Instruction Modes for Motor Control Skills Acquisition: A Randomized Controlled Trial

The Development and Evaluation of the Kinesthetic Motor Imagery of Pelvic Floor Muscle Contraction Questionnaire (KMI-PFQ) in Spanish Women

Practitioners have begun using motor imagery (MI) for preventing and treating some pelvic floor disorders. Due to requirements for imagining before performing a MI intervention and because there are few instruments available for assessing this specific ability in the pelvic floor musculature, we sought to develop and test a new MI questionnaire, the Kinesthetic Motor Imagery of Pelvic Floor Muscle Contraction Questionnaire (KMI-PFQ). We focused in this study on the development and analysis of the instrument's factorial structure and internal reliability in a participant sample of 162 healthy Spanish women (M age = 20.1, SD = 2.2 years). We developed and evaluated the KMI-PFQ's psychometric properties, finding it to have good internal consistency, with Cronbach's α = .838, ω coefficient = .839, and an intraclass correlation coefficient = .809, with two factors ("ability" and "mental effort") explaining 58.36% of response variance. The standard error of measurement was 3.58, and the minimal detectable change was 9.92. No floor or ceiling effects were identified. There was also good convergent validity as seen by statistically significant positive correlations between KMI-PFQ scores and the revised-Movement Image Questionnaire and Vividness of Visual Imagery Questionnaire. There were no statistically significant correlations between KMI-PFQ scores and the Orientation to Life Questionnaire. The KMI-PFQ is a valid and reliable instrument for measuring kinesthetic ability to feel/imagine pelvic floor muscle contractions in healthy Spanish women.

Multimedia Instructions for Motor Control Exercises in Patients With Chronic Nonspecific Low Back Pain

BACKGROUND

Low back pain (LBP) is one of the top 3 diseases that may lead to disability. Current treatment guidelines define exercise as a first-line treatment for nonspecific LBP (NSLBP). There are various evidence-based exercise approaches for treating NSLBP, and many of them include motor control principles. Motor control exercises (MCEs) are better than general exercises that do not include motor control principles. Many patients find learning these exercises complex and challenging, in that MCE exercises have no standard teaching method. The researchers of this study developed multimedia instructions for an MCE program to make teaching MCE easier; thus, more effective.

METHODS

The participants were randomized into multimedia or standard (face-to-face) instruction groups. We applied the same treatments to both groups at the same dosage. The only differences between groups were the exercise instruction methods. The multimedia group learned MCE from multimedia videos; the control group learned MCE from a physiotherapist with face-to-face instructions. Treatment lasted 8 weeks. We evaluated patients' exercise adherence with Exercise Adherence Rating Scale (EARS), pain with the Visual Analog Scale, and disability with Oswestry Disability Index. Evaluations were made before and after treatment. Follow-up evaluations were carried out 4 weeks after the end of treatment.

RESULTS

There was no statistically significant interaction between the group and time on pain, F2,56 = 0.068, P = .935, partial η2 = .002 and Oswestry Disability Index scores, F2,56 = 0.951, P = .393, partial η2 = .033. Also, there was no statistically significant interaction between the group and time on Exercise Adherence Rating Scale total scores F1,20 = 2.343, P = .142, partial η2 = .105.

CONCLUSIONS

This study showed that multimedia instructions for MCE have similar effects to standard (face-to-face) instructions on pain, disability, and exercise adherence in patients with NSLBP. To our knowledge, with these results, the developed multimedia instructions became the first free, evidence-based instructions that have objective progression criteria and a Creative Commons license.

The Role of Movement Representation Techniques in the Motor Learning Process: A Neurophysiological Hypothesis and a Narrative Review

We present a neurophysiological hypothesis for the role of motor imagery (MI) and action observation (AO) training in the motor learning process. The effects of movement representation in the brain and those of the cortical–subcortical networks related to planning, executing, adjusting, and automating real movements share a similar neurophysiological activity. Coupled with the influence of certain variables related to the movement representation process, this neurophysiological activity is a key component of the present hypothesis. These variables can be classified into four domains: physical, cognitive–evaluative, motivational–emotional, and direct-modulation. The neurophysiological activity underlying the creation and consolidation of mnemonic representations of motor gestures as a prerequisite to motor learning might differ between AO and MI. Together with variations in cognitive loads, these differences might explain the differing results in motor learning. The mirror neuron system appears to function more efficiently through AO training than MI, and AO is less demanding in terms of cognitive load than MI. AO might be less susceptible to the influence of variables related to movement representation.