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Dahm SF, Krause D. Online Anticipatory Cues During Practice Disrupt Intentional and Incidental Sequence Learning. J Mot Behav 2024:1-16. [PMID: 38958336 DOI: 10.1080/00222895.2024.2369183] [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: 12/13/2023] [Accepted: 06/12/2024] [Indexed: 07/04/2024]
Abstract
In the Serial Reaction Time Task, participants respond to several stimuli usually being unaware that the stimuli follow a predefined sequence while still learning the sequence. In the present study, we aimed to clearly separate explicit intentional learning from implicit incidental learning by either informing participants about all details of the sequence or not informing participants about the existence of the sequence. Further, we explored the influence of anticipatory cues during practice while anticipatory cues were either presented (extrinsically triggered anticipation) or not presented (self-reliant intrinsic anticipation). Participants were tested before and after practice in the Practice Sequence and a Control Sequence. To test automatization, tests were performed in Single-Task and Dual-Task Blocks. Results showed that after learning with explicit instructions, participants memorized the sequence more deeply and executed the sequence faster than after learning without explicit instructions. Further, by learning with anticipatory cues, participants memorized the sequence less deeply and executed the sequence slower than by learning without anticipatory cues. Unexpectedly, automatization was sequence-unspecific and independent of the practice conditions. In conclusion, detailed explicit prior information about the sequence facilitates sequence learning while anticipatory online cues during practice hamper sequence learning.
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Affiliation(s)
- Stephan F Dahm
- Department of Psychology, Faculty of Psychology and Sports Sciences, Universität Innsbruck, Innsbruck, Austria
| | - Daniel Krause
- Department of Exercise and Health, Faculty of Science, Paderborn University, Paderborn, Germany
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2
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Zheng W. Implicit motor learning in children with autism spectrum disorder: current approaches and future directions. Front Psychiatry 2024; 15:1253199. [PMID: 38645416 PMCID: PMC11026583 DOI: 10.3389/fpsyt.2024.1253199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 03/22/2024] [Indexed: 04/23/2024] Open
Abstract
Motor dysfunction is increasingly being viewed as a core characteristic of autism spectrum disorder (ASD) in children. In particular, children with ASD have difficulty in learning new motor skills and there is a need to develop effective methods to improve this. Previous research has found that children with ASD may retain the ability to implicitly learn motor skills in comparison to their explicit learning of motor skills, which is typically impaired. This literature mini review focuses on summarizing the study of implicit learning in the acquisition of motor skills in children with ASD. First, we briefly introduce several common implicit learning methods in children's motor skill learning. Second, we focus on the role of two important implicit learning approaches in motor skill learning, namely, an external focus of attention and analogy learning. Finally, based on our review of the existing studies, we present an outlook for future research and the areas that need to be improved in the practical teaching of implicit learning in the acquisition of motor skills in children with ASD.
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Affiliation(s)
- Weiqi Zheng
- School of Psychology, Beijing Sport University, Beijing, China
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3
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Velghe S, Rameckers E, Meyns P, Johnson C, Hallemans A, Verbecque E, Klingels K. Effects of a highly intensive balance therapy camp in children with developmental coordination disorder - An intervention protocol. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 147:104694. [PMID: 38382234 DOI: 10.1016/j.ridd.2024.104694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 02/02/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Children with Developmental Coordination Disorder (DCD) often (<87 %) experience postural control problems, impacting all levels of the International Classification of Functioning, Disability and Health (ICF) including their daily participation, self-esteem and mental health. Due to the multisystemic nature of postural control, comprehensive therapy should target all systems which is currently not the case. Highly intensive therapy is effective and commonly used in pediatric populations, but has not been explored yet to train postural control in children with DCD. AIMS To investigate the effects of a highly intensive functional balance therapy camp at all ICF levels in children with DCD. METHODS AND PROCEDURES The effects on postural control, muscle activity, brain alterations, self-perceived competence, self-identified goals, gross motor activities and participation are evaluated. Participants are assessed pre- and post-intervention, including a 3 months follow-up. Forty-eight children with DCD, aged 6-12 years old, receive 40 h of comprehensive balance training. This intervention is fun, individually tailored, targets all postural control systems, implements different motor learning strategies and includes both individual and group activities. CONCLUSION Novel insights into the effects of a highly intensive comprehensive balance therapy camp designed for children with DCD will be gained at all levels of the ICF.
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Affiliation(s)
- Silke Velghe
- Rehabilitation Research Centre - REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium.
| | - Eugene Rameckers
- Rehabilitation Research Centre - REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium; Department of Rehabilitation Medicine, Functioning, Participation & Rehabilitation research line, Research School CAPHRI, Maastricht University, Maastricht, the Netherlands; Centre of Expertise, Adelante Rehabilitation Centre, Valkenburg, the Netherlands
| | - Pieter Meyns
- Rehabilitation Research Centre - REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Charlotte Johnson
- Rehabilitation Research Centre - REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium; Research group MOVANT, University of Antwerp, Antwerp, Belgium
| | - Ann Hallemans
- Research group MOVANT, University of Antwerp, Antwerp, Belgium
| | - Evi Verbecque
- Rehabilitation Research Centre - REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Katrijn Klingels
- Rehabilitation Research Centre - REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
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van der Veer IPA, Rameckers EAA, Steenbergen B, Bastiaenen CHG, Klingels K. How do paediatric physical therapists teach motor skills to children with Developmental Coordination Disorder? An interview study. PLoS One 2024; 19:e0297119. [PMID: 38300942 PMCID: PMC10833570 DOI: 10.1371/journal.pone.0297119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/27/2023] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND When teaching motor skills, paediatric physical therapists (PPTs) use various motor learning strategies (MLSs), adapting these to suit the individual child and the task being practised. Knowledge about the clinical decision-making process of PPTs in choosing and adapting MLSs when treating children with Developmental Coordination Disorder (DCD) is currently lacking. Therefore, this qualitative study aimed to explore PPTs' use of MLSs when teaching motor skills to children with DCD. METHODS Semi-structured individual and group interviews were conducted with PPTs with a wide range of experience in treating children with DCD. A conventional content analysis approach was used where all transcripts were open-coded by two reviewers independently. Categories and themes were discussed within the research group. Data were collected until saturation was reached. RESULTS Twenty-six PPTs (median age: 49 years; range: 26-66) participated in 12 individual interviews and two focus-group interviews. Six themes were identified: (1) PPTs treated children in a tailor-made way; (2) PPTs' teaching style was either more indirect or direct; (3) PPTs used various strategies to improve children's motivation; (4) PPTs had reached the optimal level of practice when children were challenged; (5) PPTs gave special attention to automatization and transfer during treatment; and (6) PPTs considered task complexity when choosing MLSs, which appeared determined by task constraints, environmental demands, child and therapist characteristics. CONCLUSION PPTs' clinical decision-making processes in choosing MLSs appeared strongly influenced by therapist characteristics like knowledge and experience, resulting in large variation in the use of MLSs and teaching styles to enhance motivation, automatization, and transfer. This study indicates the importance of the level of education on using MLSs to teach children motor skills, and clinical decision-making. Future research should focus on implementing this knowledge into daily practice.
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Affiliation(s)
- Ingrid P. A. van der Veer
- Rehabilitation Research Centre—REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Eugene A. A. Rameckers
- Rehabilitation Research Centre—REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Department of Rehabilitation Medicine, Functioning, Participation & Rehabilitation Research Line, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands
- Centre of Expertise, Adelante Rehabilitation Centre, Valkenburg, The Netherlands
| | - Bert Steenbergen
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Caroline H. G. Bastiaenen
- Department of Epidemiology, Functioning, Participation & Rehabilitation Research Line, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Katrijn Klingels
- Rehabilitation Research Centre—REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
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van der Veer IPA, Bastiaenen CHG, Rameckers EAA, Klingels K. Experts' perspectives on how to promote implicit and explicit motor learning in children: A mixed-methods study. Child Care Health Dev 2024; 50:e13147. [PMID: 37365914 DOI: 10.1111/cch.13147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/26/2023] [Accepted: 06/06/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Little is known about how motor learning strategies (MLSs) can promote implicit and explicit motor learning processes. This study aimed to explore experts' perspectives on therapists' use of MLSs to promote specific learning processes in children with and without developmental coordination disorder (DCD). METHODS In this mixed-methods study, two consecutive digital questionnaires were used to ascertain the opinions of international experts. Questionnaire 2 explored the findings of Questionnaire 1 in greater depth. In order to reach a certain level of agreement about the classification of MLSs as promoting either (more) implicit or (more) explicit motor learning, 5-point Likert scales were used in addition to open-ended questions. The open-ended questions were analysed with a conventional analysis approach. Open coding was performed by two reviewers independently. Categories and themes were discussed within the research team, taking both questionnaires as one dataset. RESULTS Twenty-nine experts from nine different countries with different backgrounds in research, education and/or clinical care completed the questionnaires. The results of the Likert scales showed large variation. Two themes emerged from the qualitative analyses: (1) Experts found it difficult to classify MLSs as promoting either implicit or explicit motor learning, and (2) experts stressed the need for clinical decisionmaking when choosing MLSs. CONCLUSIONS Insufficient insight was gained into how MLSs could promote (more) implicit or (more) explicit motor learning in children in general and in children with DCD specifically. But this study demonstrated the importance of clinical decisionmaking to model and adapt MLSs to child, task and environment, with therapists' knowledge of MLSs being an important prerequisite. Research is needed to better understand the various learning mechanisms of children and how MLSs can be used to manipulate these mechanisms.
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Affiliation(s)
- Ingrid P A van der Veer
- Rehabilitation Research Centre - REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Caroline H G Bastiaenen
- Department of Epidemiology, Functioning, Participation & Rehabilitation Research Line, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Eugene A A Rameckers
- Rehabilitation Research Centre - REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Department of Rehabilitation Medicine, Functioning, Participation & Rehabilitation Research Line, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands
- Centre of Expertise, Adelante Rehabilitation Centre, Valkenburg, The Netherlands
| | - Katrijn Klingels
- Rehabilitation Research Centre - REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
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Eguia KF, Ng SSM, Wong TWL. Attentional Focus Strategies for Promoting Children's Motor Learning: A Scoping Review With a Learner-Task-Environment Framework. Percept Mot Skills 2023; 130:2700-2722. [PMID: 37899527 DOI: 10.1177/00315125231210150] [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] [Indexed: 10/31/2023]
Abstract
There is emerging evidence that attentional focus instructions and feedback may help children with motor learning. However, information relevant to learner characteristics, settings, and contexts in which attentional focus strategies can be used has not been synthesized. Therefore, in this review, we adopted a learner-task-environment framework to map the evidence to date related to attentional focus strategies in children's motor learning. We adapted the framework for scoping reviews put forth by Arksey and O'Malley (2005) and the enhanced protocol recommended by the Joanna Briggs Institute (Peters et al., 2021). Two researchers (a) identified the research question, (b) identified relevant studies, (c) selected studies, (d) charted the data, and (e) collated, summarized, and reported these results. We included 30 papers, all of which used an experimental or quasi-experimental design. Most studies have focused on typically developing children and those in middle childhood as learners. The movement tasks in these studies included isolated fundamental movement skills and sport-related tasks. All but one study were situated in non-clinical settings (i.e., school, laboratory). We found limited use of attentional focus strategies for learning movement tasks in early childhood, especially among children with neurodevelopmental disorders. Movement tasks were mostly isolated skills, and there was extremely limited application to clinical settings.
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Affiliation(s)
- Kathlynne F Eguia
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
- THINKids - Therapeutic Intervention for Kids, Quezon City, Philippines
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Thomson W L Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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Kal E, Ellmers T, Hogg J, Slutsky-Ganesh AB, Bonnette S, Thomas S, Riehm CD, Myer GD, Diekfuss JA. Optimal Training for Movement Acquisition and Transfer: Does "Externally Focused" Visual Biofeedback Promote Implicit Motor Learning? J Athl Train 2023; 58:648-654. [PMID: 36094615 PMCID: PMC10569250 DOI: 10.4085/1062-6050-0166.22] [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] [Indexed: 11/09/2022]
Abstract
CONTEXT Visual biofeedback has been shown to facilitate injury-resistant movement acquisition in adolescent athletes. Visual biofeedback is typically thought to foster implicit learning by stimulating athletes to focus attention externally (on movement outcome). However, biofeedback may also induce explicit learning if the athlete uses the visual information to consciously guide movement execution (via an internal focus). OBJECTIVE To determine the degree to which athletes reported statements indicating implicit or explicit motor learning after engaging in a visual biofeedback intervention. DESIGN Prospective cohort study. SETTING Three-dimensional motion-analysis laboratory. PATIENTS OR OTHER PARTICIPANTS Twenty-five adolescent female soccer athletes (age = 15.0 ± 1.5 years, height = 165.7 ± 5.9 cm, mass = 59.4 ± 10.6 kg). INTERVENTIONS Standard 6-week neuromuscular training intervention (three 90-minute sessions/wk), with added visual biofeedback sessions (2 sessions/wk). For the biofeedback training, participants performed squatting and jumping movements while interacting with a visual rectangular stimulus that mapped key parameters associated with injury risk. After the last biofeedback session in each week, participants answered open-ended questions to probe learning strategies. MAIN OUTCOME MEASURE(S) Responses to the open-ended questions were categorized as externally focused (ie, on movement outcome, suggestive of implicit learning), internally focused (ie, on movement itself, suggestive of explicit learning), mixed focus, or other. RESULTS A total of 171 open-ended responses were collected. Most of the responses that could be categorized (39.2%) were externally focused (41.8%), followed by mixed (38.8%) and internally focused (19.4%). The frequency of externally focused statements increased from week 1 (18%) to week 6 (50%). CONCLUSIONS Although most statements were externally focused (suggesting implicit learning), the relatively large proportion of internal- and mixed-focus statements suggested that many athletes also engaged in explicit motor learning, especially in early practice sessions. Therefore, biofeedback may affect motor learning through a mixture of implicit and explicit learning.
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Affiliation(s)
- Elmar Kal
- College of Health, Medicine and Life Sciences, Brunel University London, United Kingdom
- Centre for Cognitive Neuroscience, Brunel University London, United Kingdom
| | - Toby Ellmers
- College of Health, Medicine and Life Sciences, Brunel University London, United Kingdom
- Centre for Cognitive Neuroscience, Brunel University London, United Kingdom
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, United Kingdom
| | - Jennifer Hogg
- Department of Health and Human Performance, University of Tennessee, Chattanooga
| | - Alexis B. Slutsky-Ganesh
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA
- Emory Sports Medicine Center, Atlanta, GA
- Department of Kinesiology, University of North Carolina, Greensboro
| | - Scott Bonnette
- Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, OH
| | - Staci Thomas
- Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, OH
| | - Christopher D. Riehm
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA
- Emory Sports Medicine Center, Atlanta, GA
| | - Gregory D. Myer
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA
- Emory Sports Medicine Center, Atlanta, GA
- Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, OH
| | - Jed A. Diekfuss
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, GA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA
- Emory Sports Medicine Center, Atlanta, GA
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8
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van der Veer IPA, Bastiaenen CHG, Goetschalckx M, van der Wielen-Heezius NNF, Rameckers EAA, Klingels K. Therapists' Use of Instructions and Feedback in Motor Learning Interventions in Children with Developmental Coordination Disorder: A Video Observation Study. Phys Occup Ther Pediatr 2023; 43:678-696. [PMID: 37012672 DOI: 10.1080/01942638.2023.2194408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 03/02/2023] [Accepted: 03/20/2023] [Indexed: 04/05/2023]
Abstract
AIM This qualitative study explored therapists' use of instructions and feedback when teaching motor tasks to children with developmental coordination disorder (DCD) as a first step in developing practical recommendations. METHODS A conventional content analysis approach was used to analyze videotaped treatment sessions of physical therapists using a newly developed analysis plan. Inductive coding was used to code purposively selected video segments. The codes were sorted into categories to identify key themes. Analyses were performed independently by two researchers until data saturation was reached. RESULTS Ten video-taped sessions were analyzed and 61 segments were coded. Three key themes were identified: (1) therapists' intention with the instructions and feedback was to motivate or to provide information; (2) the preferred therapists' teaching style was either direct or indirect; and (3) parameters to shape specific instructions and feedback were the focus of attention, modality, information content, timing and frequency. CONCLUSION Therapists used numerous instructions and feedback with different information content, often shaped by multiple focuses and/or modalities to motivate children or to provide specific information about task performance. Although therapists adapted instructions and feedback to child and task, future research should explore how characteristics of child and task can guide therapists' clinical decision-making.
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Affiliation(s)
| | - Caroline H G Bastiaenen
- Department of Epidemiology, Functioning, Participation & Rehabilitation research line, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Mieke Goetschalckx
- Rehabilitation Research Centre - REVAL, Hasselt University, Hasselt, Belgium
| | | | - Eugene A A Rameckers
- Rehabilitation Research Centre - REVAL, Hasselt University, Hasselt, Belgium
- Department of Rehabilitation Medicine, Functioning, Participation & Rehabilitation research line, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands
- Centre of Expertise, Adelante Rehabilitation Centre, Valkenburg, The Netherlands
| | - Katrijn Klingels
- Rehabilitation Research Centre - REVAL, Hasselt University, Hasselt, Belgium
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Individual differences in working memory capacity and conscious processing do not explain explicit and implicit learning outcomes in physical education. Hum Mov Sci 2022; 86:103003. [PMID: 36272202 DOI: 10.1016/j.humov.2022.103003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/30/2022] [Accepted: 09/24/2022] [Indexed: 11/04/2022]
Abstract
This study examined the effects of explicit versus implicit learning methods on motor learning and self-efficacy of 11-to 14-year old students (n = 81) practicing the basketball layup during physical education. The main aim was to test the effects of students' verbal working memory capacity (WMC) and propensity for conscious motor processing (CMP) on explicit and implicit learning outcomes. The students practiced basketball layups for three weeks (one session/week) during regular PE classes under practice conditions that either promoted explicit or implicit learning. Verbal WMC and CMP propensity were measured separately. At the posttest, students had significantly improved their layup performance and technique, and self-efficacy, but no differences were noted between the intervention groups (explicit vs. implicit). Students' verbal WMC and CMP propensity did not differentially predict the learning outcomes for the explicit or implicit learning groups. Therefore, in this PE setting, both explicit and implicit learning methods seemed to similarly improve movement skill. Further study is needed to examine under which conditions individual constraints such as verbal WMC and propensity for conscious processing influence the effects of explicit and implicit learning.
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van der Veer IPA, Verbecque E, Rameckers EAA, Bastiaenen CHG, Klingels K. How can instructions and feedback with external focus be shaped to enhance motor learning in children? A systematic review. PLoS One 2022; 17:e0264873. [PMID: 36007080 PMCID: PMC9409566 DOI: 10.1371/journal.pone.0264873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 08/08/2022] [Indexed: 11/18/2022] Open
Abstract
Aim
This systematic review investigates the effectiveness of instructions and feedback with external focus applied with reduced frequency, self-controlled timing and/or in visual or auditory form, on the performance of functional gross motor tasks in children aged 2 to 18 with typical or atypical development.
Methods
Four databases (PubMed, Web of Science, Scopus, Embase) were systematically searched (last updated May 31st 2021). Inclusion criteria were: 1. children aged 2 to 18 years old; 2. Instructions/feedback with external focus applied with reduced frequency, self-controlled timing, and/or visual or auditory form as intervention, to learn functional gross motor tasks; 3. Instructions/feedback with external focus applied with continuous frequency, instructor-controlled timing, and/or verbal form as control; 4. performance measure as outcome; 5. (randomized) controlled studies. Article selection and risk of bias assessment (with the Cochrane risk of bias tools) was conducted by two reviewers independently. Due to heterogeneity in study characteristics and incompleteness of the reported data, a best-evidence synthesis was performed.
Results
Thirteen studies of low methodological quality were included, investigating effectiveness of reduced frequencies (n = 8), self-controlled timing (n = 5) and visual form (n = 1) on motor performance of inexperienced typically (n = 348) and atypically (n = 195) developing children, for acquisition, retention and/or transfer. For accuracy, conflicting or no evidence was found for most comparisons, at most time points. However, there was moderate evidence that self-controlled feedback was most effective for retention, and limited evidence that visual analogy was most effective for retention and transfer. To improve quality of movement, there was limited evidence that continuous frequency was most effective for retention and transfer.
Conclusion
More methodologically sound studies are needed to draw conclusions about the preferred frequency, timing or form. However, we cautiously advise considering self-controlled feedback, visual instructions, and continuous frequency.
Trial registration
Registration: Prospero CRD42021225723. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021225723.
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Affiliation(s)
- Ingrid P. A. van der Veer
- Faculty of Rehabilitation Sciences and Physiotherapy, Rehabilitation Research Centre—REVAL, Hasselt University, Hasselt, Belgium
- * E-mail:
| | - Evi Verbecque
- Faculty of Rehabilitation Sciences and Physiotherapy, Rehabilitation Research Centre—REVAL, Hasselt University, Hasselt, Belgium
| | - Eugene A. A. Rameckers
- Faculty of Rehabilitation Sciences and Physiotherapy, Rehabilitation Research Centre—REVAL, Hasselt University, Hasselt, Belgium
- Department of Functioning and Rehabilitation, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands
- Centre of Expertise, Adelante Rehabilitation Centre, Valkenburg, The Netherlands
| | - Caroline H. G. Bastiaenen
- Department of Epidemiology, Functioning, Participation & Rehabilitation, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Katrijn Klingels
- Faculty of Rehabilitation Sciences and Physiotherapy, Rehabilitation Research Centre—REVAL, Hasselt University, Hasselt, Belgium
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