.02). Also at the retention, cognitive load was higher in the intervention group (mean difference = 10.0 per cent; p < 0.001). CONCLUSION Summative metrics-based feedback improved performance and lead to a safer and faster performance compared with standard instructions and seems a valuable educational tool in the early acquisition of temporal bone skills.
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Wearable Devices for Biofeedback Rehabilitation: A Systematic Review and Meta-Analysis to Design Application Rules and Estimate the Effectiveness on Balance and Gait Outcomes in Neurological Diseases. SENSORS 2021; 21:s21103444. [PMID: 34063355 PMCID: PMC8156914 DOI: 10.3390/s21103444] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/03/2021] [Accepted: 05/12/2021] [Indexed: 12/11/2022]
Abstract
Wearable devices are used in rehabilitation to provide biofeedback about biomechanical or physiological body parameters to improve outcomes in people with neurological diseases. This is a promising approach that influences motor learning and patients' engagement. Nevertheless, it is not yet clear what the most commonly used sensor configurations are, and it is also not clear which biofeedback components are used for which pathology. To explore these aspects and estimate the effectiveness of wearable device biofeedback rehabilitation on balance and gait, we conducted a systematic review by electronic search on MEDLINE, PubMed, Web of Science, PEDro, and the Cochrane CENTRAL from inception to January 2020. Nineteen randomized controlled trials were included (Parkinson's n = 6; stroke n = 13; mild cognitive impairment n = 1). Wearable devices mostly provided real-time biofeedback during exercise, using biomechanical sensors and a positive reinforcement feedback strategy through auditory or visual modes. Some notable points that could be improved were identified in the included studies; these were helpful in providing practical design rules to maximize the prospective of wearable device biofeedback rehabilitation. Due to the current quality of the literature, it was not possible to achieve firm conclusions about the effectiveness of wearable device biofeedback rehabilitation. However, wearable device biofeedback rehabilitation seems to provide positive effects on dynamic balance and gait for PwND, but higher-quality RCTs with larger sample sizes are needed for stronger conclusions.
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15
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Bryson A, Arthur R, Easton C. Prior Knowledge of the Grading Criteria Increases Functional Movement Screen Scores in Youth Soccer Players. J Strength Cond Res 2021; 35:762-768. [PMID: 30024484 DOI: 10.1519/jsc.0000000000002724] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
ABSTRACT Bryson, A, Arthur, R, and Easton, C. Prior knowledge of the grading criteria increases Functional Movement Screen scores in youth soccer players. J Strength Cond Res 35(3): 762-768, 2021-We sought to determine whether familiarity with the grading criteria of the Functional Movement Screen (FMS) impacted the outcome score in elite youth soccer players. Thirty-two trained male youth soccer players (aged 17 ± 1 years) participated in a randomized control trial. Subjects were randomly assigned to evenly sized control and experimental groups, who each completed the FMS on 2 separate occasions. Subjects in the experimental group were provided the FMS grading criteria between their first and second screens. Time-synchronized video footage was used to grade the FMS using standardized criteria. Structured interviews were then conducted with selected subjects (n = 4) in the experimental group to establish athletes' perception of the FMS. The experimental group had a large increase in overall FMS score from the first to the second screen in comparison with the control group (Δ2.0 ± 1.0, p < 0.001, d = 1.3). Scores for the deep squat, hurdle step, and rotary stability tests components of the FMS all increased in the experimental group in comparison with the control group (p < 0.05). Thematic analysis of the interview data suggested that the subjects in the experimental group improved their understanding between good and poor technique during the FMS. These findings support the notion that FMS scores are influenced by awareness of the grading criteria. As a consequence, the FMS may not be suitable for objectively predicting injury in youth soccer players.
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Affiliation(s)
- Anthony Bryson
- Institute for Clinical Exercise and Health Science, University of the West of Scotland, Hamilton, United Kingdom; and.,Ayr United Football Academy, Ayr, United Kingdom
| | - Rosemary Arthur
- Institute for Clinical Exercise and Health Science, University of the West of Scotland, Hamilton, United Kingdom; and
| | - Chris Easton
- Institute for Clinical Exercise and Health Science, University of the West of Scotland, Hamilton, United Kingdom; and
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16
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Howard NM, Cook DA, Hatala R, Pusic MV. Learning Curves in Health Professions Education Simulation Research: A Systematic Review. Simul Healthc 2021; 16:128-135. [PMID: 32675731 DOI: 10.1097/sih.0000000000000477] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
SUMMARY STATEMENT Learning curves are used in health professions education to graphically represent paths to competence and expertise. However, research using learning curves often omit important information. The authors conducted a systematic review of the reporting quality of learning curves in simulation-based education research to identify specific areas for improvement. Reviewers extracted information on graphical, statistical, and conceptual elements. The authors identified 230 eligible articles. Most learning curve elements were reported infrequently, including use of an optimal linking function, detailed description of feedback or learning intervention, use of advanced visualization techniques such as overlaying and stacking, and depiction of competency thresholds. Reporting did not improve over time for most elements. Reporting of learning curves in health professions education research is incomplete and often underutilizes their desirable properties. Recommendations for improvement of the statistical, graphical, and conceptual reporting of learning curves, as well as applications to simulation research and education, are presented.
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Affiliation(s)
- Neva M Howard
- From the University of North Carolina Chapel Hill School of Medicine (N.M.H.), Chapel Hill, NC; Center for Online Learning (D.A.C.), Mayo Clinic College of Medicine; Division of General Internal Medicine (D.A.C.), Mayo Clinic, Rochester, MN; Department of Medicine (R.H.), University of British Columbia, Vancouver, British Columbia, Canada; and Division of Learning Analytics (M.V.P.), NYU School of Medicine, New York, NY
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17
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Concurrent Continuous Versus Bandwidth Visual Feedback With Varying Body Representation for the 2-Legged Squat Exercise. J Sport Rehabil 2021; 30:794-803. [PMID: 33596545 DOI: 10.1123/jsr.2020-0234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/17/2020] [Accepted: 11/27/2020] [Indexed: 11/18/2022]
Abstract
CONTEXT Continuous visual feedback (VF) can improve abilities to achieve desired movements and maximize rehabilitation outcomes by displaying actual versus target body positions in real time. Bandwidth VF reduces the reliance on feedback by displaying movement cues only when performance errors exceed specified thresholds. As such, bandwidth VF may better train independent movement abilities through greater development of intrinsic body control. In this study, continuous and bandwidth VF were investigated across modes of display (abstract and representative) that differed in body-discernibility. OBJECTIVE To compare the performance of the 2-legged squat during training with concurrent feedback (real-time VF) and short-term retention (immediately after training, VF removed). DESIGN Cross-sectional. SETTING University research laboratory. PARTICIPANTS Eighteen healthy individuals. METHODS Marker-based motion capture displayed real-time position. MAIN OUTCOME MEASURES Four VF cases (continuous-abstract, bandwidth-abstract, continuous-representative, and bandwidth-representative) were evaluated for accuracy and consistency to a target trajectory and target depth. RESULTS During training, both continuous VF cases showed significantly (P < .05) higher accuracy and consistency to the target trajectory compared with both bandwidth VF cases. Bandwidth VF resulted in greater potential learning (retention performance relative to a training baseline) compared with continuous-abstract. CONCLUSIONS Continuous-representative may offer unique performance benefits in both training and retention of multisegment movement tasks. Bandwidth VF showed greater potential for learning. For long-term learning, an optimal VF paradigm should consider continuous-representative with bandwidth features.
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18
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Charlton JM, Eng JJ, Li LC, Hunt MA. Learning Gait Modifications for Musculoskeletal Rehabilitation: Applying Motor Learning Principles to Improve Research and Clinical Implementation. Phys Ther 2021; 101:pzaa207. [PMID: 33351940 PMCID: PMC7899063 DOI: 10.1093/ptj/pzaa207] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 10/04/2020] [Indexed: 12/11/2022]
Abstract
Gait modifications are used in the rehabilitation of musculoskeletal conditions like osteoarthritis and patellofemoral pain syndrome. While most of the research has focused on the biomechanical and clinical outcomes affected by gait modification, the process of learning these new gait patterns has received little attention. Without adequate learning, it is unlikely that the modification will be performed in daily life, limiting the likelihood of long-term benefit. There is a vast body of literature examining motor learning, though little has involved gait modifications, especially in populations with musculoskeletal conditions. The studies that have examined gait modifications in these populations are often limited due to incomplete reporting and study design decisions that prohibit strong conclusions about motor learning. This perspective draws on evidence from the broader motor learning literature for application in the context of modifying gait. Where possible, specific gait modification examples are included to highlight the current literature and what can be improved on going forward. A brief theoretical overview of motor learning is outlined, followed by strategies that are known to improve motor learning, and finally, how assessments of learning need to be conducted to make meaningful conclusions.
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Affiliation(s)
- Jesse M Charlton
- Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada
- Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, BC, Canada
| | - Janice J Eng
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
- Arthritis Research Canada, Richmond, BC, Canada
| | - Michael A Hunt
- Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, BC, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
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19
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Stafford J, Rodger M. Educating Older Adults’ Attention towards and Away from Gap-Specifying Information in a Virtual Road-Crossing Task. ECOLOGICAL PSYCHOLOGY 2020. [DOI: 10.1080/10407413.2020.1826322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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20
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Rendos NK, Zajac-Cox L, Thomas R, Sato S, Eicholtz S, Kesar TM. Verbal feedback enhances motor learning during post-stroke gait retraining. Top Stroke Rehabil 2020; 28:362-377. [PMID: 32942960 DOI: 10.1080/10749357.2020.1818480] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Fast treadmill walking combined with functional electrical stimulation to ankle muscles (FastFES) is a well-studied gait intervention that improves post-stroke walking function. Although individualized verbal feedback is commonly incorporated during clinical gait training, and a variable practice structure is posited to enhance learning, the influence of these two factors on motor learning during locomotor interventions such as FastFES is poorly understood. OBJECTIVES To determine if the addition of individualized verbal feedback or variable practice to a FastFES training session enhances motor learning of targeted gait patterns. METHODS Nine individuals with post-stroke hemiparesis completed a crossover study comprising exposure to 3 dose-matched types of gait training: (1) FastFES (FF), comprising five 6-minute bouts of training with intermittent FES, (2) FF with addition of individualized verbal instructions and faded feedback delivered by a physical therapist (FF+PT), (3) FF with variable gait speed and FES timing (FF+Var). Gait biomechanics data were collected before (Pre), immediately after (Post), and 24-h following (Retention) each training type. Within-session and retention change scores of 3 targeted gait variables were calculated to assess locomotor learning. RESULTS FF+PT resulted in larger improvements within-session and at retention in trailing limb angle, and a trend for larger improvements in paretic pushoff compared to FF. FF+Var failed to show greater learning of biomechanical variables compared to FF. CONCLUSIONS Addition of individualized verbal feedback (FF+PT) to a single session of gait training may enhance within- and across-session learning of targeted gait variables in people post-stroke, and merits more investigation.
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Affiliation(s)
- Nicole K Rendos
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University School of Medicine, Atlanta, GA, USA
| | - Laura Zajac-Cox
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University School of Medicine, Atlanta, GA, USA
| | - Rahul Thomas
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University School of Medicine, Atlanta, GA, USA
| | - Sumire Sato
- Neuroscience and Behavior Graduate Program, University of Massachusetts Amherst, Amherst, MA, USA
| | - Steven Eicholtz
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University School of Medicine, Atlanta, GA, USA
| | - Trisha M Kesar
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University School of Medicine, Atlanta, GA, USA
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21
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Tarnas J, Stemplewski R, Krutki P. Sex Differences in Maintaining the Requested Handgrip Force Enhanced by Auditory or Visual Feedback. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145158. [PMID: 32708898 PMCID: PMC7400562 DOI: 10.3390/ijerph17145158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 06/30/2020] [Accepted: 07/11/2020] [Indexed: 11/16/2022]
Abstract
Thus far, the differences in effect of auditory or visual feedback in motor learning have presented results derived from mixed groups and sex differences have not been considered. However, perception and processing of auditory stimuli and performance of visual motor tasks appear to be sex-related. The purpose of this study was to investigate the learning of the simple motor task of maintaining a requested handgrip force in separate male and female groups. A total of 31 volunteers (15 males, 16 females) were randomly assigned to one of four experimental groups with defined sex and training conditions (audio or visual feedback). Participants performed training sessions over a period of six days, for which auditory or visual feedback was provided, and the effectiveness of both types of signals was compared. The evident learning effect was found in all groups, and the main effect of sex was significant among visual groups in favor of the males (p < 0.05). On the other hand, the main effect of feedback conditions was found to be significant among females, beneficially in the case of auditory displays (p < 0.05). The results lead to the conclusion that an equal number of males and females in mixed experimental groups may be supportive to obtain reliable results. Moreover, in motor-learning studies conducted on females only, a design including auditory feedback would be more suitable.
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Affiliation(s)
- Jacek Tarnas
- Department of Physical Education and Lifelong Sports, Poznan University of Physical Education, Królowej Jadwigi 27/39, 61-871 Poznań, Poland
- Correspondence: ; Tel.: +48-6183-55-320
| | - Rafał Stemplewski
- Department of Physical Activity Sciences and Health Promotion, Poznan University of Physical Education, Królowej Jadwigi 27/39, 61-871 Poznań, Poland;
| | - Piotr Krutki
- Department of Neurobiology, Poznan University of Physical Education, Królowej Jadwigi 27/39, 61-871 Poznań, Poland;
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22
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Jimenez-Diaz J, Chaves-Castro K, Morera-Castro M. Effect of Self-Controlled and Regulated Feedback on Motor Skill Performance and Learning: A Meta-Analytic Study. J Mot Behav 2020; 53:385-398. [PMID: 32623973 DOI: 10.1080/00222895.2020.1782825] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The purpose of this study was to use the meta-analytic approach to assess the effectiveness of self-controlled (SC) and regulated (R) feedback on motor skill performance (MSP). Random effects model using the standardized mean difference effect size (ES) was used to pool results. A total of 86 ES, retrieved from 18 studies, were calculated and separated into three types of feedback: SC, R, and yoked group (YG). In acquisition phase, SC (ES = 1.872; CI95% = 1.014, 2.730), R (ES = 0.852; CI95% = 0.614, 1.090), and YG (ES = 1.492; CI95% = 0.266, 2.718) significantly improved MSP. In retention phase, SC and YG had a nonsignificant decrease in MSP, R (ES = -0.819; CI95% = -1.207, -0.430) significantly decrease MSP. Several factors were analyzed as moderator variables. Results suggest that SC feedback enhances learning.
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Affiliation(s)
- Judith Jimenez-Diaz
- Escuela de Educación Física y Deportes, Universidad de Costa Rica, San José, Costa Rica.,Centro de Investigación en Ciencias del Movimiento Humano, Universidad de Costa Rica, San José, Costa Rica
| | - Karla Chaves-Castro
- Escuela de Educación Física y Deportes, Universidad de Costa Rica, San José, Costa Rica.,Centro de Investigación en Ciencias del Movimiento Humano, Universidad de Costa Rica, San José, Costa Rica
| | - Maria Morera-Castro
- Escuela de Ciencias del Movimiento Humano y Calidad de Vida, Universidad Nacional de Costa Rica, Heredia, Costa Rica
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23
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Smith I, Gill S, Bateman S, Scheme E. Comparison of Feedback Approaches to Improve Training in Partial Weight-Bearing. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:3264-3268. [PMID: 33018701 DOI: 10.1109/embc44109.2020.9176207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Assistive devices, including canes or crutches, are used in partial weight-bearing (PWB) to offload weight from limbs weakened by disease or injury, promote recovery, and prevent reinjury. While weight must be offloaded accurately to target loads prescribed by healthcare providers for maximum benefit, current training methods result in poor adherence. It is, however, currently unknown how best to provide feedback during training so that users can build an accurate internal model for PWB. In this work, we investigate seven feedback schemes using an instrumented cane, which vary the modality, timing, and the level of detail provided. We find that auditory schemes and a retrospective visual scheme outperform current clinical practices for PWB training. These findings provide results that can be applied directly to improve current clinical practices and provide valuable new insight into the design of feedback for training internal models in force-based motor control tasks. Clinically, this work presents a simple modification to clinical PWB training practices that can improve compliance by up to 75%, positively influencing rehabilitation outcomes and reducing the risk of complications.
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24
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Yamamoto R, Akizuki K, Kanai Y, Nakano W, Kobayashi Y, Ohashi Y. Differences in skill level influence the effects of visual feedback on motor learning. J Phys Ther Sci 2019; 31:939-945. [PMID: 31871382 PMCID: PMC6879409 DOI: 10.1589/jpts.31.939] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 08/23/2019] [Indexed: 11/24/2022] Open
Abstract
[Purpose] No previous studies have confirmed whether the effects of visual feedback on motor learning vary according to learner skill level for a learning task. The purpose of this study was to clarify whether differences in skill influence the effects of visual feedback on motor learning. [Participants and Methods] Sixty-four participants were assigned to one of four different feedback groups (concurrent-100%, concurrent-50%, terminal-100%, or terminal-50%). The learning task was to adjust the load amount continuously to the left lower limb in accordance with sound stimulation at intervals of 1 Hz. The four groups performed a pretest, practice sessions, and a retention test 24 hours after practice. After completing these measurements, the participants were classified as either high- or low-skilled based on the results of the pretest. [Results] Only the groups of low-skilled participants who used concurrent feedback showed lower root mean square errors in the retention test compared to in the pretest. [Conclusion] Differences in skill level for the same task influenced the effects of visual feedback on motor learning. Furthermore, concurrent visual feedback can help improve motor learning in low-skilled learners for the same task.
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Affiliation(s)
- Ryohei Yamamoto
- Department of Rehabilitation, Kyushu University of Nursing and Social Welfare: 888 Tomio, Tamana, Kumamoto 865-0062, Japan
| | - Kazunori Akizuki
- Department of Physical Therapy, Kobe International University, Japan
| | - Yoshihide Kanai
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Japan
| | - Wataru Nakano
- Department of Shizuoka Physical Therapy, Tokoha University, Japan
| | - Yasuto Kobayashi
- Department of Sport Management, Sakushin Gakuin University, Japan
| | - Yukari Ohashi
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Japan
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25
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Mulloy F, Irwin G, Williams GKR, Mullineaux DR. Quantifying bi-variate coordination variability during longitudinal motor learning of a complex skill. J Biomech 2019; 95:109295. [PMID: 31439333 DOI: 10.1016/j.jbiomech.2019.07.039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 07/27/2019] [Accepted: 07/29/2019] [Indexed: 01/23/2023]
Abstract
Biofeedback (BFb) can enhance the motor learning process by guiding skill exploration. Too much BFb, however, can foster dependency leading to skill retention deficits once removed. A reducing BFb schedule could negate dependency effects, however limited methodologies exist to assess the effectiveness of an intervention during application. This research proposes a new bi-variate method (CI2Area) to quantify coordination variability (CoordVar) as a measure of skill exploration during a motor learning intervention. Thirty-two participants were introduced to a novel explosive-lunge task. A BFb group (n = 16) were provided with visual BFb on rear hip, knee and ankle joint extension magnitudes and timing during a 26-week reducing schedule BFb intervention. CoordVar of hip-knee and knee-ankle angular velocities were quantified by calculating the area encompassed by the 95% confidence intervals of joint coupling angular-velocity bi-variate plots (CI2Area). Linear regressions were fitted to group and individual CoordVar longitudinal data. The BFb was effective in successfully altering whole limb technique within just two sessions, and these changes were retained. The BFb group demonstrated a continual increase of CoordVar throughout the intervention, showing continual skill exploration strategies, while the Control group remained unchanged. Gradually increasing time between sessions, using a longitudinally reducing BFb schedule, successfully negates dependency effects on BFb while also encouraging motor learning. Manipulating time between sessions allows for the provision of a high frequency of 100% BFb without fostering dependency. The CI2Area method was able to detect individual exploration strategies and could be used in the future to direct individual intervention modifications.
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Affiliation(s)
- F Mulloy
- School of Sport and Exercise Science, University of Lincoln, UK.
| | - G Irwin
- School of Sport and Health Sciences, Cardiff Metropolitan University, UK
| | | | - D R Mullineaux
- School of Sport and Exercise Science, University of Lincoln, UK
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26
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Gorman AJ, Willmott AP, Mullineaux DR. The effects of concurrent biomechanical biofeedback on novel skill acquisition. Sports Biomech 2019; 21:297-311. [DOI: 10.1080/14763141.2019.1650101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Anthony J. Gorman
- School of Sport & Exercise Science, University of Lincoln, Lincoln, UK
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27
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Scheduling Concurrent Visual Feedback in Learning a Continuous Balance Task. JOURNAL OF MOTOR LEARNING AND DEVELOPMENT 2019. [DOI: 10.1123/jmld.2017-0067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This investigation held concurrent visual feedback frequency at 50% in the acquisition phase and manipulated three different feedback schedules while comparing those to a 0% feedback frequency. In an assessment of dynamic postural stability, young, healthy adults performed 20 acquisition trials and four retention trials 48-hr later on a circular platform that moved in the anterior/posterior and medial/lateral axes simultaneously. Three concurrent feedback schedules were manipulated: a fade schedule consisting of high relative frequency of concurrent feedback early in the acquisition phase which was systematically reduced throughout acquisition (e.g., 100%, 75%, 50%, 25%, 0%), a constant schedule consisting of a uniform scheduling of concurrent feedback on every other acquisition trial, and a reverse fade group consisting of a schedule exactly opposite to that of the fade group. A no concurrent feedback group was also utilized to determine if feedback was necessary to learn the balance task. Acquisition and retention results revealed the concurrent groups performed with significantly greater accuracy and stability than the no concurrent feedback group. There were no significant differences between the three concurrent feedback schedules. Results indicate that manipulating concurrent feedback scheduling did not produce similar results to those investigations manipulating knowledge of results scheduling.
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28
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Goodwin JE, Goggin NL. An Older Adult Study of Concurrent Visual Feedback in Learning Continuous Balance. Percept Mot Skills 2018; 125:1160-1172. [PMID: 30193556 DOI: 10.1177/0031512518795758] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This investigation manipulated concurrent visual feedback for older adults learning to perform a continuous balance task. We randomly assigned 21 older adults to one of three knowledge of results (KR) groups with varying concurrent but always 100% terminal feedback percentages during acquisition: 100% Concurrent and Terminal (100% C&T), 50% Concurrent and 100% Terminal (50% C & 100% T), and 0% Concurrent and 100% Terminal (0% C & 100% T). The continuous balance task involved learning to maintain balance on a circular platform that moved simultaneously on both anterior/posterior and medial/lateral axes. We tested participants before acquisition phase learning and two days afterwards (retention test). At retention testing, participants in the 50% C & 100% T and those in the 0% C & 100% T conditions demonstrated significantly greater accuracy and stability than did participants in the 100% C&T condition. These findings extend previous research with young adults in supporting the guidance theory that too frequent a provision of concurrent knowledge of results negatively affects learning.
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29
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Popovic T, Caswell SV, Benjaminse A, Siragy T, Ambegaonkar J, Cortes N. Implicit video feedback produces positive changes in landing mechanics. J Exp Orthop 2018; 5:12. [PMID: 29721781 PMCID: PMC5931948 DOI: 10.1186/s40634-018-0129-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 04/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Implicit (IF) and explicit (EF) feedback are two motor learning strategies demonstrated to alter movement patterns. There is conflicting evidence on which strategy produces better outcomes. The purpose of this study was to examine the effects of reduced IF and EF video feedback on lower extremity landing mechanics. METHODS Thirty participants (24 ± 2 years, 1.7 ± 0.1 m, 70 ± 11 kg) were randomly assigned to three groups: IF (n = 10), EF (n = 10), and control (CG) (n = 10). They performed twelve box-drop jumps three times a week on the training sessions for six weeks. Only IF and EF groups received video feedback on the training sessions. IF was cued to focus their attention on the overall jump, while EF was cued to focus on position of their knees. 3D lower extremity biomechanics were tested on testing sessions with no feedback. All sessions were at least 24 h apart from another. Testing sessions included baseline testing (pretest), testing after 3 training sessions with 100% feedback (pst1), testing after 6 training sessions with 33.3% feedback (pst2), testing after 6 training sessions with 16.6% feedback (Pst3), and testing 1 month after with no feedback (retention - ret). ANOVA compared differences between groups and time at initial contact and peak for hip flexion (HF, °) and abduction angle (HA, °), hip abduction moment (HAM, Nm/kgm), knee flexion (KF, °) and abduction angle (KA, °), knee abduction moment (KAM, Nm/kgm) and VGRF (N) (p < 0.05). RESULTS A significant main effect for group was found between IF and EF groups for HA (IF = - 6.7 ± 4; EF = - 9.4 ± 4.1) and KAM (IF = 0.05 ± 0.2; EF = - 0.07 ± 0.2) at initial contact, and peaks HA (IF = - 3.5 ± 4.5; EF = - 7.9 ± 4.7) and HAM (IF = 1.1 ± 0.6; EF = 0.9 ± 0.4). A significant main effect for time at initial contact for HF (pre = 32.4 ± 3.2; pst2 = 36.9 ± 3.2; pst3 = 37.9 ± 3.7; ret. = 34.1 ± 3.7), HAM (pre = 0.1 ± 0.1; pst1 = 0.04 ± 0.1; pst3 = 0.1 ± 0.01), KA (pre = 0.7 ± 1.1; pst1 = 0.2 ± 1.2; pst3 = 1.7 ± 1), and KAM (pre = 0.003 ± 0.1; pst3 = 0.01 ± 0.1) was found. DISCUSSION/CONCLUSION We found that implicit feedback produced positive changes in landing mechanics while explicit feedback degraded motor learning. Our results indicate that implicit feedback should be used in programs to lower the ACL injury risk. We suggest that implicit feedback should be frequent in the beginning and not be reduced as much following the acquisition phase.
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Affiliation(s)
- Tijana Popovic
- Sports Medicine Assessment, Research & Testing (SMART) Laboratory, George Mason University, 10890 George Mason Circle Bull Run Hall 220, MSN 4E5, Manassas, VA, 20110, USA.,Department of Radiology and Biomedical Imaging, University of California, 185 Berry Street, Lobby 6, Suite 391, San Francisco, CA, 94107, USA
| | - Shane V Caswell
- Sports Medicine Assessment, Research & Testing (SMART) Laboratory, George Mason University, 10890 George Mason Circle Bull Run Hall 220, MSN 4E5, Manassas, VA, 20110, USA
| | | | - Tarique Siragy
- Sports Medicine Assessment, Research & Testing (SMART) Laboratory, George Mason University, 10890 George Mason Circle Bull Run Hall 220, MSN 4E5, Manassas, VA, 20110, USA.,School of Human Kinetics, Faculty of Health Sciences at the University of Ottawa, 75 Laurier Avenue East, Ottawa, ON, K1N 6N5, Canada
| | - Jatin Ambegaonkar
- Sports Medicine Assessment, Research & Testing (SMART) Laboratory, George Mason University, 10890 George Mason Circle Bull Run Hall 220, MSN 4E5, Manassas, VA, 20110, USA
| | - Nelson Cortes
- Sports Medicine Assessment, Research & Testing (SMART) Laboratory, George Mason University, 10890 George Mason Circle Bull Run Hall 220, MSN 4E5, Manassas, VA, 20110, USA.
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Ghai S, Schmitz G, Hwang TH, Effenberg AO. Auditory Proprioceptive Integration: Effects of Real-Time Kinematic Auditory Feedback on Knee Proprioception. Front Neurosci 2018; 12:142. [PMID: 29568259 PMCID: PMC5852112 DOI: 10.3389/fnins.2018.00142] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 02/22/2018] [Indexed: 01/23/2023] Open
Abstract
The purpose of the study was to assess the influence of real-time auditory feedback on knee proprioception. Thirty healthy participants were randomly allocated to control (n = 15), and experimental group I (15). The participants performed an active knee-repositioning task using their dominant leg, with/without additional real-time auditory feedback where the frequency was mapped in a convergent manner to two different target angles (40 and 75°). Statistical analysis revealed significant enhancement in knee re-positioning accuracy for the constant and absolute error with real-time auditory feedback, within and across the groups. Besides this convergent condition, we established a second divergent condition. Here, a step-wise transposition of frequency was performed to explore whether a systematic tuning between auditory-proprioceptive repositioning exists. No significant effects were identified in this divergent auditory feedback condition. An additional experimental group II (n = 20) was further included. Here, we investigated the influence of a larger magnitude and directional change of step-wise transposition of the frequency. In a first step, results confirm the findings of experiment I. Moreover, significant effects on knee auditory-proprioception repositioning were evident when divergent auditory feedback was applied. During the step-wise transposition participants showed systematic modulation of knee movements in the opposite direction of transposition. We confirm that knee re-positioning accuracy can be enhanced with concurrent application of real-time auditory feedback and that knee re-positioning can modulated in a goal-directed manner with step-wise transposition of frequency. Clinical implications are discussed with respect to joint position sense in rehabilitation settings.
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Affiliation(s)
- Shashank Ghai
- Institute of Sports Science, Leibniz University Hannover, Hannover, Germany
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Williams CK, Tseung V, Carnahan H. Self-Control of Haptic Assistance for Motor Learning: Influences of Frequency and Opinion of Utility. Front Psychol 2017; 8:2082. [PMID: 29255438 PMCID: PMC5723017 DOI: 10.3389/fpsyg.2017.02082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 11/15/2017] [Indexed: 11/16/2022] Open
Abstract
Studies of self-controlled practice have shown benefits when learners controlled feedback schedule, use of assistive devices and task difficulty, with benefits attributed to information processing and motivational advantages of self-control. Although haptic assistance serves as feedback, aids task performance and modifies task difficulty, researchers have yet to explore whether self-control over haptic assistance could be beneficial for learning. We explored whether self-control of haptic assistance would be beneficial for learning a tracing task. Self-controlled participants selected practice blocks on which they would receive haptic assistance, while participants in a yoked group received haptic assistance on blocks determined by a matched self-controlled participant. We inferred learning from performance on retention tests without haptic assistance. From qualitative analysis of open-ended questions related to rationales for/experiences of the haptic assistance that was chosen/provided, themes emerged regarding participants' views of the utility of haptic assistance for performance and learning. Results showed that learning was directly impacted by the frequency of haptic assistance for self-controlled participants only and view of haptic assistance. Furthermore, self-controlled participants' views were significantly associated with their requested haptic assistance frequency. We discuss these findings as further support for the beneficial role of self-controlled practice for motor learning.
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Affiliation(s)
- Camille K. Williams
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Victrine Tseung
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Heather Carnahan
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL, Canada
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Dyer JF, Stapleton P, Rodger M. Mapping Sonification for Perception and Action in Motor Skill Learning. Front Neurosci 2017; 11:463. [PMID: 28871218 PMCID: PMC5566964 DOI: 10.3389/fnins.2017.00463] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 08/07/2017] [Indexed: 11/16/2022] Open
Affiliation(s)
- John F Dyer
- School of Psychology, Queen's University BelfastAntrim, United Kingdom
| | - Paul Stapleton
- Sonic Arts Research Centre, School of Arts, English and Languages, Queen's University BelfastAntrim, United Kingdom
| | - Matthew Rodger
- School of Psychology, Queen's University BelfastAntrim, United Kingdom
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Fujii S, Lulic T, Chen JL. More Feedback Is Better than Less: Learning a Novel Upper Limb Joint Coordination Pattern with Augmented Auditory Feedback. Front Neurosci 2016; 10:251. [PMID: 27375414 PMCID: PMC4893479 DOI: 10.3389/fnins.2016.00251] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 05/20/2016] [Indexed: 11/26/2022] Open
Abstract
Motor learning is a process whereby the acquisition of new skills occurs with practice, and can be influenced by the provision of feedback. An important question is what frequency of feedback facilitates motor learning. The guidance hypothesis assumes that the provision of less augmented feedback is better than more because a learner can use his/her own inherent feedback. However, it is unclear whether this hypothesis holds true for all types of augmented feedback, including for example sonified information about performance. Thus, we aimed to test what frequency of augmented sonified feedback facilitates the motor learning of a novel joint coordination pattern. Twenty healthy volunteers first reached to a target with their arm (baseline phase). We manipulated this baseline kinematic data for each individual to create a novel target joint coordination pattern. Participants then practiced to learn the novel target joint coordination pattern, receiving either feedback on every trial i.e., 100% feedback (n = 10), or every other trial, i.e., 50% feedback (n = 10; acquisition phase). We created a sonification system to provide the feedback. This feedback was a pure tone that varied in intensity in proportion to the error of the performed joint coordination relative to the target pattern. Thus, the auditory feedback contained information about performance in real-time (i.e., “concurrent, knowledge of performance feedback”). Participants performed the novel joint coordination pattern with no-feedback immediately after the acquisition phase (immediate retention phase), and on the next day (delayed retention phase). The root-mean squared error (RMSE) and variable error (VE) of joint coordination were significantly reduced during the acquisition phase in both 100 and 50% feedback groups. There was no significant difference in VE between the groups at immediate and delayed retention phases. However, at both these retention phases, the 100% feedback group showed significantly smaller RMSE than the 50% group. Thus, contrary to the guidance hypothesis, our findings suggest that the provision of more, concurrent knowledge of performance auditory feedback during the acquisition of a novel joint coordination pattern, may result in better skill retention.
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Affiliation(s)
- Shinya Fujii
- Canadian Partnership for Stroke Recovery, Sunnybrook Research InstituteToronto, ON, Canada; Graduate School of Education, The University of TokyoTokyo, Japan
| | - Tea Lulic
- Canadian Partnership for Stroke Recovery, Sunnybrook Research InstituteToronto, ON, Canada; Department of Kinesiology, McMaster UniversityHamilton, ON, Canada
| | - Joyce L Chen
- Canadian Partnership for Stroke Recovery, Sunnybrook Research InstituteToronto, ON, Canada; Department of Physical Therapy and Rehabilitation Sciences Institute, University of TorontoToronto, ON, Canada
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Transposing musical skill: sonification of movement as concurrent augmented feedback enhances learning in a bimanual task. PSYCHOLOGICAL RESEARCH 2016; 81:850-862. [PMID: 27233646 PMCID: PMC5486555 DOI: 10.1007/s00426-016-0775-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 05/17/2016] [Indexed: 11/27/2022]
Abstract
Concurrent feedback provided during acquisition can enhance performance of novel tasks. The 'guidance hypothesis' predicts that feedback provision leads to dependence and poor performance in its absence. However, appropriately structured feedback information provided through sound ('sonification') may not be subject to this effect. We test this directly using a rhythmic bimanual shape-tracing task in which participants learned to move at a 4:3 timing ratio. Sonification of movement and demonstration was compared to two other learning conditions: (1) Sonification of task demonstration alone and (2) completely silent practice (control). Sonification of movement emerged as the most effective form of practice, reaching significantly lower error scores than control. Sonification of solely the demonstration, which was expected to benefit participants by perceptually unifying task requirements, did not lead to better performance than control. Good performance was maintained by participants in the Sonification condition in an immediate retention test without feedback, indicating that the use of this feedback can overcome the guidance effect. On a 24-h retention test, performance had declined and was equal between groups. We argue that this and similar findings in the feedback literature are best explained by an ecological approach to motor skill learning which places available perceptual information at the highest level of importance.
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Optimization of the anterior cruciate ligament injury prevention paradigm: novel feedback techniques to enhance motor learning and reduce injury risk. J Orthop Sports Phys Ther 2015; 45:170-82. [PMID: 25627151 DOI: 10.2519/jospt.2015.4986] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Primary anterior cruciate ligament (ACL) injury prevention programs effectively reduce ACL injury risk in the short term. Despite these programs, ACL injury incidence is still high, making it imperative to continue to improve current prevention strategies. A potential limitation of current ACL injury prevention training may be a deficit in the transfer of conscious, optimal movement strategies rehearsed during training sessions to automatic movements required for athletic activities and unanticipated events on the field. Instructional strategies with an internal focus of attention have traditionally been utilized, but may not be optimal for the acquisition of the control of complex motor skills required for sports. Conversely, external-focus instructional strategies may enhance skill acquisition more efficiently and increase the transfer of improved motor skills to sports activities. The current article will present insights gained from the motor-learning domain that may enhance neuromuscular training programs via improved skill development and increased retention and transfer to sports activities, which may reduce ACL injury incidence in the long term.
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Schliessmann D, Schuld C, Schneiders M, Derlien S, Glöckner M, Gladow T, Weidner N, Rupp R. Feasibility of visual instrumented movement feedback therapy in individuals with motor incomplete spinal cord injury walking on a treadmill. Front Hum Neurosci 2014; 8:416. [PMID: 24987344 PMCID: PMC4060051 DOI: 10.3389/fnhum.2014.00416] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 05/23/2014] [Indexed: 11/15/2022] Open
Abstract
Background: Incomplete spinal cord injury (iSCI) leads to motor and sensory deficits. Even in ambulatory persons with good motor function an impaired proprioception may result in an insecure gait. Limited internal afferent feedback (FB) can be compensated by provision of external FB by therapists or technical systems. Progress in computational power of motion analysis systems allows for implementation of instrumented real-time FB. The aim of this study was to test if individuals with iSCI can normalize their gait kinematics during FB and more importantly maintain an improvement after therapy. Methods: Individuals with chronic iSCI had to complete 6 days (1 day per week) of treadmill-based FB training with a 2 weeks pause after 3 days of training. Each day consists of an initial gait analysis followed by 2 blocks with FB/no-FB. During FB the deviation of the mean knee angle during swing from a speed matched reference (norm distance, ND) is visualized as a number. The task consists of lowering the ND, which was updated after every stride. Prior to the tests in patients the in-house developed FB implementation was tested in healthy subjects with an artificial movement task. Results: Four of five study participants benefited from FB in the short and medium term. Decrease of mean ND was highest during the first 3 sessions (from 3.93 ± 1.54 to 2.18 ± 1.04). After the pause mean ND stayed in the same range than before. In the last 3 sessions the mean ND decreased slower (2.40 ± 1.18 to 2.20 ± 0.90). Direct influences of FB ranged from 60 to 15% of reduction in mean ND compared to initial gait analysis and from 20 to 1% compared to no-FB sessions. Conclusions: Instrumented kinematic real-time FB may serve as an effective adjunct to established gait therapies in normalizing the gait pattern after incomplete spinal cord injury. Further studies with larger patient groups need to prove long term learning and the successful transfer of newly acquired skills to activities of daily living.
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Affiliation(s)
- Daniel Schliessmann
- Experimental Neurorehabilitation, Spinal Cord Injury Center, Heidelberg University Hospital Heidelberg, Germany
| | - Christian Schuld
- Experimental Neurorehabilitation, Spinal Cord Injury Center, Heidelberg University Hospital Heidelberg, Germany
| | - Matthias Schneiders
- Experimental Neurorehabilitation, Spinal Cord Injury Center, Heidelberg University Hospital Heidelberg, Germany
| | - Steffen Derlien
- Institut für Physiotherapie, University Hospital Jena Jena, Germany
| | - Maria Glöckner
- Institut für Physiotherapie, University Hospital Jena Jena, Germany
| | | | - Norbert Weidner
- Experimental Neurorehabilitation, Spinal Cord Injury Center, Heidelberg University Hospital Heidelberg, Germany
| | - Rüdiger Rupp
- Experimental Neurorehabilitation, Spinal Cord Injury Center, Heidelberg University Hospital Heidelberg, Germany
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Yamamoto R, Ohashi Y. The effects of inaccessible visual feedback used concurrently or terminally. J Phys Ther Sci 2014; 26:731-5. [PMID: 24926140 PMCID: PMC4047240 DOI: 10.1589/jpts.26.731] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 12/14/2013] [Indexed: 01/01/2023] Open
Abstract
[Purpose] Concurrent feedback is more detrimental for long-term retention of motor skills because learners depend on accessible visual information provided in parallel with movements. However, visual information is not always accessible. Furthermore, the effects of concurrent feedback vary with aspects of the task being performed. We investigated the effects of inaccessible visual feedback used concurrently or terminally, focusing on aspects of movement. [Subjects and Methods] Fourteen subjects were quasi-randomly assigned to either a concurrent feedback group or a terminal feedback group. They practiced a task that involved right shoulder flexion with a specific acceleration. Learning achievements were assessed by measurement of errors in movement duration, peak timing, and strength. [Results] Regarding errors in movement duration, the concurrent feedback group was superior to the terminal feedback group during the midterm and final sessions. Regarding errors in peak timing, learning occurred in the concurrent feedback group, but not in the terminal feedback group because the improvement in performance during practice was inadequate. Regarding errors in peak strength, learning occurred in both groups. [Conclusion] Concurrent visual feedback that is used inaccessibly has learning effects that either equal or surpass those of terminal feedback that is used with inaccessible visual information for all parameters.
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Affiliation(s)
- Ryohei Yamamoto
- Graduate School of Health Sciences, Ibaraki Prefectural University of Health Sciences: 4669-2 Ami, Ami-machi, Inashiki-gun, Ibaraki 300-0394, Japan
| | - Yukari Ohashi
- Graduate School of Health Sciences, Ibaraki Prefectural University of Health Sciences: 4669-2 Ami, Ami-machi, Inashiki-gun, Ibaraki 300-0394, Japan
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Bouwsema H, van der Sluis CK, Bongers RM. Effect of feedback during virtual training of grip force control with a myoelectric prosthesis. PLoS One 2014; 9:e98301. [PMID: 24865570 PMCID: PMC4035328 DOI: 10.1371/journal.pone.0098301] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 04/30/2014] [Indexed: 01/12/2023] Open
Abstract
The aim of this study was to determine whether virtual training improves grip force control in prosthesis use, and to examine which type of augmented feedback facilitates its learning most. Thirty-two able-bodied participants trained grip force with a virtual ball-throwing game for five sessions in a two-week period, using a myoelectric simulator. They received either feedback on movement outcome or on movement execution. Sixteen controls received training that did not focus on force control. Variability over learning was examined with the Tolerance-Noise-Covariation approach, and the transfer of grip force control was assessed in five test-tasks that assessed different aspects of force control in a pretest, a posttest and a retention test. During training performance increased while the variability in performance was decreased, mainly by reduction in noise. Grip force control only improved in the test-tasks that provided information on performance. Starting the training with a task that required low force production showed no transfer of the learned grip force. Feedback on movement execution was detrimental to grip force control, whereas feedback on movement outcome enhanced transfer of grip force control to tasks other than trained. Clinical implications of these results regarding virtual training of grip force control are discussed.
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Affiliation(s)
- Hanneke Bouwsema
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
- * E-mail:
| | - Corry K. van der Sluis
- University Medical Center Groningen, Center for Rehabilitation, Groningen, The Netherlands
| | - Raoul M. Bongers
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
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Sigrist R, Rauter G, Riener R, Wolf P. Terminal feedback outperforms concurrent visual, auditory, and haptic feedback in learning a complex rowing-type task. J Mot Behav 2013; 45:455-72. [PMID: 24006910 DOI: 10.1080/00222895.2013.826169] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Augmented feedback, provided by coaches or displays, is a well-established strategy to accelerate motor learning. Frequent terminal feedback and concurrent feedback have been shown to be detrimental for simple motor task learning but supportive for complex motor task learning. However, conclusions on optimal feedback strategies have been mainly drawn from studies on artificial laboratory tasks with visual feedback only. Therefore, the authors compared the effectiveness of learning a complex, 3-dimensional rowing-type task with either concurrent visual, auditory, or haptic feedback to self-controlled terminal visual feedback. Results revealed that terminal visual feedback was most effective because it emphasized the internalization of task-relevant aspects. In contrast, concurrent feedback fostered the correction of task-irrelevant errors, which hindered learning. The concurrent visual and haptic feedback group performed much better during training with the feedback than in nonfeedback trials. Auditory feedback based on sonification of the movement error was not practical for training the 3-dimensional movement for most participants. Concurrent multimodal feedback in combination with terminal feedback may be most effective, especially if the feedback strategy is adapted to individual preferences and skill level.
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Affiliation(s)
- Roland Sigrist
- a Sensory-Motor Systems Lab, ETH Zurich & Spinal Cord Injury Center, University Hospital Balgrist , Zurich , Switzerland
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Pre-training evaluation and feedback improved skills retention of basic life support in medical students. Resuscitation 2013; 84:1274-8. [PMID: 23665155 DOI: 10.1016/j.resuscitation.2013.04.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Accepted: 04/17/2013] [Indexed: 01/03/2023]
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Augmented visual, auditory, haptic, and multimodal feedback in motor learning: a review. Psychon Bull Rev 2013; 20:21-53. [PMID: 23132605 DOI: 10.3758/s13423-012-0333-8] [Citation(s) in RCA: 476] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
It is generally accepted that augmented feedback, provided by a human expert or a technical display, effectively enhances motor learning. However, discussion of the way to most effectively provide augmented feedback has been controversial. Related studies have focused primarily on simple or artificial tasks enhanced by visual feedback. Recently, technical advances have made it possible also to investigate more complex, realistic motor tasks and to implement not only visual, but also auditory, haptic, or multimodal augmented feedback. The aim of this review is to address the potential of augmented unimodal and multimodal feedback in the framework of motor learning theories. The review addresses the reasons for the different impacts of feedback strategies within or between the visual, auditory, and haptic modalities and the challenges that need to be overcome to provide appropriate feedback in these modalities, either in isolation or in combination. Accordingly, the design criteria for successful visual, auditory, haptic, and multimodal feedback are elaborated.
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Vieira MM, Ugrinowitsch H, Oliveira FS, Gallo LG, Benda RN. Effects of knowledge of results (KR) frequency in the learning of a timing skill: absolute versus relative KR frequency. Percept Mot Skills 2012; 115:360-9. [PMID: 23265002 DOI: 10.2466/22.23.pms.115.5.360-369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The interaction between the amount of practice and frequency of Knowledge of Results (KR) was investigated in a timing skill. In the acquisition phase the task involved 90 trials of releasing a knob and transporting three tennis balls from three near recipients to three far ones in a specific sequence and target time. The retention test performed 24 hr. later had the same sequence of transport but a new target time was required. In both phases, absolute error and standard deviation plus constant error was measured. The five groups differed in relation to frequency of KR and amount of practice. The results showed that intermediate frequencies as well as higher frequencies of KR elicited better performance during the retention test.
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Affiliation(s)
- Márcio M Vieira
- Universidade Federal de Minas Gerais, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Av. Antonio Carlos 6627, 31270-901-Campus Pampulha, Belo Horizonte, Brazil
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Chan KMK, Li M, Law TY, Yiu EML. Effects of immediate feedback on learning auditory perceptual voice quality evaluation. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2012; 14:363-369. [PMID: 22646315 DOI: 10.3109/17549507.2012.679746] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The study investigated the effect of immediate feedback in training listeners to perceive subtle differences in voice quality, a perceptual skill that is important for speech-language pathologists. Sixty naive listeners were randomly assigned to a feedback group (Group F), a no feedback group (Group NF), and a no training group acting as a control group (Group C). The task was to evaluate the severity of a perceptual voice quality (breathiness) by using a reference-matching paradigm. All participants took part in three rating sessions (pre-training, 2 days after training and 1 week after training). Group F and Group NF participated in a training session immediately after the first rating session, where Group F practiced with immediate feedback given and Group NF practice with no immediate feedback given. The results showed that Group F and Group NF had significant improvement after training, but Group F did not retain the improvement in the third rating session. The use of a reference-matching training paradigm without giving frequent immediate feedback is suggested for auditory-perceptual voice evaluation training. The most effective frequency of immediate feedback is yet to be determined.
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Snodgrass SJ, Odelli RA. Objective concurrent feedback on force parameters improves performance of lumbar mobilisation, but skill retention declines rapidly. Physiotherapy 2012; 98:47-56. [DOI: 10.1016/j.physio.2011.02.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Accepted: 02/20/2011] [Indexed: 12/16/2022]
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Kelley CM, McLaughlin AC. Individual differences in the benefits of feedback for learning. HUMAN FACTORS 2012; 54:26-35. [PMID: 22409100 DOI: 10.1177/0018720811423919] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE Research on learning from feedback has produced ambiguous guidelines for feedback design--some have advocated minimal feedback, whereas others have recommended more extensive feedback that highly supported performance. The objective of the current study was to investigate how individual differences in cognitive resources may predict feedback requirements and resolve previous conflicted findings. METHOD Cognitive resources were controlled for by comparing samples from populations with known differences, older and younger adults.To control for task demands, a simple rule-based learning task was created in which participants learned to identify fake Windows pop-ups. Pop-ups were divided into two categories--those that required fluid ability to identify and those that could be identified using crystallized intelligence. RESULTS In general, results showed participants given higher feedback learned more. However, when analyzed by type of task demand, younger adults performed comparably with both levels of feedback for both cues whereas older adults benefited from increased feedbackfor fluid ability cues but from decreased feedback for crystallized ability cues. CONCLUSION One explanation for the current findings is feedback requirements are connected to the cognitive abilities of the learner-those with higher abilities for the type of demands imposed by the task are likely to benefit from reduced feedback. APPLICATION We suggest the following considerations for feedback design: Incorporate learner characteristics and task demands when designing learning support via feedback.
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Ribeiro DC, Sole G, Abbott JH, Milosavljevic S. A rationale for the provision of extrinsic feedback towards management of low back pain. ACTA ACUST UNITED AC 2011; 16:301-5. [PMID: 21353622 DOI: 10.1016/j.math.2011.01.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2010] [Revised: 01/27/2011] [Accepted: 01/28/2011] [Indexed: 10/18/2022]
Abstract
Low back pain (LBP) is associated with dysfunction of global and local muscle systems, feedback and feedforward postural control mechanisms. Physiotherapists include the use of feedback as part of treatment protocols. Such feedback can focus on a variety of neuromuscular impairments, although the literature related to feedback on the management of LBP has focused mainly on local muscle system impairments. Furthermore, there are various characteristics of feedback that can lead to motor control enhancement or deterioration. The aim of this manuscript is to present a rationale for feedback provision as a rehabilitation tool on the management of LBP. Feedback provision should focus on the main neuromuscular impairment presented by the patient. The suggested rationale describes decision-making stages for the use and progress of feedback interventions. Local muscle system impairment might benefit more from parameter feedback provision, while global muscle system and feedback mechanism impairments may benefit better from program feedback. The described rationale has the potential to help clinicians select the appropriate feedback for the treatment of their patients. Additionally, the presented rationale could be used by researchers to assess how different forms of feedback provision impact on clinical outcomes.
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Affiliation(s)
- Daniel Cury Ribeiro
- Centre for Physiotherapy Research, School of Physiotherapy, University of Otago, 325 Great King Street, PO Box 56, Dunedin 9016, New Zealand.
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Ribeiro DC, Sole G, Abbott JH, Milosavljevic S. Extrinsic feedback and management of low back pain: A critical review of the literature. ACTA ACUST UNITED AC 2011; 16:231-9. [PMID: 21269869 DOI: 10.1016/j.math.2010.12.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2010] [Revised: 11/22/2010] [Accepted: 12/13/2010] [Indexed: 02/08/2023]
Abstract
Effective intervention for low back pain (LBP) can include feedback in one form or other. Although extrinsic feedback (EF) can be provided in a number of ways, most research has not considered how different EF characteristics (e.g. timing and content) influence treatment outcomes. A systematic search related to feedback and LBP was performed on relevant electronic databases. This narrative review aims to describe the forms of feedback provision in the literature regarding management of LBP, and to discuss these in light of previously recommended principles for the use of extrinsic feedback. The present review found support for the provision of EF that focuses on content characteristics including program feedback, summary results feedback, and external focus of attention. Temporal characteristics should enhance the use of intermittent or self-selected feedback. The literature does not support the provision of concurrent or constant EF. As much of the literature related to EF in the management of LBP has not considered content and timing characteristics we have identified future research directions that will clarify the use of content and timing characteristics of EF relative to the management of LBP.
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Affiliation(s)
- Daniel Cury Ribeiro
- Centre for Physiotherapy Research, School of Physiotherapy, University of Otago, 325 Great King Street, Dunedin 9016, New Zealand.
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McNeil MR, Katz WF, Fossett TRD, Garst DM, Szuminsky NJ, Carter G, Lim KY. Effects of online augmented kinematic and perceptual feedback on treatment of speech movements in apraxia of speech. Folia Phoniatr Logop 2010; 62:127-33. [PMID: 20424468 PMCID: PMC2871060 DOI: 10.1159/000287211] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Apraxia of speech (AOS) is a motor speech disorder characterized by disturbed spatial and temporal parameters of movement. Research on motor learning suggests that augmented feedback may provide a beneficial effect for training movement. This study examined the effects of the presence and frequency of online augmented visual kinematic feedback (AVKF) and clinician-provided perceptual feedback on speech accuracy in 2 adults with acquired AOS. Within a single-subject multiple-baseline design, AVKF was provided using electromagnetic midsagittal articulography (EMA) in 2 feedback conditions (50 or 100%). Articulator placement was specified for speech motor targets (SMTs). Treated and baselined SMTs were in the initial or final position of single-syllable words, in varying consonant-vowel or vowel-consonant contexts. SMTs were selected based on each participant's pre-assessed erred productions. Productions were digitally recorded and online perceptual judgments of accuracy (including segment and intersegment distortions) were made. Inter- and intra-judge reliability for perceptual accuracy was high. Results measured by visual inspection and effect size revealed positive acquisition and generalization effects for both participants. Generalization occurred across vowel contexts and to untreated probes. Results of the frequency manipulation were confounded by presentation order. Maintenance of learned and generalized effects were demonstrated for 1 participant. These data provide support for the role of augmented feedback in treating speech movements that result in perceptually accurate speech production. Future investigations will explore the independent contributions of each feedback type (i.e. kinematic and perceptual) in producing efficient and effective training of SMTs in persons with AOS.
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Affiliation(s)
- M R McNeil
- Geriatric Research Education and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA 15260, USA.
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Memmert D, Hagemann N, Althoetmar R, Geppert S, Seiler D. Conditions of practice in perceptual skill learning. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2009; 80:32-43. [PMID: 19408465 DOI: 10.1080/02701367.2009.10599527] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This study uses three experiments with different kinds of training conditions to investigate the "easy-to-hard" principle, context interference conditions, and feedback effects for learning anticipatory skills in badminton. Experiment 1 (N = 60) showed that a training program that gradually increases the difficulty level has no advantage over the randomized variant. Experiment 2 (N = 60) pointed out that when comparing the blocked (lateral before depth dimension) perceptual training group with the random perceptual training group a significant advantage for the random group was found in the retention test (depth error). Experiment 3 (N = 40) demonstrated that training with reduced feedback (66 %) is no more effective than 100% feedback training in a group of novice performers.
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Affiliation(s)
- D Memmert
- Department of Human Movement Studies, Ruprecht-Karl-University, Heidelberg, Germany.
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Hermens HJ, Vollenbroek-Hutten MMR. Towards remote monitoring and remotely supervised training. J Electromyogr Kinesiol 2008; 18:908-19. [PMID: 19004646 DOI: 10.1016/j.jelekin.2008.10.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2008] [Revised: 09/30/2008] [Accepted: 10/02/2008] [Indexed: 11/27/2022] Open
Abstract
The growing number of elderly and people with chronic disorders in our western society puts such a pressure on our healthcare system that innovative approaches are required to make our health care more effective and more efficient. One way of innovating healthcare can be obtained by introducing new services that support and enable these elderly and people with chronic disorders in a more independent living and in self management with respect to their disorders. Examples of such services are remote monitoring and remotely supervised training (together RMT). Remote monitoring focuses on continuous monitoring of the health status with the assurance of assistance whenever required. Remotely supervised training focuses on efficient and effective individually tailored training anywhere and anytime with intensity not feasible in an intramural setting. It is expected that services of remote monitoring and remotely supervised treatment will become important for at least patients (safety, more in control, convenience), health care insurances (efficiency, cost reduction) and healthcare service providers (more effective care). RMT systems are in general quite complex distributed Information and Communication Technology (ICT) systems. RMT systems integrate ambulant sensing to measure relevant biosignals and (possibly) subject's context information, secure data transport and storage, appropriate decisions support systems to assist in both technical and clinical decision making but also feedback on information to both patients and care providers. Feedback is essential for patients to make them aware of their health status, to give them a feeling of safety and to motivate and enable them to change/improve their health status. Feedback of information to healthcare professionals enables them in making appropriate decisions and to monitor changes/improvements in a patient's health status. Despite this apparent complexity, these systems must be very dependable to be accepted and used in a healthcare setting. During the past years knowledge and experience has been gained with the development of the building blocks of RMT systems. In parallel, experience has been gained with respect to the challenges involved when using RMT systems in a clinical environment. Examples are: activity monitoring in low back pain, monitoring of spasticity, myofeedback in subjects with neck shoulder and lower back pain and post rehabilitation home training. Until now, the main focus has been on the technical realization of the sensing and transportation part of it. The development of intelligent decision support systems is still in its infancy and clinical validation studies and models how to implement these services and how to make them profitable are largely lacking. In conclusion, the combination of Biomedical Engineering with Information and Communication Technology has opened a new extensive area of research and development with a high potential to have substantial impact on our future healthcare.
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Affiliation(s)
- Hermie J Hermens
- Roessingh Research and Development, Enschede, Roessinghsbleekweg 33, 7522AH Enschede, The Netherlands.
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