Learning and transfer in two perceptual-motor skills in Duchenne muscular dystrophy

Analysis of Different Device Interactions in a Virtual Reality Task in Individuals With Duchenne Muscular Dystrophy-A Randomized Controlled Trial

There is a need to support individuals with Duchenne Muscular Dystrophy (DMD) to achieve optimal functionality in everyday life and with meaningful tasks and activities, throughout stages of the disease progression. Thus, technological developments have created an exciting opportunity for the use of affordable virtual reality (VR) systems with different kinds of interaction devices, providing an efficient and fun tool for enabling improvement in motor performance. Objective: To compare performance on a virtual task using interfaces with and without physical contact in order to identify functionality by using different devices in individuals with DMD. Methods: One hundred and twenty male individuals took part on this study: 60 with DMD with a mean age of 16 ± 5 (range 9-34 years old) and 60 without DMD in the control group (CG) matched by age. Participants were divided into three groups of 20 individuals each which performed a virtual task in three different interfaces: Kinect®, computer Touch Screen and Leap Motion®, in a cross over design in which all participants used all devices. Motor impairment in the DMD group was measured by using the Motor Function Measurement and Vignos scales. Results: All participants improved performance through practice, regardless of the interface used, although the DMD group had a continuous lower performance compared to the CG. In addition, the DMD group obtained a significant better performance with Leap Motion interface compared to the other interfaces, while the CG presented better performance on Touch Screen interface. Conclusion: Leap Motion provided better performance for individuals with DMD due to enablement of distal muscle function and ease of instrument adjustment using the virtual interface. Therefore, this type of interface should be encouraged for promoting functionality on general tasks using computer systems. Clinical Trial register number: NCT02891434.

Improvements in motor tasks through the use of smartphone technology for individuals with Duchenne muscular dystrophy

BACKGROUND

In individuals severely affected with Duchenne muscular dystrophy (DMD), virtual reality has recently been used as a tool to enhance community interaction. Smartphones offer the exciting potential to improve communication, access, and participation, and present the unique opportunity to directly deliver functionality to people with disabilities.

OBJECTIVE

To verify whether individuals with DMD improve their motor performance when undertaking a visual motor task using a smartphone game.

PATIENTS AND METHODS

Fifty individuals with DMD and 50 healthy, typically developing (TD) controls, aged 10-34 years participated in the study. The functional characterization of the sample was determined through Vignos, Egen Klassifikation, and the Motor Function Measure scales. To complete the task, individuals moved a virtual ball around a virtual maze and the time in seconds was measured after every attempt in order to analyze improvement of performance after the practice trials. Motor performance (time to finish each maze) was measured in phases of acquisition, short-term retention, and transfer.

RESULTS

Use of the smartphone maze game promoted improvement in performance during acquisition in both groups, which remained in the retention phase. At the transfer phases, with alternative maze tasks, the performance in DMD group was similar to the performance of TD group, with the exception of the transfer to the contralateral hand (nondominant). However, the group with DMD demonstrated longer movement time at all stages of learning, compared with the TD group.

CONCLUSION

The practice of a visual motor task delivered via smartphone game promoted an improvement in performance with similar patterns of learning in both groups. Performance can be influenced by task difficulty, and for people with DMD, motor deficits are responsible for the lower speed of execution. This study indicates that individuals with DMD showed improved performance in a short-term motor learning protocol using a smartphone. We advocate that this technology could be used to promote function in this population.

Computer task performance by subjects with Duchenne muscular dystrophy

AIMS

Two specific objectives were established to quantify computer task performance among people with Duchenne muscular dystrophy (DMD). First, we compared simple computational task performance between subjects with DMD and age-matched typically developing (TD) subjects. Second, we examined correlations between the ability of subjects with DMD to learn the computational task and their motor functionality, age, and initial task performance.

METHOD

The study included 84 individuals (42 with DMD, mean age of 18±5.5 years, and 42 age-matched controls). They executed a computer maze task; all participants performed the acquisition (20 attempts) and retention (five attempts) phases, repeating the same maze. A different maze was used to verify transfer performance (five attempts). The Motor Function Measure Scale was applied, and the results were compared with maze task performance.

RESULTS

In the acquisition phase, a significant decrease was found in movement time (MT) between the first and last acquisition block, but only for the DMD group. For the DMD group, MT during transfer was shorter than during the first acquisition block, indicating improvement from the first acquisition block to transfer. In addition, the TD group showed shorter MT than the DMD group across the study.

CONCLUSION

DMD participants improved their performance after practicing a computational task; however, the difference in MT was present in all attempts among DMD and control subjects. Computational task improvement was positively influenced by the initial performance of individuals with DMD. In turn, the initial performance was influenced by their distal functionality but not their age or overall functionality.

The practice effect and its difference of the pursuit rotor test with the dominant and non-dominant hands

The purpose of this study was to examine the practice effect and what difference it makes in the pursuit rotor test for the dominant and non-dominant hands in 30 right-handed Japanese male adults aged 18 to 23 years (Age 20.8+/-1.4 yrs). The subjects performed the pursuit rotor test for 1 min in 20 trials with a 1-min interval alternately using the dominant and non-dominant hands. After continuing for 10 trials, a 5-min rest was taken. The measurement order was randomly assigned. Contact time of a steel pen and a target was measured in units of 1/10 sec. The measurements showed a constant increasing tendency at every trial until the 6th trial in both hands. Significant linear regressions were identified, but the increase-rate of the dominant hand was significantly larger. Individual differences showed a decreasing tendency at every trial in the dominant hand, but in the non-dominant hand it increased until the 4th trial then decreased. The relationships between measurements of the 1st and 10th trials in both hands and both hands in the 1st or 10th trial were not high. The performance of the pursuit rotor test improves at every trial in both hands, but the improvement rate decreases after the 7th trial. The improvement rate of the dominant hand is high. The change in individual differences differs in both hands and the relationship between the measurements is not high. It can be judged that the practice effect of the pursuit rotor test differs in the dominant and non-dominant hands.