Influence of Feedback Modality on Sensorimotor Adaptation: Contribution of Visual, Kinesthetic, and Verbal Cues

Updating of Implicit Adaptation Processes through Erroneous Numeric Feedback

There is debate about how implicit and explicit processes interact in sensorimotor adaptation, implicating how error signals drive learning. Target error information is thought to primarily influence explicit processes, therefore manipulations to the veracity of this information should impact adaptation but not implicit recalibration (i.e. after-effects). Thirty participants across three groups initially adapted to rotated cursor feedback. Then we manipulated numeric target error through knowledge of results (KR) feedback, where groups practised with correct or incorrect (+/-15°) numeric KR. Participants adapted to erroneous KR, but only the KR + 15 group showed augmented implicit recalibration, evidenced by larger after-effects than before KR exposure. In the presence of sensory prediction errors, target errors modulated after-effects, suggesting an interaction between implicit and explicit processes.

Implicit Adaptation Processes Promoted by Immediate Offline Visual and Numeric Feedback

In adaptation learning, visual feedback impacts how adaptation proceeds. With concurrent feedback, a more implicit/feedforward process is thought to be engaged, compared to feedback after movement, which promotes more explicit processes. Due to discrepancies across studies, related to timing and type of visual feedback, we isolated these conditions here. Four groups (N = 52) practiced aiming under rotated feedback conditions; feedback was provided concurrently, immediately after movement (visually or numerically), or visually after a 3 s delay. All groups adapted and only delayed feedback attenuated implicit adaptation as evidenced by post-practice after-effects. Contrary to some suggestions, immediately presented offline and numeric feedback resulted in implicit after-effects, potentially due to comparisons between feedforward information and seen or imagined feedback.

Gradual exposure to Coriolis force induces sensorimotor adaptation with no change in peripersonal space

The space immediately surrounding the body is crucial for the organization of voluntary motor actions and seems to be functionally represented in the brain according to motor capacities. However, despite extensive research, little is known about how the representation of peripersonal space is adjusted to new action capacities. Abrupt exposure to a new force field has been shown to cause the representation of peripersonal space to shrink, possibly reflecting a conservative spatial strategy triggered by consciously-perceived motor errors. The present study assessed whether the representation of peripersonal space is influenced by gradual exposure of reaching movements to a new force field, produced by a stepwise acceleration of a rotating platform. We hypothesized that such gradual exposure would induce progressive sensorimotor adaptation to motor errors, albeit too small to be consciously perceived. In contrast, we hypothesized that reachability judgments, used as a proxy of peripersonal space representation, would not be significantly affected. Results showed that gradual exposure to Coriolis force produced a systematic after-effect on reaching movements but no significant change in reachability judgments. We speculate that the conscious experience of large motor errors may influence the updating of the representation of peripersonal space.

Effects of Quiet Eye Training on Performance of Bimanual Coordination in Children with DCD

Objectives

Children with developmental coordination disorder (DCD) are physically characterized by poor motor coordination and are at particular risk of losing their motor control. Quiet eye training (QET), with the latest techniques as an uncomplicated approach recently entered the field of rehabilitation research, has drawn the researchers’ attention. Therefore, the objective of this study was to examine the effects of QET on the performance of bimanual coordination in children with DCD.

Materials & Methods

Children with DCD (n=20; aged 8-9 years) were randomly divided into two groups, including QET and traditional training (TT). The participants performed bimanual in-phase and anti-phase movements with their wrists at three speed levels ranging from slow to fast. Bimanual coordination accuracy was assessed at the baseline, after 4 weeks at study completion, and at the retention test.

Results

Bimanual coordination improved over time from the baseline to study completion. The results showed that there was a significant difference between the pretest and posttest in the QET group (P=0.001), and bimanual coordination accuracy in the posttest significantly increased, compared to that reported for the pretest. Moreover, there was a significant difference between the pretest and posttest in bimanual coordination accuracy in the TT group (P=0.01), and the posttest accuracy significantly increased (F=2.32); however, the increase was less than that of the QET group.

Conclusion

The obtained results indicated that the performance of the in-phase and anti-phase coordination modes was strongly influenced by QET. Furthermore, it was concluded that a successful performance of a bimanual linear task mainly depends on the availability of visual feedback.

Visual but Not Auditory-Verbal Feedback Induces Aftereffects Following Adaptation to Virtual Prisms

Visuo-motor adaptation with optical prisms that displace the visual scene (prism adaptation, PA) has been widely used to study visuo-motor plasticity in healthy individuals and to decrease the lateralized bias of brain-damaged patients suffering from spatial neglect. Several factors may influence PA aftereffects, such as the degree of optical deviation (generally measured in dioptres of wedge prisms) or the direction of the prismatic shift (leftward vs. rightward). However, the mechanisms through which aftereffects of adaptation in healthy individuals and in neglect affect performance in tasks probing spatial cognition remain controversial. For example, some studies have reported positive effects of PA on auditory neglect, while other studies failed to obtain any changes of performance even in the visual modality. We here tested a new adaptation method in virtual reality to evaluate how sensory parameters influence PA aftereffects. Visual vs. auditory-verbal feedback of optical deviations were contrasted to assess whether rightward deviations influence manual and perceptual judgments in healthy individuals. Our results revealed that altered visual, but not altered auditory-verbal feedback induces aftereffects following adaptation to virtual prisms after 30-degrees of deviation. These findings refine current models of the mechanisms underlying the cognitive effects of virtual PA in emphasizing the importance of visual vs. auditory-verbal feedback during the adaptation phase on visuospatial judgments. Our study also specifies parameters which influence virtual PA and its aftereffect, such as the sensory modality used for the feedback.

Individual movement features during prism adaptation correlate with after-effects and interlimb transfer

The human nervous system displays such plasticity that we can adapt our motor behavior to various changes in environmental or body properties. However, how sensorimotor adaptation generalizes to new situations and new effectors, and which factors influence the underlying mechanisms, remains unclear. Here we tested the general hypothesis that differences across participants can be exploited to uncover what drives interlimb transfer. Twenty healthy adults adapted to prismatic glasses while reaching to visual targets with their dominant arm. Classic adaptation and generalization across movement directions were observed but transfer to the non-dominant arm was not significant and inter-individual differences were substantial. Interlimb transfer resulted for some participants in a directional shift of non-dominant arm movements that was consistent with an encoding of visuomotor adaptation in extrinsic coordinates. For some other participants, transfer was consistent with an intrinsic coordinate system. Simple and multiple regression analyses showed that a few kinematic parameters such as peak acceleration (or peak velocity) and variability of movement direction were correlated with interlimb transfer. Low peak acceleration and low variability were related to extrinsic transfer, while high peak acceleration and high variability were related to intrinsic transfer. Motor variability was also positively correlated with the magnitude of the after-effect systematically observed on the dominant arm. Overall, these findings on unconstrained movements support the idea that individual movement features could be linked to the sensorimotor adaptation and its generalization. The study also suggests that distinct movement characteristics may be related to different coordinate frames of action representations in the nervous system.

Audio Feedback Associated With Body Movement Enhances Audio and Somatosensory Spatial Representation

In the last years, the positive impact of sensorimotor rehabilitation training on spatial abilities has been taken into account, e.g., providing evidence that combined multimodal compared to unimodal feedback improves responsiveness to spatial stimuli. To date, it still remains unclear to which extent spatial learning is influenced by training conditions. Here we investigated the effects of active and passive audio-motor training on spatial perception in the auditory and proprioceptive domains on 36 healthy young adults. First, to investigate the role of voluntary movements on spatial perception, we compared the effects of active vs. passive multimodal training on auditory and proprioceptive spatial localization. Second, to investigate the effectiveness of unimodal training conditions on spatial perception, we compared the impact of only proprioceptive or only auditory sensory feedback on spatial localization. Finally, to understand whether the positive effects of multimodal and unimodal trainings generalize to the untrained part, both dominant and non-dominant arms were tested. Results indicate that passive multimodal training (guided movement) is more beneficial than active multimodal training (active exploration) and only in passive condition the improvement is generalized also on the untrained hand. Moreover, we found that combined audio-motor training provides the strongest benefit because it significantly affects both auditory and somatosensory localization, while the effect of a single feedback modality is limited to a single domain, indicating a cross-modal influence of the two domains. Therefore, the use of multimodal feedback is more efficient in improving spatial perception. These results indicate that combined sensorimotor signals are effective in recalibrating auditory and proprioceptive spatial perception and that the beneficial effect is mainly due to the combination of auditory and proprioceptive spatial cues.

The Effects of Coding Schemes on Vibrotactile Biofeedback for Dynamic Balance Training in Parkinson's Disease and Healthy Elderly Individuals

Coding scheme for earlier versions of vibrotactile biofeedback systems for balance-related applications was primarily binary in nature, either on or off at a given threshold (range of postural tilt), making it unable to convey information about error magnitude. The purpose of this paper was to explore the effects of two coding schemes (binary versus continuous) for vibrotactile biofeedback during dynamic weight-shifting exercises that are common physical therapists' recommended balance exercises used in clinical settings. Nine individuals with idiopathic Parkinson's disease and nine healthy elderly individuals participated in this paper. All participants performed dynamic weight-shifting exercises assisted with either the binary or continuous vibrotactile biofeedback delivered using with vibrating actuators (tactors) in either the anterior-posterior or medial-lateral direction. Participants' limits of stability at pre and post exercises were compared to evaluate the effects of the exercises on their range of motion. The continuous coding scheme produced significantly better performance than the binary scheme when both groups were performing dynamic weight-shifting balance exercises with assistive vibrotactile biofeedback. The results have implications in terms of maximizing the effects of error-driven motor learning and increasing performance on balance rehabilitation training combined with vibrotactile biofeedback.

The integration of temporally shifted visual feedback in a synchronization task: The role of perceptual stability in a visuo-proprioceptive conflict situation

The present study examined whether the beneficial role of coherently grouped visual motion structures for performing complex (interlimb) coordination patterns can be generalized to synchronization behavior in a visuo-proprioceptive conflict situation. To achieve this goal, 17 participants had to synchronize a self-moved circle, representing the arm movement, with a visual target signal corresponding to five temporally shifted visual feedback conditions (0%, 25%, 50%, 75%, and 100% of the target cycle duration) in three synchronization modes (in-phase, anti-phase, and intermediate). The results showed that the perception of a newly generated perceptual Gestalt between the visual feedback of the arm and the target signal facilitated the synchronization performance in the preferred in-phase synchronization mode in contrast to the less stable anti-phase and intermediate mode. Our findings suggest that the complexity of the synchronization mode defines to what extent the visual and/or proprioceptive information source affects the synchronization performance in the present unimanual synchronization task.

Extrinsic feedback and management of low back pain: A critical review of the literature

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.

Delayed visual feedback affects both manual tracking and grip force control when transporting a handheld object

When we manipulate an object, grip force is adjusted in anticipation of the mechanical consequences of hand motion (i.e., load force) to prevent the object from slipping. This predictive behavior is assumed to rely on an internal representation of the object dynamic properties, which would be elaborated via visual information before the object is grasped and via somatosensory feedback once the object is grasped. Here we examined this view by investigating the effect of delayed visual feedback during dextrous object manipulation. Adult participants manually tracked a sinusoidal target by oscillating a handheld object whose current position was displayed as a cursor on a screen along with the visual target. A delay was introduced between actual object displacement and cursor motion. This delay was linearly increased (from 0 to 300 ms) and decreased within 2-min trials. As previously reported, delayed visual feedback altered performance in manual tracking. Importantly, although the physical properties of the object remained unchanged, delayed visual feedback altered the timing of grip force relative to load force by about 50 ms. Additional experiments showed that this effect was not due to task complexity nor to manual tracking. A model inspired by the behavior of mass-spring systems suggests that delayed visual feedback may have biased the representation of object dynamics. Overall, our findings support the idea that visual feedback of object motion can influence the predictive control of grip force even when the object is grasped.

Direct evidence for cortical suppression of somatosensory afferents during visuomotor adaptation

Upon exposure to novel visuomotor relationships, the information carried by visual and proprioceptive signals becomes discrepant, often disrupting motor execution. It has been shown that degradation of the proprioceptive sense (arising either from disease or experimental manipulation) enhances performance when drawing with mirror-reversed vision. Given that the central nervous system can exert a dynamic control over the transmission of afferent signals, reducing proprioceptive inflow to cortical areas could be part of the normal adaptive mechanisms deployed in healthy humans upon exposure to novel visuomotor environments. Here we address this issue by probing the transmission of somatosensory afferents throughout the course of adaptation to a visuomotor conflict, by recording median nerve somatosensory evoked potentials. We show that early exposure to tracing with mirror-reversed vision is accompanied by substantial proprioceptive suppression occurring in the primary somatosensory cortex (S1). This proprioceptive gating is gradually alleviated as performance increases with adaptation, returning to baseline levels. Peripheral and spinal evoked potentials were not modulated throughout, suggesting that the gating acted to reduce cortico-cortico excitability directly within S1. These modulations provide neurophysiological evidence for flexibility in sensory integration during visuomotor adaptation, which may functionally serve to reduce the sensory conflict until the visuo-proprioceptive mapping is updated.