Immediate effects of a novel hand rehabilitation board on fine motor skills in children with cerebral palsy: A pilot study

BACKGROUND

In children with cerebral palsy (CP), fine motor skills limit forearm supination and active extension of the elbow, wrist, or fingers. Therapeutic interventions focusing on improving the ranges at these joints while facilitating active movements are the key to augmenting fine motor skills.

OBJECTIVE

This pilot study examines if children with CP (with UE involvement) exposed to the Novel Hand Rehabilitation (NHR) Board will demonstrate 1) changes in spasticity and passive ROM of forearm and wrist/finger muscles, and 2) improvement in fine motor abilities.

METHODS

The forearm and wrist/fingers of children with spastic CP (N = 15; M = 7, F = 8) aged 49-72 months (65.33±6.355 months) were positioned on the NHR board till their tolerance limit or a minimum duration of 30 minutes. The outcome measures, i.e., spasticity (Modified Ashworth Scale), passive range of motion (PROM) of wrist and fingers, and fine motor skills (PDMS-2 - Fine motor scale), were recorded.

RESULTS

The spasticity of forearm pronators (0.001) and wrist flexors (0.008) reduced significantly, but not in wrist extensors. Post-intervention improvements in wrist extension (p = 0.005) and ulnar deviation ROM (p = 0.007) were significant. In thumb, changes were non-significant for the CMC flexion, but extension (0.003) and abduction (0.001) as well as MCP extension (0.004) were significant. The post-intervention MCP extension ROM for the 2nd (0.001), 3rd (0.007), and 4th fingers (0.014) were also substantial, but not for PIP and DIP joints. The post-intervention percentage change in the Grasping and Visual-motor integration subtests of PDMS-2 was 11.03% (p = 0.002) and 5.09% (p = 0.001) respectively.

CONCLUSION

The immediate effects on fine motor skills in children with CP after the NHR board application were positive and encouraging. Hence, the NHR board can be recommended as an intervention to improve the fine motor abilities of children with CP.

The Relative Strengths of Relationships Between Fine Motor Skills, Working Memory, Processing Speed and Fluid Intelligence in Early Elementary School Children

The goal in the present paper was to examine the combined and relative impact of fine motor ability, auditory working memory, and processing speed on fluid intelligence in a sample of early elementary school students. Our participant sample was 145 children (Mage = 9.1 years, SD = 1.1; 80 boys, 65 girls). We used the Raven's Colored Progressive Matrices Test as a measure of fluid intelligence and five other measures to represent the three predictor variables: the Grooved Pegboard Test as a measure of fine motor skills, Digit Span Forwards and Digit Span Backwards tests as measures of working memory, and Rapid Automatized Naming and Letter-Digit Substitution tasks as measures of processing speed. Regression analyses indicated that only two of these measures had a statistically significant association with the fluid intelligence test scores, namely, scores on the Grooved Pegboard (fine motor skills) and Digit Span Backwards (working memory) tests, with these two measures explaining 35% of the variance in the fluid intelligence test scores. Thus, fine motor skills and working memory were correlated with fluid intelligence in early elementary-grade students. Until the directions of these relationships are better understood, we might assume that interventions aiming to increase young children's fluid intelligence, or at least their intelligence scores, might partly target working memory and fine motor skills.

Preliminary Adaptation of Motor Tests to Evaluate Fine Motor Skills Associated with Mathematical Skills in Preschoolers

Mathematics is the subject in which many school-age children reveal difficulties. The literature has shown that fine motor skills, namely fine motor coordination and visuomotor integration, have been more robustly associated with mathematical performance. Studies have shown the importance that instruments have to evaluate these skills, however, the characteristics of these instruments do not fit the reality of kindergartens, they are usually time consuming and expensive and are usually administered by specialists. Thus, the main objective of this study was to identify, select, adapt and validate motor tests to evaluate fine motor skills associated with mathematical skills to allow the kindergarten teachers to apply them simultaneously to the class, with few material resources, in a short period of time and without the need for a lot of training to apply, score and classify. For this purpose, firstly, it was necessary to understand the main difficulties highlighted by kindergarten teachers regarding the use of instruments to evaluate fine motor skills and, thus, elaborate criteria to identify and select the tests that best fit the reality of kindergartens. The test identified, selected and adapted to evaluate fine motor coordination was threading beads from the Movement Evaluation Battery for Children, 2nd Edition. The main adaptation of the test was related to time, that is, instead of counting the time it takes the child to string the total number of cubes on the string, we counted the number of cubes the child strung on the string in a pre-defined time. To evaluate visual-motor integration, the test identified, selected and adapted was the Visual-Motor Integration (6th Edition) test. The main adaptation was related to material resources, that is, it will be possible to apply the test using only one sheet per child instead of the seven suggested by the original test. After the preliminary adaptation of the tests, their validation was performed by means of the degree of reliability (test-retest) and predictive validity. The results indicated that the adapted tests presented an excellent degree of reliability (>0.9) and could therefore be used to administer them simultaneously to the class group. The adapted Visual-Motor Integration test seems to be the most suitable one to be used by kindergarten teachers, in a classroom context, to simultaneously evaluate students' fine motor skills and associate their results with mathematical skills.

Sollerman Hand Function Sub-Test "Write with a Pen": A Computer-Vision-Based Approach in Rehabilitation Assessment

Impaired hand function is one of the most frequently persistent consequences of stroke. Throughout the rehabilitation process, physicians consistently monitor patients and perform kinematic evaluations in order to assess their overall progress in motor recovery. The Sollerman Hand Function Test (SHT) is a valuable assessment tool used to evaluate a patient's capacity to engage in daily activities. It holds great importance in the field of medicine as it aids in the assessment of treatment effectiveness. Nevertheless, the requirement for a therapist's physical presence and the use of specialized materials make the test time-consuming and reliant on clinic availability. In this paper, we propose a computer-vision-based approach to the "Write with a pen" sub-test, originally included in the SHT. Our implementation does not require extra hardware equipment and is able to run on lower-end hardware specifications, using a single RGB camera. We have incorporated all the original test's guidelines and scoring methods into our application, additionally providing an accurate hand spasticity evaluator. After briefly presenting the current research approaches, we analyze and demonstrate our application, as well as discuss some issues and limitations. Lastly, we share some preliminary findings from real-world application usage conducted at the University campus and outline our future plans.

Case report: An evaluation of early motor skills in an infant later diagnosed with autism

Researchers and clinicians are increasingly interested in understanding the etiology of autism spectrum disorder (ASD) and identifying behaviors that can provide opportunities for earlier detection and therefore earlier onset of intervention activities. One promising avenue of research lies in the early development of motor skills. The present study compares the motor and object exploration behaviors of an infant later diagnosed with ASD (T.I.) with the same skills in a control infant (C.I.). There were notable difference in fine motor skills by just 3 months of age, one of the earliest fine motor differences reported in the literature. In line with previous findings, T.I. and C.I. demonstrated different patterns of visual attention as early as 2.5 months of age. At later visits to the lab, T.I. engaged in unique problem-solving behaviors not demonstrated by the experimenter (i.e., emulation). Overall, findings suggest that infants later diagnosed with ASD may show differences in fine motor skills and visual attention to objects from the first months of life.

Digital Devices Use and Fine Motor Skills in Children between 3-6 Years

(1) Background: The principal aim of our research was to explore the relationship between digital devices use and fine motor skills in children aged three to six years and to explore the effect of some socio-demographic factors. (2) Methods: we enrolled 185 children aged between three to six years. The parents of all the participants fulfilled a questionnaire to explore the digital device use, and their children performed a standardized test to assess fine motor skills (APCM-2). We performed the Spearman correlation test to explore the relationship between different variables. (3) Results: the children spent an average of 3.08 ± 2.30 h/day on digital devices. We did not find a significant association between the time of use of digital devices and fine motor skills (p = 0.640; r = -0.036). The youngest children experienced digital tools earlier than older ones (p < 0.001; r = 0.424) and they were also the ones who used digital tools more time afterwards (p = 0.012; -0.202). The children who had working parents spent more time on digital devices (p = 0.028; r = 0.164/p = 0.037; r = 0.154) and used digital devices earlier (p = 0.023; r = 0.171). (4) Conclusions: This data suggest that it would be useful to monitor the use of digital tools, especially in the very first years of life. Future studies are needed to further explore this topic.

The impact of reflex-based recreational activities and preclinical training on psychomotor skills in an educational dental environment

BACKGROUND

Participating in recreational activities from a young age may have the potential enhance psychomotor skills early on, and conversely, low levels of participation in these activities may predict slower development of preclinical hand skills.

PURPOSE

This study aims to evaluate the eye-hand coordination benefits of leisure and reflex-based activities to those of typical instructional techniques among dental students.

DATA SOURCES

The databases used were PubMed, EBSCOhost, and Scopus.

STUDY SELECTION

Ten articles were selected from a total of 1135 articles found across three databases.

DATA EXTRACTION

The articles were screened by four investigators through a series of steps in accordance to inclusion and exclusion criteria and rid of any duplicates.

DATA SYNTHESIS

The majority of the 10 featured articles were conducted in the United States. All of the research included was cohort observational studies. This systematic review includes a total of 1975 participants from the publications selected for this purpose.

RESULTS

Manual dexterity may be taught and improved by practice, and tests designed to measure it should be used primarily to pinpoint which students would benefit most from individualized, close supervision during their education.

CONCLUSION

Researchers found that reflex-based activities helped students develop better hand-eye coordination in a classroom setting. However, more precise dental-related tests and questionnaires can always be developed through further study; doing so would yield a wealth of information that would be immensely useful to the dental sector.

Pinch Strength Measurements in Adolescents With Pediatric Multiple Sclerosis

BACKGROUND

Multiple sclerosis (MS) is a degenerative disease with typical onset between 20 and 50 years of age. An increase in MS cases has been found in the adolescent US population. Adolescents require fine motor manipulation skills for their functional and academic performance. Deficits in the major components of manipulation skills may result in insufficient function. This study examined the 2-point, 3-point, and lateral pinch strength of adolescents diagnosed as having MS.

METHODS

Seventy-four adolescents, 37 with a diagnosis of relapsing-remitting MS and a control group of 37 age-matched peers, participated in this study. Data on 2-point, 3-point, and lateral pinch strength in both hands were collected using a pinch meter. Analyses of covariance were used to describe differences across the 2 groups, and effect sizes (Cohen d) were calculated by finding the mean difference between the study groups divided by the pooled SD.

RESULTS

A significant difference was found in the 2-point pinch strength of the right hand of participants with pediatric MS compared with age- and sex-matched control participants. There were no significant differences in 2-point pinch strength of the left hand or in 3-point or lateral pinch strength of the right and left hands.

CONCLUSIONS

Pinch grasp strength was differentially affected in adolescents with MS. Pinch strength should be assessed and considered in adolescents with MS for a better understanding of their functional performance of fine motor tasks in activities of daily living and academics.

Fine Motor Skills in Children with Tourette Syndrome and their Unaffected First-degree Siblings

Background

The exact etiology of Tourette Syndrome (TS) remains unclear, making the search for impaired neuropsychological functions possibly connected to the underlying cause of TS as important as it is challenging. One neuropsychological domain of interest is fine motor skills.

Method

This study compared fine motor skill performance on the Purdue Pegboard Task (PPT) in 18 children with TS, 24 unaffected first-degree siblings and 20 controls. A set of screening questionnaires was administered to determine comorbid psychiatric illness.

Results

Children with TS, their siblings and controls did not differ significantly in fine motor skills as measured with the PPT. Performance on the PPT was not correlated with tic severity; however, we found an inverse correlation with severity of attention-deficit/hyperactivity disorder (ADHD) symptoms, as assessed by parent reported ADHD symptoms. Children with TS were found to have significantly higher parent reported ADHD symptoms compared to controls, yet only two out of the 18 participants had been diagnosed with ADHD.

Conclusion

This study suggests that fine motor skill impairment in children with TS may be more strongly correlated with comorbid ADHD than to TS and tics.

The Effect of a Combined Exercise Program on Postural Control and Fine Motor Skills in Parkinson's Disease: Study Design

Parkinson's disease (PD) is a progressive and neurodegenerative disorder defined by physical symptoms such as hand disability and postural instability. To counteract the detrimental effects of PD, physical activity programs showed improvements in overall aspects of physical functioning. Therefore, this protocol will aim to evaluate the effect a of postural and fine motor skills training program in older adults with PD. PD individuals, with mild to moderate stage PD, aged between 65 to 80 years, will be voluntary selected from the Nursing Home Residences and Rehabilitation Centers. Subsequently, they will be randomly assigned to intervention group (PD) to receive a combined training program (postural control and fine motor skills exercises) or to the Control group (CON) to receive a stretching program. Before (PRE) and after (POST) a 12-week program both groups will perform wobble board (WB) and grooved pegboard (GPT) tests. Different performances between groups will be expected: (1) no significant differences between PD and CON group for WB and GPT test values before the beginning of the training intervention (PRE); (2) significantly better WB and GPT test values in PD subjects after the training intervention (POST) when compared to the base values (PRE); and (3) no significant differences in WB and GPT test values in CON subjects after the training intervention (POST) when compared to the base values (PRE). The findings of the present study protocol could be used for future studies investigating clinical populations, such as PD, and the effects of different rehabilitative interventions aiming to improve postural control and fine motor skills performances assessed by WB and GPT tests.

[Methods to restore fine motor skills in stroke patients]

The review article considers the problem of nonmedical post-stroke rehabilitation, in particular the restoration of fine motor skills in patients in the early period of the disease. A review and analysis of various randomized controlled trials concerning the use of various rehabilitation methods both in monotherapy and in their combined application is carried out, and modern technical devices, with the use of computer technology and biofeedback, are reviewed. Proceeding from the presented literature data and their analysis, there are certain grounds for introducing modern apparatus complexes and robotized devices for fine motor skills restoration in post-stroke patients, especially in the early period, into the multimodal rehabilitation system. However, further research in this direction is needed to achieve a sustained positive result.

[Effectiveness of using a hardware complex with biofeedback in the rehabilitation of children with dysfunction of the upper limbs]

The upper limb is of exceptional importance for human life as an organ of cognitive and practical activity. Fine motor skills of hands are a set of small, highly coordinated, precise and coordinated movements of varying degrees. Diseases and injuries of the musculoskeletal and nervous systems lead to violations of fine motor skills. Effective programs for medical rehabilitation of hand and fingers include using biofeedback devices (BFB).

PURPOSE OF THE STUDY

Efficiency evaluation of the hardware-software complex with BFB in restoring the impaired function of the upper limb in children.

MATERIAL AND METHODS

The clinical study included 79 patients aged 4 to 18 years with dysfunction of the upper limb not higher than level III according to MACS (The Manual Ability Classification System), who were divided by simple randomization into the main group (49 patients) who received 21 days of a comprehensive rehabilitation program (physiotherapy exercises, paretic muscle massage, mechanotherapy, hydrokinesiotherapy, methods of apparatus physiotherapy) using a hardware-software complex, and a comparison group (30 patients), in which the complex rehabilitation program did not include biofeedback procedures.

RESULTS

This performed prospective open randomized comparative study revealed the effectiveness of the standard rehabilitation program in combination with training on the BFB complex (main group) to be higher than using only the standard program. After treatment, patients of the main group showed a noticeable decrease in the degree of muscle spasticity in the affected limb, strengthening of muscle strength, improvement of fine and gross motor skills of the hands, and improvement of manual skills.

CONCLUSION

The use of a hardware-software complex with biofeedback in children with dysfunction of upper limbs increases effectiveness of the rehabilitation program.

Longitudinal assessment of cognitive function in young children undergoing general anaesthesia

BACKGROUND

Exposure to general anaesthesia in children may be related to deficits in certain areas of cognition. It is unclear if these deficits could be measured in the immediate postoperative period in young children. The goal of the current study was to evaluate the trajectory of cognitive function in the domains of processing speed, working memory, and fine motor skills amongst children aged 2.5-6 yr who underwent general anaesthesia for elective surgery.

METHODS

Children who were scheduled to receive general anaesthesia for surgery were recruited for assessment of cognitive function at three times: preoperatively, 1-2 weeks postoperatively, and 3 months postoperatively. Assessments included processing speed, working memory, and fine motor skills. To assess longitudinal changes in the cognitive outcomes, linear mixed models were built with visit number included as a categorical variable and subject-specific random intercepts.

RESULTS

Sixty-one children (33 girls [54%]) enrolled in the study. Twenty-three children (38%) had received general anaesthesia previously. Significant improvements in picture memory, cancellation, and the processing speed composite were found at Visit 2. The improvement in cancellation and processing speed composite remained significant at Visit 3. Statistically significant improvement in Mullen fine motor score was noticed at Visit 3 compared with Visit 1. The pattern of results did not depend upon prior anaesthesia exposure.

CONCLUSIONS

General anaesthesia for elective surgery in young children was not associated with declines in working memory, processing speed, and fine motor skills in the first 3 months postoperatively, including in children with prior exposure to anaesthesia.

Crosstalk between Gross and Fine Motor Domains during Late Childhood: The Influence of Gross Motor Training on Fine Motor Performances in Primary School Children

Gross and fine motor competence have a close relationship during development and are shown to correlate to some extent. However, the study of the interaction between these domains still requires further insights. In this study, we investigated the developmental changes in overall motor skills as well as the effects of gross motor training programs on fine motor skills in children (aged 6–11, n = 240). Fine motor skills were assessed before and after gross motor intervention using the Box and Block Test. The gross motor intervention was based on the Test of Gross Motor Development—3rd Edition. Results showed that gross and fine motor skills correlate across all years of primary school, both significantly improving with age. Finally, the gross motor intervention appeared to not influence fine motor skills. Our findings show that during primary school age, overall motor development is continuous, but non-linear. From age nine onward, there seems to be a major step-up in overall motor competence, of which teachers/educators should be aware of in order to design motor educational programs accordingly. While gross and fine motor domains might be functionally integrated to enhance children’s motor performances, further research is needed to clarify the effect of gross motor practice on fine motor performances.

Longitudinal change in fine motor skills after brain radiotherapy and in vivo imaging biomarkers associated with decline

BACKGROUND

We explored fine motor skills (FMS) before and after brain radiotherapy (RT), analyzing associations between longitudinal FMS and imaging biomarkers of cortical and white matter (WM) integrity in motor regions of interest (ROIs).

METHODS

On a prospective trial, 52 primary brain tumor patients receiving fractionated brain RT underwent volumetric brain MRI, diffusion tensor imaging, and FMS assessments (Delis-Kaplan Executive Function System Trail Making Test Motor Speed [DKEFS-MS], Grooved Pegboard Dominant Hands [PDH], and Grooved Pegboard Nondominant Hands [PNDH]) at baseline and 3-, 6-, and 12-month post-RT. Motor ROIs autosegmented included: sensorimotor cortices and superficial WM, corticospinal tracts, cerebellar cortices and WM, and basal ganglia. Volume (cc) was measured in all ROIs at each timepoint. Diffusion biomarkers (FA [fractional anisotropy] and MD [mean diffusivity]) were additionally measured in WM ROIs. Linear mixed-effects models assessed biomarkers as predictors of FMS scores. P values were corrected for multiple comparisons.

RESULTS

Higher RT dose was associated with right paracentral cortical thinning (β = -2.42 Gy/(month × mm), P = .03) and higher right precentral WM MD (β = 0.69 Gy/(month × µm2/ms), P = .04). Higher left (β = 38.7 points/(month × µm2/ms), P = .004) and right (β = 42.4 points/(month × µm2/ms), P = .01) cerebellar WM MD, left precentral cortical atrophy (β = -8.67 points/(month × mm), P = .02), and reduced right cerebral peduncle FA (β = -0.50 points/month, P = .01) were associated with worse DKEFS-MS performance. Left precentral cortex thinning was associated with worse PDH scores (β = -17.3 points/(month × mm), P = .02). Left (β = -0.87 points/(month × cm3), P = .001) and right (β = -0.64 points/(month × cm3), P = .02) cerebellar cortex, left pons (β = -19.8 points/(month × cm3), P = .02), and right pallidum (β = -10.8 points/(month × cm3), P = .02) atrophy and reduced right internal capsule FA (β = -1.02 points/month, P = .03) were associated with worse PNDH performance.

CONCLUSIONS

Biomarkers of microstructural injury in motor-associated brain regions were associated with worse FMS. Dose avoidance in these areas may preserve FMS.

Effects of Different Types of Exercise Training on Fine Motor Skills and Testosterone Concentration in Adolescents: A Cluster Randomized Controlled Trial

We sought to compare the effect of two types of exercise training on fine motor skills and to establish their association with the salivary testosterone. Research participants, 135 adolescents (68 adolescent females; mean age = 12.76, SD = 0.85) were assigned into three groups: coordinative exercise (CE), cardiovascular exercise (CVE), and the control group (CON). Fine motor skills were assessed with a drawing trail test and salivary testosterone concentration was measured before and after 10 weeks of intervention. There were no significant changes in fine motor skills and testosterone concentration after either CE or CVE training. However, a significant positive correlation between post-test fine motor skills and post-test testosterone concentration was found after the CVE training. One type of exercise training cannot be singled out as more effective for fine motor skills and testosterone activity. Nevertheless, our results showed a relationship between fine motor skills and testosterone concentration after the CVE training. Thus, the type of exercise training is important in the exercise-induced testosterone effect on fine motor skills.

Oncological Children and Well-Being: Occupational Performance and HRQOL Change after Fine Motor Skills Stimulation Activities

Cancer children experience long periods of hospitalization, which are associated with limited performance in several developmental domains and participation restrictions in age appropriate occupations. Fine motor abilities represent building blocks in performing daily life skills and have been found to be closely connected with later academic success. Moreover, medical and psychological sequelae for cancer inpatients may result in diminished daily activities functioning, poor perceived health related quality of life (HRQOL), and increase the likelihood of long-term impairments. This study examines the variations in the occupational performance of children hospitalized for acute lymphoblastic leukemia (ALL) after their participation to a stimulation program designed to enhance fine motor skills. Parents reported significant gains in children's motor functioning, a slight improvement in overall occupational performance related to an increase in the area of productivity and self-care, and a better quality of life perception following the stimulation activities. Feasibility of the stimulation program in a health care setting are discussed evaluating its benefits for cancer children and their families.

Sensorineural hearing loss imprint on fine motor skills: A pediatric and adolescent innovative study

BACKGROUND

Sensorineural hearing loss is the most common type of permanent hearing impairment and results in balance and motor deficits in children which may affect and/or delay all developmental indicators.

OBJECTIVE

The purpose of this study was to investigate the consequences of sensorineural hearing loss regarding fine motor skills in children and adolescents.

METHODS

Two hundred children with an age range between 7 to 18 years and diagnosed with sensorineural hearing loss were selected from the Public School for the Deaf and Hard of Hearing in El-Minia district, Minia governorate, Egypt. The outcome was assessed by the use of Bruininks-Oseretsky Test of Motor Proficiency Second Edition scale (BOT-2) to measure fine motor skills.

RESULTS

There was a statistically significant difference between the scores of Fine Motor Precision and Fine Motor Integration subtests of each study subgroup and its counterpart subgroup in the control group (normative values according to the scale) which has the same age and gender characteristics where p value equals (0.0008 or less, 0.0009 or less) respectively, with a large effect size less than -0.83.

CONCLUSION

The findings of this study suggest that children with sensorineural hearing loss have a defect in their fine motor skills when compared to normal children of the same gender and age groups according to Bruininks-Oseretsky scale.

Analysis of Fine Motor Skills in Essential Tremor: Combining Neuroimaging and Handwriting Biomarkers for Early Management

Essential tremor (ET) is a highly prevalent neurological disorder characterized by action-induced tremors involving the hand, voice, head, and/or face. Importantly, hand tremor is present in nearly all forms of ET, resulting in impaired fine motor skills and diminished quality of life. To advance early diagnostic approaches for ET, automated handwriting tasks and magnetic resonance imaging (MRI) offer an opportunity to develop early essential clinical biomarkers. In this study, we present a novel approach for the early clinical diagnosis and monitoring of ET based on integrating handwriting and neuroimaging analysis. We demonstrate how the analysis of fine motor skills, as measured by an automated Archimedes' spiral task, is correlated with neuroimaging biomarkers for ET. Together, we present a novel modeling approach that can serve as a complementary and promising support tool for the clinical diagnosis of ET and a large range of tremors.

Fine Motor Skills and Lexical Processing in Children and Adults

Children’s fine motor skills (FMS) link to cognitive development, however, research on their involvement in language processing, also with adults, is scarce. Lexical items are processed differently depending on the degree of sensorimotor information inherent in the words’ meanings, such as whether these imply a body-object interaction (BOI) or a body-part association (i.e., hand, arm, mouth, foot). Accordingly, three studies examined whether lexical processing was affected by FMS, BOIness, and body-part associations in children (study 1, n = 77) and adults (study 2, n = 80; study 3, n = 71). Analyses showed a differential link between FMS and lexical processing as a function of age. Whereas response latencies indicated that children’s FMS were associated with “hand” words, adults’ FMS linked to the broader concept of BOI. Findings have implications for shared activation theories positing that FMS support lexical processing.

Evaluation of Conscious Monitoring and Movement Control Efforts Among Dental Students

Prior research has demonstrated that motor skill learning is often disrupted by self-focus and attempts to control movement. The propensity for reinvestment (i.e., self-focus and movement control) has been associated with poor motor skill learning in sport and surgery, but it has not yet been examined in dental education. Therefore, the aim of this study was to evaluate the propensity for disruptive reinvestment among dental students so as to optimize their learning needs. Volunteer dental students (210) completed three reinvestment surveys to investigate their self-reported propensity to engage in conscious self-monitoring and control of their movements and decisions. We used analysis of variance (ANOVA), with post-hoc analyses as appropriate, to assess the effect of various participant demographics on their reinvestment scores. Male participants had a lower mean reinvestment scale score than females (p < .05). Older participants were found to have a lower mean movement reinvestment score, compared to younger reinvesters (p < .05). On the other hand, younger reinvesters had a lower mean decision reinvestment score compared to the older age group (p < .05). When compared with participants in previous studies our participants obtained a significantly higher reinvestment score (p < .05). In conclusion, gender and age may be related to dental students' self-reported propensity to reinvest. Moreover, dental students were found to be more self-conscious when compared with individuals who perform gross motor skill tasks. These results provide insight into the acquisition of dental skills that may assist in designing pre-clinical training curriculum in dental education.

Effect of force accuracy on hemodynamic response: an fNIRS study using fine visuomotor task

Objective. Despite converging neuroimaging studies investigating how neural activity is modulated by various motor related factors, such as movement velocity and force magnitude, little has been devoted to identifying the effect of force accuracy. This study thus aimed to investigate the effect of task difficulty on cortical neural responses when participants performed a visuomotor task with varying demands on force accuracy.Approach. Fourteen healthy adults performed a set of force generation operations with six levels of force accuracy. The participants held a pen-shaped tool and moved the tool along a planar ring path, meanwhile producing a constant force against the plane under visual guidance. The required force accuracy was modulated by allowable tolerance of the force during the task execution. We employed functional near-infrared spectroscopy to record signals from bilateral prefrontal, sensorimotor and occipital areas, used the hemoglobin concentration as indicators of cortical activation, then calculated the effective connectivity across these regions by Granger causality.Main results.We observed overall stronger activation (oxy-hemoglobin concentration,p= 0.015) and connectivity (p< 0.05) associated with the initial increase in force accuracy, and the diminished trend in activation and connectivity when participants were exposed to excessive demands on accurate force generation. These findings suggested that the increasing task difficulty would be only beneficial for the mental investment up to a certain point, and above that point neural responses would show patterns of lower activation and connections, revealing mental overload at excessive task demands.Significance.Our results provide the first evidence for the inverted U-shaped effect of force accuracy on hemodynamic responses during fine visuomotor tasks. The insights obtained through this study also highlight the essential role of inter-region connectivity alterations for coping with task difficulty, enhance our understanding of the underlying motor neural processes, and provide the groundwork for developing adaptive neurorehabilitation strategies.

Physical Activity With Eduball Stimulates Graphomotor Skills in Primary School Students

Despite the general agreement that the interdisciplinary model of physical education (PE), based on the incorporation of core academic subjects into the PE curriculum, stimulates the holistic development of students, there is still a lack of methods for its implementation. Therefore, Eduball was created, i.e., a method that uses educational balls with printed letters, numbers, and other signs. Numerous studies have shown that children participating in activities with Eduballs can develop their physical fitness while simultaneously improving their academic performance, particularly in math and language, including some writing skills. However, little is known about the effects of Eduball on children's graphomotor skills, which are key for the academic performance of students throughout the entire schooling process. Here, we investigate whether 6-month participation in PE with Eduball stimulates graphomotor skills in primary school students, such as drawing prehandwriting letter patterns on unlined or lined paper and rewriting text on unlined or lined paper. Our results show that the Eduball class (N = 28) significantly improved these skills compared to the control class (N = 26) participating in traditional PE. For example, students from the experimental group wrote with a lower pen pressure and better stability of the line, in contrast to those from the control group. Therefore, this study demonstrates that the Eduball method successfully supports teachers in developing graphomotor skills in children. More broadly, our findings make clear once again that there is the need to integrate physical and cognitive development in education, which can be achieved by using an interdisciplinary model of PE.

Motor Developmental Outcomes in Children Exposed to Maternal Diabetes during Pregnancy: A Systematic Review and Meta-Analysis

Studies on the association of maternal diabetes with motor development in children provide inconsistent findings. We searched MEDLINE/PubMed, EMBASE, Emcare, PsycINFO, and Google Scholar databases for primary observational, case-control, or cohort studies that report on the motor development of children exposed to maternal diabetes during pregnancy. Quality appraisal and data extraction were performed independently and in duplicate. A meta-analysis of summary measures was performed using random-effect models. Eighteen studies were identified for inclusion, however, only 13 were included in the meta-analysis. Exposure to maternal diabetes during pregnancy was associated with a lower pooled motor development in children and a decrease in both gross and fine motor development. Among all other factors, pre-existing diabetes and other gestational comorbidities, such as hypertension and obesity, or low socioeconomic status, also affect child development. Therefore, among children of diabetic mothers, those with other gestational comorbidities or pre-existing diabetes were more likely to be at risk developmentally.

Monitoring the Motor Phenotype in Huntington's Disease by Analysis of Keyboard Typing During Real Life Computer Use

BACKGROUND

Besides cognitive and psychiatric abnormalities, motor symptoms are the most prominent in Huntington's disease. The manifest disease is preceded by a prodromal phase with subtle changes such as fine motor disturbances or concentration problems.

OBJECTIVE

Movement disorders show a high variation in their clinical manifestation depending on condition and external influences. Therefore, devices for continuous measurements, which patients use in their daily life and which can monitor motor abnormalities, in addition to the medical examination, might be useful. The aim of current scientific efforts is to find markers that reflect the prodromal phase in gene carriers. This is important for future interventional studies, as future therapies should be applied at the stage of neuronal dysfunction, i.e., before the clinical manifestation.

METHODS

We performed a software-supported, continuous monitoring of keyboard typing on the participants' own computer to evaluate this method as a tool to assess the motor phenotype in HD. We included 40 participants and obtained sufficient data from 25 participants, 12 of whom were manifest HD patients, 7 HD gene expansion carriers (HDGEC) and 6 healthy controls.

RESULTS

In a cross-sectional analysis we found statistically significant higher typing inconsistency in HD patients compared to controls. Typing inconsistency compared between HDGEC and healthy controls showed a trend to higher inconsistency levels in HDGEC. We found correlations between typing cadence and clinical scores: the UHDRS finger tapping item, the composite UHDRS and the CAP score.

CONCLUSION

The typing cadence inconsistency is an appropriate marker to evaluate fine motor skills of HD patients and HDGEC and is correlated to established clinical measurements.

Transient Early Fine Motor Abnormalities in Infants Born to COVID-19 Mothers Are Associated With Placental Hypoxia and Ischemia

Background: Long-term effects of Coronavirus Disease 2019 (COVID-19) on infants born to infected mothers are not clear. Fine motor skills are crucial for the development of infant emotional regulation, learning ability and social skills. Methods: Clinical information of 100 infants born to 98 mothers (COVID-19 n = 31, non-COVID-19 n = 67) were collected. Infants were follow-up up to 9 months post-partum. The placental tissues were examined for SARS-CoV-2 infection, pathological changes, cytokines, and mtDNA content. Results: Decreased placental oxygen and nutrient transport capacity were found in infected pregnant women. Increased IL-2, IL-6, TNF-α, and IFN-γ were detected in trophoblast cells and maternal blood of COVID-19 placentas. Elevated early fine motor abnormal-ities and increased serum TNI (troponin I) levels at delivery were observed in infants born to mothers with COVID-19. Increased abnormal mitochondria and elevated mtDNA content were found in the placentas from infected mothers. The placental mtDNA content of three infants with abnormal DDST were increased by 4, 7, and 10%, respectively, compared to the mean of the COVID-19 group. The Maternal Vascular Malperfusion (MVM), elevated cytokines and increased placental mtDNA content in mothers with COVID-19 might be associated with transient early fine motor abnormalities in infants. These abnormalities are only temporary, and they could be corrected by daily training. Conclusions: Babies born to COVID-19 mothers with mild symptoms appeared to have little or no excess long-term risks of abnormal physical and neurobehavioral development as compared with the infants delivered by non-COVID-19 mothers.

Can jaw position affect the fine motor activity of the hand during writing?

BACKGROUND

Jaw and neck systems have been shown to be functionally related and changes in either system can modulate gross motor functions, such as posture control. It remains to be seen if any change in jaw position can affect fine motor skills. The objective of this study was to determine the effect of resting, open and clenched jaw positions on various handwriting parameters while standing on firm and unstable surfaces.

METHODS

Handwriting samples were collected from 36 healthy male participants (age, 15-35 years) using a digitizer tablet (WACOM Intuos 4) with noninking pen in the resting, open and clenched jaw positions while standing on firm and unstable surfaces. The measured handwriting parameters included duration, vertical size, horizontal size, absolute size, average absolute velocity, and absolute jerk. Recordings and analyses were performed using NeuroScript MovAlyzeR software.

RESULTS

All handwriting parameters varied among the resting, open, and clenched jaw positions on both the firm and unstable surfaces. However, based on statistical analyses, there were no significant differences in the handwriting parameters among three jaw positions on both surfaces (p > .05).

CONCLUSION

This study revealed that all handwriting parameters varied among the resting, open, and clenched jaw positions on both the firm and unstable surfaces, showing that change in the jaw motor system may potentially affect the fine motor skills. However, on statistical analysis, there was no significant effect of 3 studied jaw positions on fine motor skills as seen on gross motor skills among healthy individuals.

Effect of errorless learning on the acquisition of fine motor skills in pre-clinical endodontics

This study aimed to evaluate the impact of errorless and errorful learning, on acquisition of root canal hand-instrumentation skills. Dental students prepared standardised canals of different diameters and curvatures. Learning involved minimising (errorless: n = 21) or maximising errors (errorful: n = 21). Students who had completed accredited pre-clinical activities provided comparative data (n = 17). During testing, the distal canal of a plastic mandibular molar was prepared, first as a single task and then under multi-tasking conditions. Performance was assessed by preparation accuracy and time. Differences were assessed using anova (P < 0.05). Performance in the experimental groups was similar during learning. When multi-tasking, errorful learners showed a deterioration in preparation accuracy (P < 0.05). In contrast, preparation accuracy and completion times for the errorless and comparative groups remained stable when multi-tasking. Errorless learning resulted in stable performance under multi-tasking conditions. Investigation of alternative approaches to learning motor skills in dentistry is warranted as such approaches may provide better outcomes, especially under demanding conditions.

Laterality in Children: Evidence for Task-Dependent Lateralization of Motor Functions

The behavioral preference for the use of one side of the body starts from pre-natal life and prompt humans to develop motor asymmetries. The type of motor task completed influences those functional asymmetries. However, there is no real consensus on the occurrence of handedness during developmental ages. Therefore, we aimed to determine which motor asymmetries emerged differently during childhood. A total sample of 381 children in grades 1 to 5 (6-11 years old) of primary school were recruited and tested for two fine coordination tasks (Floppy, led by dexterity, and Thumb, led by speed-dominated skills) and handgrip strength (HS). Data about their handedness, footedness and sports participation were also collected. Children performed better with their dominant side, especially for the Floppy and HS tests. The asymmetries were more marked in right-handed children and did not differ by age, gender or type of sport. Our findings support the thesis of a functional lateralization in complex coordinative tasks and in maximal strength during developmental ages. Furthermore, our findings extend the evidence of a stronger lateralization in right-handed individuals, demonstrating it at a functional level in primary school children performing motor tasks. Fine motor skills allow a "fine" understanding of developmental trajectories of lateralized behavior.

Assessment of speech and fine motor coordination in children with autism spectrum disorder

Autism Spectrum Disorder (ASD) is a developmental disorder characterized by difficulty in communication, which includes a high incidence of speech production errors. We hypothesize that these errors are partly due to underlying deficits in motor coordination and control, which are also manifested in degraded fine motor control of facial expressions and purposeful hand movements. In this pilot study, we computed correlations of acoustic, video, and handwriting time-series derived from five children with ASD and five children with neurotypical development during speech and handwriting tasks. These correlations and eigenvalues derived from the correlations act as a proxy for motor coordination across articulatory, laryngeal, and respiratory speech production systems and for fine motor skills. We utilized features derived from these correlations to discriminate between children with and without ASD. Eigenvalues derived from these correlations highlighted differences in complexity of coordination across speech subsystems and during handwriting, and helped discriminate between the two subject groups. These results suggest differences in coupling within speech production and fine motor skill systems in children with ASD. Our long-term goal is to create a platform assessing motor coordination in children with ASD in order to track progress from speech and motor interventions administered by clinicians.

Investigating fine motor deficits during maintenance therapy in children with acute lymphoblastic leukemia

OBJECTIVES

Children diagnosed with acute lymphoblastic leukemia (ALL) in their early childhood are more susceptible to neuromuscular and musculoskeletal impairments. This cross-sectional study was designed to address different types of fine motor impairments in Egyptian children diagnosed with ALL.

METHODS

Fifty-four children treated for ALL in maintenance phase aged from four to seven years were compared with an age- and sex-matched control group. Fine motor performance was assessed using the total fine motor form of the Bruininks-Oseretsky Test of Motor Proficiency-second edition (BOT-2). Sex- and age-specific norms of BOT-2 were used to calculate scale and standard scores in both groups.

RESULTS

Children with ALL had significantly impaired fine motor skills in all subtests and composites of BOT-2 compared with the typically developing group (P < 0.00001). Cumulative doses of vincristine, methotrexate, and dexamethasone revealed no significant correlation with any BOT-2 measure. Males performed significantly better than females in all BOT-2 scores except for the fine motor integration subtest and the total fine motor control composite as no significant differences were observed. The protocol risk stratum, duration of maintenance treatment, and the age at assessment did not significantly affect the BOT-2 measures.

CONCLUSION

About 67% of children with ALL on maintenance treatment experienced fine motor difficulties. Periodic evaluation along the course of chemotherapy could identify specific impaired fine motor domains providing the base for a successful rehabilitation program.

The Implicit Contribution of Fine Motor Skills to Mathematical Insight in Early Childhood

Understanding number magnitude is an important prerequisite for children's mathematical development. One early experience that contributes to this understanding is the common practice of finger counting. Recent research suggested that through repeated finger counting, children internalize their fingers as representations of number magnitude. Furthermore, finger counting habits have been proposed to predict concurrent and future mathematical performance. However, little is known about how finger-based number representations are formed and by which processes they could influence mathematical development. Regarding the emergence of finger-based number representations, it is likely that they result from repeated practice of finger counting. Accordingly, children need sufficient fine motor skills (FMS) to successfully count on their fingers. However, the role that different types of FMS (such as dexterity and graphomotor skills) might play in the development of finger-based number representations is still unknown. In the current study, we investigated (a) whether children's FMS (dexterity and graphomotor skills) are associated with their emerging finger-based number representations (ordinal and cardinal), (b) whether FMS explain variance in children's finger-based number representations beyond the influence of general cognitive skills, and (c) whether the association between FMS and numerical skills is mediated by finger-based representations. We tested associations between preschool children's (N = 80) FMS (dexterity and graphomotor skills), finger-based number representations, and numerical skills. Furthermore, visuo-spatial working memory and nonverbal intelligence were controlled for. Dexterity was related to children's finger-based number representations as well as numerical skills after controlling for chronological age, but not after also controlling for cognitive skills. Moreover, the relationship between dexterity and numerical skills was mediated by finger-based number representations. No such associations were observed for graphomotor skills. These results suggest that dexterity plays a role in children's development of finger-based number representations, which in turn contribute to their numerical skills. Possible explanations are discussed.

Putting a Finger on Numerical Development - Reviewing the Contributions of Kindergarten Finger Gnosis and Fine Motor Skills to Numerical Abilities

The well-documented association between fingers and numbers is not only based on the observation that most children use their fingers for counting and initial calculation, but also on extensive behavioral and neuro-functional evidence. In this article, we critically review developmental studies evaluating the association between finger sensorimotor skills (i.e., finger gnosis and fine motor skills) and numerical abilities. In sum, reviewed studies were found to provide evidential value and indicated that both finger gnosis and fine motor skills predict measures of counting, number system knowledge, number magnitude processing, and calculation ability. Therefore, specific and unique contributions of both finger gnosis and fine motor skills to the development of numerical skills seem to be substantiated. Through critical consideration of the reviewed evidence, we suggest that the association of finger gnosis and fine motor skills with numerical abilities may emerge from a combination of functional and redeployment mechanisms, in which the early use of finger-based numerical strategies during childhood might be the developmental process by which number representations become intertwined with the finger sensorimotor system, which carries an innate predisposition for said association to unfold. Further research is nonetheless necessary to clarify the causal mechanisms underlying this association.

Impact of Psycho-Educational Activities on Visual-Motor Integration, Fine Motor Skills and Name Writing among First Graders: A Kinematic Pilot Study

This pilot study presents the effects on acquisition of pre-writing skills of educational activities targeting visual-motor integration and fine motor skills on a convenient sample of first graders. After a 10-week intervention program, visual perceptual skills and fine motor control were tested on 13 six-year-old aged children. Participants completed the Beery-Buktenica VMI and the manual dexterity scale of the Movement ABC-2 at baseline (T1), after the intervention program (T2), and one month after the end of the educational activities (T3). Children's writing pressure, frequency, and automaticity were measured using a digitizer during the administration of name writing test at T1, T2, and T3. The purpose of the study was to investigate changes in visual-perceptual abilities and fine motor skills after the intervention program and examine correlational effects on children's kinematic writing performances. Findings reveal that educational activities impacted positively on children's visual motor coordination component of writing improving VMI scores. No statistically significant difference was detected across the three time points on students' manual dexterity skills. Measurement of writing kinematics allows to report and document variations in children's writing during intervention. This pilot study discusses these findings and their implications for the field on early childhood acquisition of foundational skills for handwriting. It also proposes potential topics for future research on this field.

Who Benefits from An Intervention Program on Foundational Skills for Handwriting Addressed to Kindergarten Children and First Graders?

This study examined the effectiveness of a 10-wk intervention program based on occupational therapy principles on visual-motor integration skills and fine motor abilities in kindergartners and first graders. We recruited 55 students tested three times with the Visual-Motor Integration Test (VMI) and Movement Assessment Battery for Children-2 (MABC-2): before the intervention (T1), post-intervention (T2) and one month later (T3). Research findings: Significant improvements were found on VMI between T1 and T2, particularly for kindergartners. Neither group of children demonstrated changes on manual dexterity scores. The present study showed that the intervention program led to different changes in the at-risk of motor impairment group than in the not at-risk children. Results indicated that games and stimulation activities helped children below the 16th percentile over time in the manual dexterity domain. A gender effect was observed, with female children increasing their abilities over time more than male peers. Future research should concentrate on stimulating fine motor skills in hand manipulation and test how these abilities influence graphomotor skills and handwriting over time. Finally, more research is needed to determine the impact of activities and games carried out in educational settings.

Cognitive, Motor and Social Factors of Music Instrument Training Programs for Older Adults' Improved Wellbeing

Given emerging evidence that learning to play a musical instrument may lead to a number of cognitive benefits for older adults, it is important to clarify how these training programs can be delivered optimally and meaningfully. The effective acquisition of musical and domain-general skills by later-life learners may be influenced by social, cultural and individual factors within the learning environment. The current study examines the effects of a 10-week piano training program on healthy older adult novices' cognitive and motor skills, in comparison to an inactive waitlisted control group. Fifteen participants completed piano training led by a music facilitator in small groups (max n = 4 per lesson class; two experimental, two waitlisted control groups). Data was collected using an explanatory sequential design: quantitative data from a battery of cognitive and motor tests was collected pre/post-test on all participants, with further post-test data from the waitlisted control group (n = 7). Qualitative data included weekly facilitator observations, participant practice diaries, and an individual, semi-structured, post-experiment interview. Bayesian modelling demonstrated moderate evidence of a strong positive impact of training on part A of the Trail Making test (TMT), indicating improved visuo-motor skills. Moderate evidence for negative impacts of training on part B of the Trail Making Test (and difference score delta) was also found, suggesting no benefit of cognitive switching. Qualitative results revealed that the group learning environment motivated participants to play in musical ensembles and to socialize. Motivation was optimal when all participants were happy with the chosen repertoire (participants reported they were motivated by learning to play familiar music) and when the facilitator observed that groups had formed cohesive bonds. Informed by these factors, exploratory analyses demonstrated strong evidence that a participant's lesson class had an impact on post-test scores (TMT part A). These results not only demonstrate the extent of cognitive benefits of a short-term piano training intervention for older adults, but also the importance of considering the group dynamics in the learning environment.

Inhaler Devices in a Geriatric Patient Population: A Prospective Cross-Sectional Study on Patient Preferences

PURPOSE

The aim of this study was to examine the perception and preference of geriatric patients for commonly used inhaler devices in Germany.

PATIENTS AND METHODS

This was a prospective, open-label cross-sectional study with inpatient inhaler-naïve geriatric volunteers (age ≥ 70 years). All 106 participants were interviewed and subjected to a geriatric examination for cognitive, motor and fine motor skills before demonstrating the use of nine inhalers in random order. For each device, patients were asked to test the handling, to assess the device properties and to name the device that they would most or least prefer.

RESULTS

The mean age of the patients was 80.8 years. From a selection of 7 predefined general inhaler attributes, ease of use, discrete handling and inhalation resistance were the most important for the geriatric participants. Across all inhaler devices, the volunteers needed an average of 2.47 attempts to error-free use. The device with the lowest mean number of attempts was the Nexthaler^® (1.75; SD ± 0.903), followed by Spiromax^® (1.96; SD ± 0.965) and Genuair^® (2.05; SD ± 1.027). There was a weak to moderate correlation between the number of attempts required to ensure the correct use of these three inhalers and the patient's cognitive and fine motor skills. Fifty-nine patients (56%) chose the Nexthaler as the inhalation device that they would most prefer (p<0.001 vs other devices). This was followed by Spiromax (n=23; 22%) and Genuair (n=12; 11%). The device that was least favored was the Elpenhaler^® (p<0.001 vs other devices).

CONCLUSION

Patient preference and frequency of inhaler handling-errors may vary between inhaler devices. The Nexthaler was the easiest-to-use and most popular device among inhaler-naïve patients.

Concurrent maturation of visuomotor skills and motion perception in typically-developing children and adolescents

Perceptual and visuomotor skills undergo considerable development from early childhood into adolescence; however, the concurrent maturation of these skills has not yet been examined. This study assessed visuomotor function and motion perception in a cross-section of 226 typically-developing children between 4 and 16 years of age. Participants were tested on three tasks hypothesized to engage the dorsal visual stream: threading a bead on a needle, marking dots using a pen, and discriminating form defined by motion contrast. Mature performance was reached between 8 and 12 years, with youngest maturation for kinematic measures for a reach-to-grasp task, and oldest maturation for a precision tapping task. Performance on the motion perception task shared no association with motor skills after controlling for age.

Long-Term Fine Motor Capability on the Staircase Test Correlates with the Absolute Number, but Not the Density, of DARPP-Positive Neurons in the Caudate-Putamen

Measurement of long-term functional and anatomical outcomes in the same animal is considered a powerful strategy for correlating structure with function. In a neonatal animal model of hypoxic-ischemic brain injury that is relevant to cerebral palsy, long-term functional deficits on the staircase test and long-term anatomical deficits in the absolute number of medium-spiny projection neurons in the caudate-putamen were reported in different animals due to logistical constraints. Here, we investigated if these functional and anatomical measures were correlated when measured in the same animals. The medium-spiny projection neurons were investigated because (1) they comprise the vast majority (>97%) of all neurons in the caudate-putamen and (2) motor deficits observed during staircase testing are likely to involve these striatal medium-spiny projection neurons through their connections. We found that long-term skilled forepaw capability on the staircase test was correlated with the absolute number of DARPP-32-positive medium-spiny projection neurons in the caudate-putamen. Specifically, deficits in skilled forepaw ability for the number of sugar pellets eaten and retrieved, and for the maximum staircase level reached, were significantly correlated with a lower absolute neuronal number. We also found that skilled forepaw ability on the staircase test was not correlated with the neuronal density (i.e., number per unit volume) of DARPP-32-positive medium-spiny projection neurons. Since neuronal density is an indirect measure of neuronal survival that is used in the literature, and absolute neuronal number is a direct measure, the results also highlight the scientific value of measuring absolute neuronal number. Anat Rec, 302:2040-2048, 2019. © 2019 American Association for Anatomy.

A School-Based Screening Tool for Adolescents With Low Motor Coordination Abilities

This study sought to select the most relevant test items from the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOTMP-2) and from a selection of health-related fitness tests for identifying school teenagers with poor motor coordination. The 241 participants in this study (144 boys, 97 girls aged 13-14 years old) were tested on the short form of the BOTMP-2 and on the following additional fitness tests: (a) seated medicine ball test, (b) broad jump, (c) handgrip strength, (d) alternate hand ball wall toss, (e) 10 × 5-meter agility shuttle run, and (f) Chester step test. We performed a factor analysis of participant scores on these various tasks and BOTMP-2 test items to reduce them to the least number of meaningful and useful items. Four factors explained 45% of the data variance: gross motor skills and power (including broad jump, hand ball toss, shuttle run, and sit-ups tests); fine motor skills (including copying star, following the maze and paper folding); core strength and balance (including push-ups, hopping, and balance beam); and general body strength (including medicine ball throw and handgrip). We conclude that an efficient school-based battery of test items to screen 13-14 year old adolescents for fitness and coordination should assess these four factors and might especially rely upon the broad jump, copying a star shape, hopping handgrip strength, aerobic fitness, and wall ball toss.

Occupational Exposure to Manganese and Fine Motor Skills in Elderly Men: Results from the Heinz Nixdorf Recall Study

Objectives

Exposure to manganese (Mn) may cause movement disorders, but less is known whether the effects persist after the termination of exposure. This study investigated the association between former exposure to Mn and fine motor deficits in elderly men from an industrial area with steel production.

Methods

Data on the occupational history and fine motor tests were obtained from the second follow-up of the prospective Heinz Nixdorf Recall Study (2011-2014). The study population included 1232 men (median age 68 years). Mn in blood (MnB) was determined in archived samples (2000-2003). The association between Mn exposure (working as welder or in other at-risk occupations, cumulative exposure to inhalable Mn, MnB) with various motor functions (errors in line tracing, steadiness, or aiming and tapping hits) was investigated with Poisson and logistic regression, adjusted for iron status and other covariates. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated for substantially impaired dexterity (errors >90th percentile, tapping hits <10th percentile).

Results

The median of cumulative exposure to inhalable Mn was 58 µg m-3 years in 322 men who ever worked in at-risk occupations. Although we observed a partly better motor performance of exposed workers at group level, we found fewer tapping hits in men with cumulative Mn exposure >184.8 µg m-3 years (OR 2.15, 95% CI 1.17-3.94). MnB ≥ 15 µg l-1, serum ferritin ≥ 400 µg l-1, and gamma-glutamyl transferase ≥74 U l-1 were associated with a greater number of errors in line tracing.

Conclusions

We found evidence that exposure to inhalable Mn may carry a risk for dexterity deficits. Whether these deficits can be exclusively attributed to Mn remains to be elucidated, as airborne Mn is strongly correlated with iron in metal fumes, and high ferritin was also associated with errors in line tracing. Furthermore, hand training effects must be taken into account when testing for fine motor skills.

Development and initial validity of the in-hand manipulation assessment

BACKGROUND/AIM

A review of the literature related to in-hand manipulation (IHM) revealed that there is no assessment which specifically measures this construct in the adult population. This study reports the face and content validity of an IHM assessment for adults with impaired hand function based on expert opinion.

METHODS

The definition of IHM skills, assessment tasks and scoring methods identified from literature was discussed in a focus group (n = 4) to establish face validity. An expert panel (n = 16) reviewed the content validity of the proposed assessment; evaluating the representativeness and relevance of encompassing the IHM skills in the proposed assessment tasks, the clarity and importance to daily life of the task and the clarity and applicability to clinical environment of the scoring method. The content validity was calculated using the content validity index for both the individual task and all tasks together (I-CVI and S-CVI). Feedback was incorporated to create the assessment.

RESULTS

The focus group members agreed to include 10 assessment tasks that covered all IHM skills. In the expert panel review, all tasks received an I-CVI above 0.78 and S-CVI above 0.80 in representativeness and relevance ratings, representing good content validity. With the comments from the expert panel, tasks were modified to improve the clarity and importance to daily life. A four-point Likert scale was identified for assessing both the completion of the assessment tasks and the quality of IHM skills within the task performance.

CONCLUSION

Face and content validity were established in this new IHM assessment. Further studies to examine psychometric properties and use within clinical practice are recommended.

Development of an Age Band on the ManuVis for 3-Year-Old Children with Visual Impairments

AIM

To compare fine motor performance of 3-year-old children with visual impairment with peers having normal vision, to provide reference scores for 3-year-old children with visual impairment on the ManuVis, and to assess inter-rater reliability.

METHOD

26 children with visual impairment (mean age: 3 years 7 months (SD 3 months); 17 boys) and 28 children with normal vision (mean age: 3 years 7 months (SD 4 months); 14 boys) participated in the study. The ManuVis age band for 3-year-old children comprised two one-handed tasks, two two-handed tasks, and a pre-writing task.

RESULTS

Children with visual impairment needed more time on all tasks (p < .01) and performed the pre-writing task less accurately than children with normal vision (p < .001). Children aged 42-47 months performed significantly faster on two tasks and had better total scores than children aged 36-41 months (p < .05). Inter-rater reliability was excellent (Intra-class Correlation Coefficient = 0.96-0.99).

CONCLUSIONS

The ManuVis age band for 3-year-old children is appropriate to assess fine motor skills, and is sensitive to differences between children with visual impairment and normal vision and between half-year age groups. Reference scores are provided for 3-year-old children with visual impairment to identify delayed fine motor development.

Improving the utility of the fine motor skills subscale of the comprehensive developmental inventory for infants and toddlers: a computerized adaptive test

AIM

This study aimed at improving the utility of the fine motor subscale of the comprehensive developmental inventory for infants and toddlers (CDIIT) by developing a computerized adaptive test of fine motor skills.

METHODS

We built an item bank for the computerized adaptive test of fine motor skills using the fine motor subscale of the CDIIT items fitting the Rasch model. We also examined the psychometric properties and efficiency of the computerized adaptive test of fine motor skills with simulated computerized adaptive tests.

RESULTS AND CONCLUSIONS

Data from 1742 children with suspected developmental delays were retrieved. The mean scores of the fine motor subscale of the CDIIT increased along with age groups (mean scores = 1.36-36.97). The computerized adaptive test of fine motor skills contains 31 items meeting the Rasch model's assumptions (infit mean square = 0.57-1.21, outfit mean square = 0.11-1.17). For children of 6-71 months, the computerized adaptive test of fine motor skills had high Rasch person reliability (average reliability >0.90), high concurrent validity (rs = 0.67-0.99), adequate to excellent diagnostic accuracy (area under receiver operating characteristic = 0.71-1.00), and large responsiveness (effect size = 1.05-3.93). The computerized adaptive test of fine motor skills used 48-84% fewer items than the fine motor subscale of the CDIIT. The computerized adaptive test of fine motor skills used fewer items for assessment but was as reliable and valid as the fine motor subscale of the CDIIT. Implications for Rehabilitation We developed a computerized adaptive test based on the comprehensive developmental inventory for infants and toddlers (CDIIT) for assessing fine motor skills. The computerized adaptive test has been shown to be efficient because it uses fewer items than the original measure and automatically presents the results right after the test is completed. The computerized adaptive test is as reliable and valid as the CDIIT.

The Effectiveness of a Computer Game-Based Rehabilitation Platform for Children With Cerebral Palsy: Protocol for a Randomized Clinical Trial

BACKGROUND

It is difficult to engage young children with cerebral palsy (CP) in repetitive, tedious therapy. As such, there is a need for innovative approaches and tools to motivate these children. We developed the low-cost, computer game-based rehabilitation platform CGR that combines fine manipulation and gross movement exercises with attention and planning game activities appropriate for young children with CP.

OBJECTIVE

The objective of this study is to provide evidence of the therapeutic value of CGR to improve upper extremity (UE) motor function for children with CP.

METHODS

This randomized controlled, single-blind, clinical trial with an active control arm will be conducted at 4 sites. Children diagnosed with CP between the ages of 4 and 10 years old with moderate UE impairments and fine motor control abnormalities will be recruited.

RESULTS

We will test the difference between experimental and control groups using the Quality of Upper Extremity Skills Test (QUEST) and Peabody Developmental Motor Scales, Second Edition (PDMS-2) outcome measures. The parents of the children and the therapist experiences with the interventions and tools will be explored using semi-structured interviews using the qualitative description approach.

CONCLUSIONS

This research protocol, if effective, will provide evidence for the therapeutic value and feasibility of CGR in the pediatric rehabilitation of UE function.

TRIAL REGISTRATION

Clinicaltrials.gov NCT02728375; http:https://clinicaltrials.gov/ct2/show/NCT02728375 (Archived by WebCite at http://www.webcitation.org/6qDjvszvh).

Relationship between motor proficiency and body composition in 6- to 10-year-old children

AIM

The aim of this study is to examine the relationship between motor skill competence and body composition of 6- to 10-year-old children.

METHODS

Seventy girls and 86 boys participated. Body composition was measured by body mass index and skinfold thickness. Motor proficiency was evaluated through the Bruininks-Oseretsky Test of Motor Proficiency-Short Form, which included measures of gross motor skills and fine motor skills.

RESULTS

Significant associations were found for both sexes between the percentage of body fat and (i) the performance in each gross motor task, (ii) the composite score for gross motor skills and (iii) the motor proficiency score. The percentage of body fat was not significantly associated with the majority of the fine motor skills items and with the respective composite score. Considering body weigh categories, children with normal weight had significantly higher scores than their peers with overweight or with obesity in gross motor skills and in overall motor proficiency.

CONCLUSIONS

Children's motor proficiency is negatively associated with body fat, and normal weight children show better motor competence than those who are overweight or obese. The negative impact of excessive body weight is stronger for gross motor skills that involve dynamic body movements than for stationary object control skills; fine motor skills appear to be relatively independent of the constraints imposed by excessive body weight.

Ancestral Exposure to Stress Generates New Behavioral Traits and a Functional Hemispheric Dominance Shift

In a continuously stressful environment, the effects of recurrent prenatal stress (PS) accumulate across generations and generate new behavioral traits in the absence of genetic variation. Here, we investigated if PS or multigenerational PS across 4 generations differentially affect behavioral traits, laterality, and hemispheric dominance in male and female rats. Using skilled reaching and skilled walking tasks, 3 findings support the formation of new behavioral traits and shifted laterality by multigenerational stress. First, while PS in the F1 generation did not alter paw preference, multigenerational stress in the F4 generation shifted paw preference to favor left-handedness only in males. Second, multigenerational stress impaired skilled reaching and skilled walking movement abilities in males, while improving these abilities in females beyond the levels of controls. Third, the shift toward left-handedness in multigenerationally stressed males was accompanied by increased dendritic complexity and greater spine density in the right parietal cortex. Thus, cumulative multigenerational stress generates sexually dimorphic left-handedness and dominance shift toward the right hemisphere in males. These findings explain the origins of apparently heritable behavioral traits and handedness in the absence of DNA sequence variations while proposing epigenetic mechanisms.

Can Touch Screen Tablets be Used to Assess Cognitive and Motor Skills in Early Years Primary School Children? A Cross-Cultural Study

Assessment of cognitive and motor functions is fundamental for developmental and neuropsychological profiling. Assessments are usually conducted on an individual basis, with a trained examiner, using standardized paper and pencil tests, and can take up to an hour or more to complete, depending on the nature of the test. This makes traditional standardized assessments of child development largely unsuitable for use in low-income countries. Touch screen tablets afford the opportunity to assess cognitive functions in groups of participants, with untrained administrators, with precision recording of responses, thus automating the assessment process. In turn, this enables cognitive profiling to be conducted in contexts where access to qualified examiners and standardized assessments are rarely available. As such, touch screen assessments could provide a means of assessing child development in both low- and high-income countries, which would afford cross-cultural comparisons to be made with the same assessment tool. However, before touch screen tablet assessments can be used for cognitive profiling in low-to-high-income countries they need to be shown to provide reliable and valid measures of performance. We report the development of a new touch screen tablet assessment of basic cognitive and motor functions for use with early years primary school children in low- and high-income countries. Measures of spatial intelligence, visual attention, short-term memory, working memory, manual processing speed, and manual coordination are included as well as mathematical knowledge. To investigate if this new touch screen assessment tool can be used for cross-cultural comparisons we administered it to a sample of children (N = 283) spanning standards 1–3 in a low-income country, Malawi, and a smaller sample of children (N = 70) from first year of formal schooling from a high-income country, the UK. Split-half reliability, test-retest reliability, face validity, convergent construct validity, predictive criterion validity, and concurrent criterion validity were investigated. Results demonstrate “proof of concept” that touch screen tablet technology can provide reliable and valid psychometric measures of performance in the early years, highlighting its potential to be used in cross-cultural comparisons and research.

A Characterization of Movement Skills in Obese Children With and Without Prader-Willi Syndrome

PURPOSE

The aim of this study was twofold: (a) to measure and compare motor proficiency in obese children with Prader-Willi syndrome (OB-PWS) to that in obese children without PWS (OB), and (b) to compare motor proficiency in OB-PWS and OB to normative data.

METHOD

Motor proficiency was measured using the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition-Complete Form, a norm-referenced assessment of motor function. Participants were 18 OB-PWS and 44 OB (8 to 11 years of age). The scores on the 8 subtests and the total motor composite were used to compare OB-PWS and OB. Furthermore, the scores on the 4 motor-area composites were used to compare OB-PWS and OB against normative data.

RESULTS

OB-PWS scored significantly lower than OB across all 8 subtests. OB-PWS also had significantly lower motor proficiency scores on all motor-area composites when compared with the normative sample. OB-PWS most frequently (67%-83%) scored well below average on the gross motor subtests. Although not as high as on the gross motor subtests, this finding also held true for the fine motor subtests with 39% to 45% of OB-PWS scoring well below average.

CONCLUSION

Motor proficiency is very poor in OB-PWS, in particular for gross motor skills. Physical, neurological, and developmental characteristics inherent to the syndrome may explain this low performance.

Effective and Efficient Stand Magnifier Use in Visually Impaired Children

PURPOSE

The main objective of this study was to analyze the effectiveness and efficiency of magnifier use in children with visual impairment who did not use a low vision aid earlier, in an ecologically valid goal-directed perceptuomotor task.

METHODS

Participants were twenty-nine 4- to 8-year-old children with visual impairment and 47 age-matched children with normal vision. After seeing a first symbol (an Lea Hyvärinen [LH] symbol), children were instructed to (1) move the stand magnifier as quickly as possible toward a small target symbol (another LH symbol that could only be seen by using the magnifier), (2) compare the two symbols, and (3) move the magnifier to one of two response areas to indicate whether the two symbols were identical. Performance was measured in terms of accuracy, response time, identification time, and movement time. Viewing distance, as well as hand and eye dominance while using the magnifier was assessed.

RESULTS

There were no significant differences between the two groups in accuracy, reaction time, and movement time. Contrary to the prediction, children with visual impairment required less time to identify small symbols than children with normal vision. Both within-subject and between-subject variability in viewing distance were smaller in the visually impaired group than in the normally sighted group. In the visually impaired group, a larger viewing distance was associated with shorter identification time, which in turn was associated with higher accuracy. In the normally sighted group, a faster movement with the magnifier and a faster identification were associated with increasing age.

CONCLUSION

The findings indicate that children with visual impairment can use the stand magnifier adequately and efficiently. The normally sighted children show an age-related development in movement time and identification time and show more variability in viewing distance, which is not found in visually impaired children. Visually impaired children seem to choose a standard but less adaptive strategy in which they primarily used their preferred hand to manipulate the magnifier and their preferred eye to identify the symbol.

TRIAL REGISTRATION

Registered at http://www.trialregister.nl; NTR2380.