Repetitive Transcranial Magnetic Stimulation Combined with Sling Exercise Modulates the Motor Cortex in Patients with Chronic Low Back Pain

The study aims to explore the effects of combining repetitive transcranial magnetic stimulation (rTMS) with sling exercise (SE) intervention in patients with chronic low back pain (CLBP). This approach aims to directly stimulate brain circuits and indirectly activate trunk muscles to influence motor cortex plasticity. However, the impact of this combined intervention on motor cortex organization and clinical symptom improvement is still unclear, as well as whether it is more effective than either intervention alone. To investigate this, patients with CLBP were randomly assigned to three groups: SE/rTMS, rTMS alone, and SE alone. Motor cortical organization, numerical pain rating scale (NPRS), Oswestry Disability Index (ODI), and postural balance stability were measured before and after a 2-week intervention. The results showed statistically significant differences in the representative location of multifidus on the left hemispheres, as well as in NPRS and ODI scores, in the combined SE/rTMS group after the intervention. When compared to the other two groups, the combined SE/rTMS group demonstrated significantly different motor cortical organization, sway area, and path range from the rTMS alone group, but not from the SE alone group. These findings highlight the potential benefits of a combined SE/rTMS intervention in terms of clinical outcomes and neuroadaptive changes compared to rTMS alone. However, there was no significant difference between the combined intervention and SE alone. Therefore, our research does not support the use of rTMS as a standalone treatment for CLBP. Our study contributed to optimizing treatment strategies for individuals suffering from CLBP.

Psychometric Properties of the Pictorial Scale of Perceived Movement Skill Competence for Young Norwegian Children

The objective of this study was to examine the psychometric properties of the Pictorial Scale of Perceived Movement Skill Competence (PMSC) for young Norwegian children, a scale that is aligned with skills assessed in the Test of Gross Motor Development- Third Edition. We used convenience sampling to recruit 396 Norwegian-speaking children (7-10-year-olds) who completed the PMSC. A confirmatory factor analysis (CFA) confirmed factorial validity for the proposed three-factor model of the PMSC, encompassing measures of self-perceived ball, locomotor, and active play competence. Internal item consistency coefficients of these sub-scales were acceptable, and subsequent measurement invariant analysis found a gender difference such that boys rated their competence higher than girls in running, jumping forward, hitting a ball (racket), kicking, throwing a ball and rope climbing, while girls rated themselves higher, compared to boys, in galloping and skating/blading. Furthermore, there was a slightly better model fit for boys than for girls. Several items were significantly related to children's age, and the three-factor model exhibited differential age related factor mean differences across older and younger children. Overall, we found the PMSC to have acceptable psychometric properties for confident use in assessing perceived motor competence among 7-10-year-old Norwegian children, though we observed age and gender differences in children's responses that warrant careful interpretation of results and further research investigation.

Psychometric properties of the Adolescent Motor Competence Questionnaire for Norwegian adolescents

The objective of this study was to examine the psychometric properties of the Adolescent Motor Competence Questionnaire (AMCQ) for Norwegian adolescents. To this end, a sample of 349 Norwegian-speaking adolescents (13-16 years old) were recruited and completed the AMCQ. Initial results showed that confirmatory factor analysis (CFA) did not indicate statistical support for previous statistical models reported in the literature. Further analysis indicated factorial validity for a novel three-factor model identified through exploratory factor analysis, encompassing measures of fine motor skill (α = 0.65), gross motor skill (α = 0.74), and activities of daily living (ADL; α = 0.79) with acceptable internal consistency coefficients. Subsequent analysis indicated indices of measurement invariance in the study sample, as males rated their competence higher compared to females in 19 of the 27 items, and better model fit was obtained for the female adolescents. Strong invariance was tenable, and no factor mean differences were found across older and younger adolescents or across BMI scores. Overall results thus suggested that the AMCQ has acceptable psychometric properties and can be confidently used in further work with perceived motor competence in Norwegian 13-16 years-old adolescents.

Effectiveness of perceptual-motor exercises and physical activity on the cognitive, motor, and academic skills of children with learning disorders: A systematic review

BACKGROUND

Children with specific learning disorders (SLD) may have issues in cognitive, motor, and academic skills, affecting their mental health and level of participation in academic and nonacademic activities at school and in everyday life. Research shows that perceptual-motor (PM) exercises and physical activities can improve the cognitive and motor skills of typically developing children. To use PM exercises as an intervention in clinical practice for children with learning disorders, or to use it in future research, it seems necessary to discuss and summarize the existing documents in this group of children.

OBJECTIVES

We aimed to appraise the extent, and the quality of studies about PM interventions for enhancing cognitive, motor, and academic skills in children with learning disorders.

METHODS

The search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles published between January 2000 and June 2022 were searched in the following scientific databases: PubMed, Medline, Scopus, Web of Science, Cochrane library, Science direct, and Google Scholar. The study eligibility criteria were previously established according to the PICOS model. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the studies, and the Cochrane Collaboration tool (ROB2) was used to assess the risk of bias.

RESULTS

The initial search yielded 2160 studies among which 10 studies were systematically reviewed. The total number of participants was 483 children (intervention: 251; control: 232). Findings showed significant improvements in cognitive skills (n = 7/8) such as working memory, attention, and information processing speed. In addition, studies showed that PM and physical activity interventions could increase academic performance (n = 4/5) and motor skills (n = 5/5) in children with LD. Results regarding the mental health effects of PM exercises (n = 1/3) are few in number and contradicting.

DISCUSSION

PM exercises may positively affect cognitive, motor, and academic skills in children with SLD; However, due to the small number of studies, fair methodological quality, and high risk of bias, caution should be taken when interpreting the results.

Cerebellar Transcranial Direct Current Stimulation Applied over Multiple Days Does Not Enhance Motor Learning of a Complex Overhand Throwing Task in Young Adults

Cerebellar transcranial direct current stimulation (tDCS) enhances motor skill and learning in relatively simple motor tasks, but it is unclear if c-tDCS can improve motor performance in complex motor tasks. The purpose of this study was to determine the influence of c-tDCS applied over multiple days on motor learning in a complex overhand throwing task. In a double-blind, randomized, between-subjects, SHAM-controlled, experimental design, 30 young adults were assigned to either a c-tDCS or a SHAM group. Participants completed three identical experiments on consecutive days that involved overhand throwing in a pre-test block, five practice blocks with concurrent c-tDCS, and a post-test block. Overhand throwing endpoint accuracy was quantified as the endpoint error. The first dorsal interosseous muscle motor evoked potential (MEP) amplitude elicited by transcranial magnetic stimulation was used to quantify primary motor cortex (M1) excitability modulations via c-tDCS. Endpoint error significantly decreased over the 3 days of practice, but the magnitude of decrease was not significantly different between the c-tDCS and SHAM group. Similarly, MEP amplitude slightly increased from the pre-tests to the post-tests, but these increases did not differ between groups. These results indicate that multi-day c-tDCS does not improve motor learning in an overhand throwing task or increase M1 excitability.

Transcranial Direct Current Stimulation of Primary Motor Cortex over Multiple Days Improves Motor Learning of a Complex Overhand Throwing Task

Transcranial direct current stimulation (tDCS) applied to the primary motor cortex (M1) improves motor learning in relatively simple motor tasks performed with the hand and arm. However, it is unknown if tDCS can improve motor learning in complex motor tasks involving whole-body coordination with significant endpoint accuracy requirements. The primary purpose was to determine the influence of tDCS on motor learning over multiple days in a complex over-hand throwing task. This study utilized a double-blind, randomized, SHAM-controlled, between-subjects experimental design. Forty-six young adults were allocated to either a tDCS group or a SHAM group and completed three experimental sessions on three consecutive days at the same time of day. Each experimental session was identical and consisted of overhand throwing trials to a target in a pre-test block, five practice blocks performed simultaneously with 20 min of tDCS, and a post-test block. Overhand throwing performance was quantified as the endpoint error. Transcranial magnetic stimulation was used to obtain motor-evoked potentials (MEPs) from the first dorsal interosseus muscle to quantify changes in M1 excitability due to tDCS. Endpoint error significantly decreased over the three days of practice in the tDCS group but not in the SHAM group. MEP amplitude significantly increased in the tDCS group, but the MEP increases were not associated with increases in motor learning. These findings indicate that tDCS applied over multiple days can improve motor learning in a complex motor tasks in healthy young adults.

Aiming Movement After Stroke: Do Time-Since-Injury and Impairment Severity Influence Ipsilateral Performance?

In this cross-sectional study, we evaluated post-stroke ipsilesional (less affected) upper limb aiming movement in individuals whose strokes were either 2-5 months (n = 16) or >6 months (n = 17) prior to our testing; we also compared both stroke groups to a control group of healthy individuals (n = 14). We evaluated the participants' level of movement impairment in the contralateral upper limb from the site of the cerebrovascular lesion as an indicator of the severity of the participants' impairment. Participants were asked to move a stylus on a tablet with their ipsilesional upper limb according to a visual stimulus seen on a monitor. Those who had experienced more recent strokes showed poorer movement planning and execution, regardless of their impairment level. Since the stroke occurred, the amount of time was significantly associated with the ipsilesional aiming movement, and improvement over time brought performance levels closer to that of healthy controls.

Differential features of early childhood motor skill development and working memory processing: evidence from fNIRS

Objective

The study investigated the differential characteristics associated with motor skill development and working memory processing during early childhood, thereby providing insights for understanding motor learning and cognitive development in young children.

Methods

In total, 101 preschool children (age: 4-6 years) were recruited for this study. The motor skill development level and the working memory capacity of the children were assessed using the MOBAK Motor Development Assessment Scale and a block task paradigm, respectively. Functional near-infrared spectroscopy brain imaging technology was used to monitor hemodynamic signals in the prefrontal cortex (PFC) of the children while they completed different memory tasks. MATLAB software and the Homer2 plugin were used to calculate the oxygenated hemoglobin (Oxy-Hb) concentration in relevant brain regions during the tasks.

Results

(1) The low motor skill group exhibited significantly lower accuracy during the three-memory load condition than during the two-memory load condition. Under both two-memory and three-memory load conditions, the high motor skill group exhibited significantly higher accuracy than the low motor skill group. (2) Significant differences in the Oxy-Hb concentration were observed in the left dorsolateral PFC (L-DLPFC), and right and left triangular part of the Broca's area (R-PTBA and L-PTBA, respectively) between the two memory difficulty levels for the high motor skill group. The Oxy-Hb concentration was significantly higher during the three-memory load condition than during the two-memory load condition. Under the two-memory load condition, the high motor skill group exhibited significantly higher Oxy-Hb concentration in the L-DLPFC and L-PTBA regions than in the low motor skill group. Under the three-memory load condition, the high motor skill group exhibited significantly higher Oxy-Hb concentration in the L-DLPFC, R-PTBA, and L-PTBA regions than the low motor skill group.

Conclusion

A close association was observed between the motor skill levels and working memory in young children, with higher motor skill levels being associated with more pronounced brain activation patterns during working memory tasks.

A Single Application of Cerebellar Transcranial Direct Current Stimulation Fails to Enhance Motor Skill Acquisition in Parkinson's Disease: A Pilot Study

Parkinson's disease (PD) is a progressive neurodegenerative disorder that leads to numerous impairments in motor function that compromise the ability to perform activities of daily living. Practical and effective adjunct therapies are needed to complement current treatment approaches in PD. Transcranial direct current stimulation applied to the cerebellum (c-tDCS) can increase motor skill in young and older adults. Because the cerebellum is involved in PD pathology, c-tDCS application during motor practice could potentially enhance motor skill in PD. The primary purpose was to examine the influence of c-tDCS on motor skill acquisition in a complex, visuomotor isometric precision grip task (PGT) in PD in the OFF-medication state. The secondary purpose was to determine the influence of c-tDCS on transfer of motor skill in PD. The study utilized a double-blind, SHAM-controlled, within-subjects design. A total of 16 participants completed a c-tDCS condition and a SHAM condition in two experimental sessions separated by a 7-day washout period. Each session involved practice of the PGT concurrent with either c-tDCS or SHAM. Additionally, motor transfer tasks were quantified before and after the practice and stimulation period. The force error in the PGT was not significantly different between the c-tDCS and SHAM conditions. Similarly, transfer task performance was not significantly different between the c-tDCS and SHAM conditions. These findings indicate that a single session of c-tDCS does not elicit acute improvements in motor skill acquisition or transfer in hand and arm tasks in PD while participants are off medications.

A 6-Week Badminton-Based Movement Intervention Enhances Fundamental Movement Skills and Physical Fitness in Saudi Boys and Girls

This study examined the short (pre-post) and longer-term (post to 10 weeks post) effects of the Badminton World Federation (BWF) Shuttle Time program on fundamental movement skills (FMS) and physical fitness in Saudi boys and girls. Seventy-six children aged 9-11 years (44 boys, 32 girls; mean ± SD = 10.2 ± 0.9 years) undertook twice weekly Shuttle Time sessions for 6 weeks. Pre, post, and 10 weeks post, FMS was measured using the test of gross motor development 3 and physical fitness was measured via 10 m sprint speed, standing long jump, seated medicine ball throw, and a 6 min walk test (6MWT). There were significant improvements in FMS from pre to post (p = 0.0001) and post to 10-weeks post (p = 0.0001) for both boys and girls. Girls demonstrated a significantly greater magnitude of change in FMS. For 10 m sprint time, seated medicine ball throw, standing long jump, and 6MWT performance, both boys and girls significantly improved from pre-10 weeks post (all p = 0.001). The magnitude of change was greater pre to 10-weeks post for girls for the seated medicine ball throw, but was greater for boys for the standing long jump and 6MWT. In terms of practical applications, the BWF Shuttle Time program is feasible for administration in the Saudi context and is beneficial in developing FMS and fitness for Saudi children aged 8-12 years.

A developmental account of the role of sequential dependencies in typical and atypical language learners

The Gerken lab has shown that infants are able to learn sound patterns that obligate local sequential dependencies that are no longer readily accessible to adults. The Goffman lab has shown that children with developmental language disorder (DLD) exhibit deficits in learning sequential dependencies that influence the acquisition of words and grammar, as well as other types of domain general sequences. Thus, DLD appears to be an impaired ability to detect and deploy sequential dependencies over multiple domains. We meld these two lines of research to propose a novel account in which sequential dependency learning is required for many phonological and morphosyntactic patterns in natural language and is also central to the language and domain general deficits that are attested in DLD. However, patterns that are not dependent on sequential dependencies but rather on networks of stored forms are learnable by children with DLD as well as by adults.

Visual skills essential for rugby

Background

Keen vision is one of the most important qualities required of athletes. It enables players to perform sports-related drills and apply decision-making skills. To accurately measure the visual ability of athletes, it is important to first identify the variety of visual skills involved in the particular sport. The objectives of this novel review are to identify the most important visual skills required for rugby, and to create a reference point for further studies to include visual skills essential to rugby players.

Methods

We conducted an electronic search with various combinations of relevant keywords using the following databases: Sport Discuss, Ovid's Evidence-Based Medicine Reviews, PubMed/MEDLINE, Current Contents, Science Direct, the National Research Council's Canada Institute for Scientific and Technical Information, Cochrane Database of Systematic Reviews, Google Scholar, and international electronic catalogues to assess the scientific literature related to the visual skills required for rugby. Only the records published in English were included. We extracted data on the relationship between vision and match performance, the defined problem or purpose of the study, and the inclusion of theoretical definitions of tactical behaviors.

Results

Our search yielded 80 records, 51 of which fulfilled the inclusion criteria. The most important visual skills in rugby are classified based on whether they meet the requirements for visual hardware or visual software skills. Visual hardware skills include visual acuity, depth perception, fusion flexibility, and contrast sensitivity; visual software skills include eye tracking, hand-eye coordination, eye focusing, peripheral vision, speed and span of recognition, visual response time, and visual memory.

Conclusions

Rugby players must use both visual hardware and software skills to reliably observe their teammates' positions, understand their opponents' actions and tactics, handle the ball, analyze the immediate circumstances, and anticipate what will occur. Further studies are needed to verify the significance of each visual skill in actual competition to determine a relationship between vision and the results of a championship.

Insights into motor memory interference among experts and competent individuals

Memory interference can arise when multiple motor skill tasks are learned. A study by Nepotiuk and Brown (Nepotiuk AH, Brown LE. J Neurophysiol 128: 969-981, 2022) demonstrated that the susceptibility of motor memory to interference differs depending on expertise, using a vegetable-chopping task. The authors suggest that the motor memories of expert chefs and competent home cooks are organized differently. This Neuro Forum article offers an alternative explanation for their results and provides insights into motor memory processing in both experts and competents.

Training of novice surgeons using dynamic computer assisted dental implant surgery: An exploratory randomized trial

BACKGROUND

Dynamic Computer Assisted Implant Surgery (CAIS) systems have been shown to improve accuracy of implant placement, thus training in the use of such systems is becoming increasingly important. There is a scarcity of research on how to implement dynamic CAIS training in the settings of postgraduate university education.

PURPOSE

To determine the effectiveness of two modes of CAIS training programs on motor skill acquisition of novice surgeons.

MATERIALS AND METHODS

Thirty-six postgraduate students without experience in dynamic CAIS systems were randomly assigned to a distributed training program (3 training sessions over 3 days) or a massed training (3 training sessions over the same day). A post-test involving the placement of one implant was conducted for both groups, 7 days after completion of the training. Surgical time and implant accuracy were recorded and analyzed, using independent t-tests, with 0.05 significant level.

RESULTS

Both groups reached the accuracy benchmarks expected by current standards in the use of CAIS. No significant differences with regards to accuracy were found between the groups, but a trend was documented favoring performance of distributed (mean difference-0.4, 95% confidence interval-0.7-0.1) in the accuracy at platform level. Distributed training students performed faster than massed for the third trial (mean difference-95.0, 95% confidence interval-178.8 to -11.2).

CONCLUSIONS

Novice students reached the accuracy benchmarks with the use of CAIS through both a massed and a distributed training program, while there was a strong but marginally not significant trend for higher accuracy in the distributed group. Students who received the training in the distributed format over the process of different days, performed faster. Trial registered in Thai Clinical Trials Registry: https://www.thaiclinicaltrials.org/show/TCTR20230109002. This clinical trial was not registered prior to participant recruitment and randomization.

Participating in a School-Integrated Daily Exercise Program Improves Motor Performance Significantly in School-Children

Children's sedentary time has increased, while daily physical activity and motor performance have decreased. We evaluated an integrated school-based exercise program by assessing changes in motor skills after one year and comparing these changes to children who did not participate. We included 303 children from five schools in this longitudinal study and assigned them either to the exercise group (EG; n = 183 with daily exercise program) or the waiting group (WG; n = 120). Motor skills were assessed at baseline and after one year. Mixed modeling was used to analyze inter-group differences of change in motor skills and to determine the effect of sex, age group, and weight status. EG improved more strongly than WG for sprint, side jumps (both p = 0.017), stand and reach (p = 0.012), and ergometry (p ≤ 0.001) when compared to WG. Girls improved more strongly in the sit-ups than boys, second graders more than fifth graders in the backwards balance and the ergometry, and non-overweight children more in the standing long jump than overweight children. The exercise program is effective in increasing motor skills and physical fitness. Girls were not disadvantaged, and overweight children profited as much as their non-overweight peers in all categories but one.

Effects of positive social comparative feedback on motor sequence learning and performance expectancies

Introduction

Positive social comparative feedback indicates to the learner that they are performing better than others. While this type feedback supports motor skill learning in some tasks, the effect of social comparative feedback on implicit motor sequence learning remains unknown. The aim of this study was to determine the effect of positive social comparative feedback on the learning of and expectancies for a motor sequence task.

Methods

Forty-eight individuals practiced a joystick-based sequence task and were divided into three feedback groups: CONTROL (no performance feedback), RT ONLY (response time only feedback), and RT+POS (response time plus positive social comparison). Participants attended sessions on two consecutive days: Day 1 for repetitive motor practice/skill acquisition and Day 2 for retention testing. Performance related expectancies, like perceived competence, were measured before and after motor practice on Day 1 and at retention on Day 2.

Results

While all groups improved with practice, the CONTROL group showed better overall performance/learning (faster response times) compared with the RT ONLY group. Despite similar response times, the RT+POS showed higher peak velocities than the RT ONLY group. Overall, the RT+POS and CONTROL demonstrated increases in perceived competence while the RT ONLY group did not.

Discussion

The results of this study suggest that feedback content is an important consideration during motor practice sessions since feedback without context (RT ONLY) may be detrimental to motor sequence learning. The results also suggest that, if providing performance related feedback during practice of a skill that relies on implicit sequence learning processes, comparative context may be necessary for enhancing expectancies and supporting.

Delayed Formation of Neonatal Reflexes and of Locomotor Skills Is Associated with Poor Maternal Behavior in OXYS Rats Prone to Alzheimer's Disease-like Pathology

Postnatal brain development is characterized by high plasticity with critical windows of opportunity where any intervention may positively or adversely influence postnatal growth and lead to long-lasting consequences later in life. Poor maternal care is among these interventions. Here, we found that senescence-accelerated OXYS rats prone to an Alzheimer's disease-like pathology are characterized by more passive maternal behavior and insufficient care for pups as compared to control (Wistar) rats. OXYS pups demonstrated a delay in physical development (of auricle detachment, of emergence of pelage and incisors, of eye opening, and of vaginal opening in females) and late manifestation of reflexes and locomotor skills. All observed behavioral abnormalities are connected either with poor coordination of limbs' movements or with a decrease in motivation and development of depression-like behavior. It is possible that their manifestations can be promoted by the features of maternal behavior of OXYS rats. Overall, these early-life events may have long-lasting consequences and contribute to neurodegeneration and development of the Alzheimer's disease-like pathology later in life.

The Effect of 12-Weeks Recreational Football (Soccer) for Health Intervention on Functional Movement in Older Adults

There is growing evidence that recreational football offers health benefits for older adults and an important pathway for physical activity for older adult groups. Despite anecdotal evidence that recreational football is beneficial for older adults, no empirical data are available to support this assertion. This study addressed this issue and examined the effects of a 12-week recreational football intervention on the functional fitness of older adults. Using a pre-post case-control design, thirteen males, aged 61-73 years (mean age ± SD = 66 ± 4 years) undertook a twice-weekly, 12-week recreational football for health intervention, and were matched with a control group, comprising thirteen males, aged 62-78 years (mean age ± SD = 66 ± 4 years) who maintained their typical exercise habits during the intervention period. Pre- and postintervention, participants underwent assessment of functional fitness, using the Rikli and Jones functional fitness battery as well as an assessment of body fatness, via bioelectrical impedance analysis and dominant handgrip strength using handgrip dynamometry. Results from a series of 2 (pre-post) X 2 (intervention vs. control) repeated-measures ANOVAs indicate significant pre-post X group interactions for the 30-second chair stand (p = 0.038, Pƞ² = 0.168), 8-foot timed up and go (p = 0.001, Pƞ² = 0.577) and 6 min walk test (p = 0.036, Pƞ² = 0.171). In all cases, performance improved significantly after the intervention for the football intervention group but not the control group. There were no significant differences in the 30 s arm curl test or dominant handgrip strength (p > 0.05). There was a non-significant trend (p = 0.07, Pƞ² = 0.127) towards a pre-post X group interaction for body fatness, showing a decreased percent body fat for the intervention group over the control group. The results of the present study demonstrate the utility of recreational football as a physical activity intervention in older adults to improve functional movement.

Control becomes habitual early on when learning a novel motor skill

When people perform the same task repeatedly, their behavior becomes habitual, or inflexible to changes in the goals or structure of a task. While habits have been hypothesized to be a key aspect of motor skill acquisition, there has been little empirical work investigating the relationship between skills and habits. To better understand this relationship, we examined whether and when people's behavior would become habitual as they learned a challenging new motor skill: maneuvering an on-screen cursor using a non-intuitive bimanual mapping from hand to cursor position. After participants practiced using this mapping for up to ten days, we altered the mapping between the hands and the cursor to assess whether participants could flexibly adjust their behavior or would habitually persist in performing the task the way they had originally learned. We found that participants' behavior became habitual within two days of practice, at which point they were still relatively unskilled. Further practice led to improved skill but did not alter the strength of habitual behavior. These data demonstrate that motor skills become habitual after relatively little training, but can nevertheless further improve with practice. We suggest that building habits early in learning may be a crucial step in acquiring new motor skills.

Effects of a blended classroom-based intervention on aerobic fitness, motor skills, inhibition, and daytime sleepiness among Hong Kong children

In response to the all-round development of primary school children, this study aimed to evaluate the effectiveness of a blended intervention program on children's health-related outcomes of aerobic fitness, motor skills, inhibition and daytime sleepiness in classroom settings. Three experimental conditions include: (1) the "Stand + Move" group combining sit-stand desks and physical activity (PA) recess, (2) "Move" group with PA recess only, and (3) Control group (CG; normal class schedule). A total of 64 primary school children (37.5% girls and 62.5% boys, M [SD] = 9.6 [0.61], BMI mean = 17.0 ± 3.0) participated in all assessments, including aerobic fitness, motor skills, inhibitory control, and daytime sleepiness. The baseline data collection starts from January 2019, with the intervention lasting for 13 weeks and followed by post-intervention and follow up tests conducted in July and October 2019. There was a significant interaction effect on aerobic fitness [F _(2,76) = 10.62, p < 0.001, η² = 0.22] after the intervention period, whereas no significant interaction was observed for other variables. Significant main effects were observed in aerobic fitness (pre - post: -11.75 and -7.22) for both experimental groups, with the blended group showing greater improvements immediately post the test, while motor skills only showed a significant increase at the three-month follow-up, with the greatest increase in the blended group (pre-follow-up: -2.50). For inhibition control and daytime sleepiness, better improvements were shown for the experimental groups than for the control group. The blended designed intervention, by incorporating multiple components as an innovative strategy to reconstruct children's traditional classroom environment in Hong Kong, has demonstrated improved physical and psychological development of school children.

Clinical trial registration

ChiCTR, ChiCTR2000035038. Registered 29 July 2020 - Retrospectively registered. http://www.chictr.org.cn/hvshowproject.aspx?id=46038.

Treatment preference changes after exposure to treatment in adults with chronic low back pain

BACKGROUND

Patients' pretreatment preferences can influence outcomes of nonpharmacologic treatments for musculoskeletal pain. Less is known about how patients' treatment preferences change following exposure to treatment.

OBJECTIVE

To examine the effect of exposure to treatment and change in disability and pain on treatment preference ratings of two exercise-based treatments for people with chronic low back pain (LBP).

DESIGN

Secondary analysis of a subsample of participants from a randomized clinical trial.

SETTING

Academic research setting.

PARTICIPANTS

Individuals with chronic LBP (n = 83).

INTERVENTIONS

6 weekly sessions of motor skill training (MST) or strength and flexibility exercise (SFE).

MAIN OUTCOME MEASURES

Prior to treatment, participants completed a treatment preference assessment measure (TPA) describing MST and SFE. Participants rated four attributes (effectiveness, acceptability/logicality, suitability/appropriateness, convenience) of each treatment on a 5-point Likert scale (0-4) with higher scores indicating higher ratings. An overall preference rating was calculated as the mean of the attribute ratings. The TPA was administered 12 months post treatment to reassess participants' ratings of the treatment they received.

RESULTS

Participants who received MST rated their preference for MST higher 12 months post treatment and participants who received SFE rated their preference for SFE lower. Smaller improvements (to worsening) in pain were associated with a reduction in preference ratings in the SFE group, whereas the MST group generally increased their ratings regardless of pain. Changes in disability were not related to changes in preference ratings.

CONCLUSIONS

Participants changed their preference ratings of two exercise-based treatments for LBP after exposure to the treatment. Participants who received the less familiar MST viewed this treatment more favorably 12 months post treatment, and this change was less contingent on changes in disability/pain than for participants in the SFE group. Assessing preference ratings at various times during treatment is crucial to understand a person's preference for and perceptions of a treatment.

A Review and Meta-Analysis of Interactive Metronome Training: Positive Effects for Motor Functioning

Interactive metronome training may be effective for improving motor performances through timing. In this systematic review and meta-analysis, 18 prospective studies met our eligibility criteria, and we summarized the effects of interactive metronome training protocols on motor functioning. We estimated effect sizes by quantifying differences in altered motor functions between participants in interactive metronome training and control groups. Two additional subgroup analyses determined whether the positive effects on motor function improvements were different among (a) three types of participants (i.e., athletes, healthy individuals, and patients with neurological disorders) and (b) two different training protocols (i.e., interactive metronome training only and interactive metronome training combined with an additional motor program). Random-effects model meta-analysis revealed moderate positive effects of interactive metronome training on motor function, with interactive metronome treatment effects significant across athletes, healthy individuals, and patients with neurological disorders. Interactive metronome training combined with additional motor programs showed comparable effects to those obtained after interactive metronome training alone. These findings suggest motor improvement benefits to strengthening or capitalizing on an individual's motor timing.

High Challenge Exercise and Learning Safe Landing Strategies among Community-Dwelling Older Adults: A Randomized Controlled Trial

There is limited research on optimal exercise programs that effectively decrease falls and fall-related injuries in older populations. This randomized controlled trial (RCT) aimed to explore the effects of a 12-week Judo4Balance program on falling techniques, physical and psychological functions, health status, and physical activity levels among 200 community-dwelling older adults (79% women and 21% men) with a mean age of 72 years. The 200 participants were randomly allocated for the Judo4Balce program (n = 100) or control group (n = 100). The RCT intervention started in mid-January 2020 and was abruptly interrupted because of the COVID-19 pandemic. A restart of the RCT was initiated in September 2021, and the 12-week intervention was offered to two groups. This study reports the results from three points of assessment: baseline, 20-month follow-up, and 12-week postintervention. At 20 months follow-up, the control group had significantly decreased physical activity levels (summer p = 0.002 and winter p = 0.003); similar changes were not seen in the exercise group. In the exercise group, learning falling techniques in 6−9 weeks led to sustained fall competence at 20 months follow-up. Further, significant improvements in physical function (exercise group p = 0.009 and control group p < 0.001) and learning falling techniques (p < 0.001 for both groups) were noted in both groups after the 12-week intervention. This effective, supervised, group-based, high-challenge multicomponent exercise program needs to be further evaluated for possible impact on falls and fall-related injuries.

High school basic life support training: Is the trainer's experience of cardiopulmonary resuscitation in the actual setting important? A randomized control trial

BACKGROUND

Although basic life support (BLS) has been taught in school by a variety of professionals, it is still unclear that, whether the instructor's previous cardiopulmonary resuscitation (CPR) experience is an important factor. This study aimed to compare the effect of BLS training, based on trainer experience in actual situations, on knowledge and skills of secondary high school students.

MATERIALS AND METHODS

In this randomized controlled trial, 150 high school students were selected based on the inclusion criteria and then assigned into two groups, (76 in Group A), and (74 in Group B) randomly. Both groups were trained according to adult BLS: 2020 American Heart Association guidelines on mannequins in three 60 min in-person training sessions. The knowledge and skill scores were measured for both groups before, immediately, and 1 month after intervention by a questionnaire. Data were analyzed by the SPSS software version 22, using Chi-square, Mann-Whitney U, repeated-measure ANOVA tests, and statistically modeling at a significance level of 0.05.

RESULTS

There were no significant differences between groups regarding demographic characteristics. The knowledge and skill scores in both groups increased significantly compared to baseline immediately and 1 month after the intervention (P = 0.001). However, there was no significant difference in knowledge scores between groups (P = 0.076(. However, at the immediacy and 1 month after the intervention, the skill score in "Group A" was significantly higher than the "Group B" (P = 0.001).

CONCLUSIONS

The trainer's experience of CPR in the actual setting in the transfer of BLS knowledge is not important, but it improved Student's BSL skill acquisition score.

Pulling the Trigger: The Effect of a 5-Minute Slow Diaphragmatic Breathing Intervention on Psychophysiological Stress Responses and Pressurized Pistol Shooting Performance

This study examined the effect of slow diaphragmatic breathing on psychophysiological stress responses and pressurized performance. Sixty-seven participants (40 female; Mage = 20.17 ± 2.77 years) were randomly assigned to either a diaphragmatic-breathing, paced-breathing, or control group. Participants completed a nonpressurized shooting task and then received instructions about a pressurized version. Next, the diaphragmatic group was told to breathe at 6 breaths/min, the paced group at 12 breaths/min, and the control group received no instructions. Following a 5-min intervention period, participants completed the pressurized task while performance was assessed. Psychophysiological stress responses (e.g., cognitive anxiety, heart rate) were recorded throughout. Results revealed that diaphragmatic breathing had mixed effects on stress responses, with some unaffected (e.g., heart rate) and others reduced (e.g., cognitive anxiety), and little effect on performance. Findings suggested that slow diaphragmatic breathing might not aid pressurized performance but could benefit psychological stress responses.

The Influence of Transcranial Direct Current Stimulation on Shooting Performance in Elite Deaflympic Athletes: A Case Series

Transcranial direct current stimulation (tDCS) has been shown to improve motor learning in numerous studies. However, only a few of these studies have been conducted on elite-level performers or in complex motor tasks that have been practiced extensively. The purpose was to determine the influence of tDCS applied to the dorsolateral prefrontal cortex (DLPFC) on motor learning over multiple days on 10-m air rifle shooting performance in elite Deaflympic athletes. Two male and two female elite Deaflympic athletes (World, European, and National medalists) participated in this case series. The study utilized a randomized, double-blind, SHAM-controlled, cross-over design. Anodal tDCS or SHAM stimulation was applied to the left DLPFC for 25 min with a current strength of 2 mA concurrent with three days of standard shooting practice sessions. Shooting performance was quantified as the points and the endpoint error. Separate 2 Condition (DLPFC-tDCS, SHAM) × 3 Day (1,2,3) within-subjects ANOVAs revealed no significant main effects or interactions for either points or endpoint error. These results indicate that DLPFC-tDCS applied over multiple days does not improve shooting performance in elite athletes. Different stimulation parameters or very long-term (weeks/months) application of tDCS may be needed to improve motor learning in elite athletes.

The Effects of Virtual Reality Nonphysical Mental Training on Balance Skills and Functional Near-Infrared Spectroscopy Activity in Healthy Adults

CONTEXT

Athletic skills such as balance are considered physical skills. However, these skills may not just improve by physical training, but also by mental training. The purpose of this study was to investigate the effects of mental training programs on balance skills and hemodynamic responses of the prefrontal cortex.

DESIGN

Randomized controlled trial.

METHODS

Fifty-seven healthy adults (28 females, 29 males), aged between 18-25 years, participated in this study. Participants were randomly assigned to 3 groups: virtual reality mental training (VRMT) group, conventional mental training (CMT) group, and control group. The training program included action observation and motor imagery practices with balance exercise videos. The VRMT group trained with a VR head-mounted display, while the CMT group trained with a non-immersive computer screen, for 30 minutes, 3 days per week for 4 weeks. At baseline and after 4 weeks of training, balance was investigated with stabilometry and Star Excursion Balance Test (SEBT). Balance tests were performed with simultaneous functional near-infrared spectroscopy (fNIRS) imaging to measure prefrontal cortex oxygenation.

RESULTS

For the stabilometry test, at least 1 variable improved significantly in both VRMT and CMT groups but not in the control group. For SEBT, composite reach distance significantly increased in both VRMT and CMT groups but significantly decreased in the control group. For separate directional scores, reach distance was significantly increased in both mental training groups for nondominant leg posterolateral and posteromedial directions, and dominant leg posterolateral direction, while nondominant posteromedial score was significantly increased only in the VRMT group. Between-group comparisons showed that dominant leg posteromedial and posterolateral score improvements were significantly higher than control group for both mental training groups, while nondominant leg improvements were significantly higher than control group only for the VRMT group. The fNIRS oxyhemoglobin levels were not significantly changed during stabilometry tests. However, oxyhemoglobin levels significantly reduced only in the control group during SEBT.

CONCLUSIONS

Our findings suggest that both mental training interventions can significantly improve balance test results. Additionally, VRMT may have some advantages over CMT. These findings are promising for the use of mental training in prevention and rehabilitation for special populations such as athletes and older adults.

The Effects of Virtual Reality Nonphysical Mental Training on Coordination and Skill Transfer in Healthy Adults

CONTEXT

Mental training is a promising method to improve motor skills. However, transfer of these improvements to different skills or functional activities is still unclear. The purpose of this study was to investigate the effects of mental balance training programs on motor coordination and skill transfer.

DESIGN

Randomized controlled trial.

METHODS

Fifty-seven healthy adults (28 females and 29 males) aged between 18 and 25 years participated in this study. Participants were randomly assigned to 3 groups: virtual reality (VR) mental training group, conventional mental training group, and control group. The training program included action observation and motor imagery practice with balance exercise videos. The VR mental training group trained with a VR head-mounted display and the conventional mental training group trained with a nonimmersive computer monitor for 30 minutes, 3 days per week, for 4 weeks. Coordination skills were tested with 2 separate custom-made obstacle course tests (OCT-1 and OCT-2). OCT tests included crouching, turning, leaning, stepping over, changing direction, walking on various surfaces, or using repeated hand and arm movement tasks. OCT-1 was used to investigate the effects of mental exercises on coordination skills, and OCT-2 to investigate transfer effects for novel tasks. Test time (total and corrected) and error types (minor, major, and total) were recorded. Touching an obstacle without changing its position was classified as a minor error, and changing its position was a major error.

RESULTS

OCT-1 test time and number of errors significantly decreased in the VR mental training and conventional mental training groups, but not in the control group. The number of minor errors was only decreased in the VR mental training group. For OCT-2, total and corrected time were not significantly different between the groups. However, both training groups were significantly superior to the control group for all types of errors.

CONCLUSIONS

Our findings suggest that both training interventions can significantly improve coordination and skill transfer test results. In addition, VR mental training may have some advantages over conventional mental training. These findings are promising for the use of mental training for prevention and rehabilitation in special populations.

Real-Life Social-Skills Training and Motor-Skills Training in Adults With Autism Spectrum Disorder: The Con-Tatto Project Walking Down the Francigena Route

Autism spectrum disorder (ASD) is a neurodevelopmental disorder with an early onset and a genetic and epigenetic component. ASD is characterized by deficits in socio-emotional reciprocity, impaired verbal and non-verbal communication skills, and specific difficulties in developing and maintaining adequate social relationships with peers. Indeed, restricted, repetitive patterns of behavior, interests, or activities are required by DSM-5 diagnostic criteria. Autistic people usually need an unchanging environment (or in any case predictable and stable) and may have hypo- or hyper-sensitivity to sensory inputs. The onset of clinical symptoms occurs during the early years of life. Social skills competence is a significant therapeutic aim to be pursued when addressing ASD core symptoms. Several considerable motor difficulties (87%) in people with autism spectrum disorder in adulthood have been found. The Con-tatto project developed a project addressing social, physical, and mental health difficulties in real-life walking down the Francigena route for 9 days with 12 autistic people, by (1) Implementing daily sessions of social skills training program whose abilities were addressed to be immediately generalized and used throughout the day. (2) Educational movement and walking activity programs were led by a fitness coach. (3) The creation of walking peers' social community with a strong and relevant impact on adults with ASD social life respecting every person's individuality. (4) Provision of social reinforcers to reduce the stigma of people with autism and the experienced perception of low self-esteem, especially when they are bullied.

Functional Training Focused on Motor Development Enhances Gross Motor, Physical Fitness, and Sensory Integration in 5-6-Year-Old Healthy Chinese Children

OBJECTIVE

Physical inactivity and sensory integration dysfunction are public health concerns among Chinese preschool children. The purpose of this study was to determine the efficacy of a novel functional training program focused on motor development for healthy children aged 5 to 6 years.

METHODS

A total of 101 healthy children aged 5 to 6 years in Tianjin were randomly assigned to the experimental group (N = 51), which received 12-week functional training featuring essential motor skills, whilst the control group (N = 50) continued with their kindergarten-based physical education curriculum. Test of Gross Motor Development-2, national physical fitness measurement, and sensory integration were evaluated before and after the intervention. Children's height, body weight, and the corresponding pre-intervention test scores were utilized as covariates to compare the post-intervention outcomes between the groups.

RESULTS

After the intervention, the experimental group scored considerably higher (P < 0.01) on the locomotor composite score, object control composite score, and overall gross motor score than the control group; the experimental group scored higher (P < 0.05) on the run, gallop, leap, stationary dribble, kick, striking a stationary ball, overhand throw, and underhand roll motor skill tests than the control group; the experimental group performed considerably better (P < 0.01) on the balance beam walking test and sit-and-reach test than the control group; and, the experimental group performed considerably better (P < 0.01) on the vestibular function, tactile defensiveness, and proprioception than the control group.

CONCLUSION

A 12-week functional training focused on motor development effectively enhanced gross motor, physical fitness, and sensory integration in 5-6-year-old healthy Chinese children.

The Effects of Cardiorespiratory and Motor Skill Fitness on Intrinsic Functional Connectivity of Neural Networks in Individuals with Parkinson's Disease

Background:

Studies in aging older adults have shown the positive association between cognition and exercise related fitness, particularly cardiorespiratory fitness. These reports have also demonstrated the association of high cardiorespiratory fitness, as well as other types of fitness, on the reversal of age-related decline in neural network connectivity, highlighting the potential role of fitness on age- and disease-related brain changes. While the clinical benefits of exercise are well-documented in Parkinson’s disease (PD), the extent to which cardiorespiratory fitness (assessed by estimated VO_2max testing) or motor skill fitness (assessed by the Physical Performance Test (PPT)) affects neural network connectivity in PD remains to be investigated. The purpose of this study was to explore the hypothesis that higher fitness level is associated with an increase in the intrinsic network connectivity of cognitive networks commonly affected in PD.

Methods:

In this cross-sectional resting state fMRI, we used a multivariate statistical approach based on high-dimensional independent component analysis (ICA) to investigate the association between two independent fitness metrics (estimated VO_2max and PPT) and resting state network connectivity.

Results:

We found that increased estimated VO_2max was associated with increased within network connectivity in cognitive networks known to be impaired in PD, including those sub-serving memory and executive function. There was a similar trend for high levels of PPT to be associated with increased within network connectivity in distinct resting state networks. The between functional network connectivity analysis revealed that cardiorespiratory fitness was associated with increased functional connectivity between somatosensory motor network and several cognitive networks sub-serving memory, attention, and executive function.

Conclusion:

This study provides important empirical data supporting the potential association between two forms of fitness and multiple resting state networks impacting PD cognition. Linking fitness to circuit specific modulation of resting state network connectivity will help establish a neural basis for the positive effects of fitness and specific exercise modalities and provide a foundation to identify underlying mechanisms to promote repair.

Effects of a Floor Hockey Intervention on Motor Proficiency, Physical Fitness, and Adaptive Development in Youths with Mild Intellectual Disabilities

This study examined the effects of a 12-week floor hockey training program on the motor proficiency, physical fitness, and adaptive development of youths with mild intellectual disabilities (IDs). A total of 54 youths with IDs were divided into two groups: a floor hockey exercise group (EG; n = 27; age, 16.59 ± 0.56 years) and a control group (CG; n = 27; age, 16.65 ± 0.63 years). The participants in the EG attended sessions of a floor hockey training program 3 times per week over a 12-week period. The CG group maintained their standard activities of daily living. The participants' scores on the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition, Brockport Physical Fitness Test, and traditional Chinese version of the teacher form of the Adaptive Behavior Assessment System, Second Edition, were obtained before and after the intervention. The results of the study indicate that the 12-week floor hockey training program significantly increased the participants' scores for most indicators of motor proficiency (p < 0.01), physical fitness (p < 0.01), and adaptive development (p < 0.01). The findings provide evidence that physical activity interventions focusing on floor hockey training are a viable therapeutic option for treating youths with IDs.

The Effect of Attentional Direction on Sub-Stages of Preparing for Motor Skill Execution Across Practice

While several empirical studies using dual-task methodology have examined the effect of attentional direction on motor skill execution; few have studied the effect of attentional direction on just the preparation phase of motor practice. In this study, via a keying sequence paradigm, we explored processing stages of preparation for a motor skill and disentangled the effect of attentional direction on various stages across practice. First, participants learned two keying sequences (three versus six keys). Then, they practiced the keying sequences in response to corresponding sequence labels under two block-wise alternating dual-task conditions. To dissect the preparation phase into sequence selection and sequence initiation stages, participants received varying amounts of preparation time (0, 300, 900 ms) before a starting signal instructed them to begin sequence execution. In each trial, a tone was paired with one of the three or six keypresses, and participants indicated either the keypress with which the tone was presented (skill-focused dual task) or the tone's pitch (extraneous dual task) after the sequence execution. We found that attentional direction affected only the sequence selection stage, not the sequence initiation stage. During early practice, compared to drawing attention away from execution, directing attention toward execution led to faster sequence selection. This advantage decreased with practice and vanished during late blocks of trials. Moreover, for the execution phase, relative to directing attention toward execution, drawing attention away from execution led to better performance of keying sequence execution across practice. Thus, attentional direction alone does not fully explain the difference between performance patterns at different skill levels in the dual-task literature; rather, types of motor skills and dual task difficulty levels may also drive performance differences.

Effects of Training Programs on Decision-Making in Youth Team Sports Players: A Systematic Review and Meta-Analysis

Background

The use of dedicated training programs for improving decision-making (DM) in team sports players has grown in the last several years. Approaches such as imagery training, video-based training, or game-based drills are some of the interventions used in youth players in order to improve DM. However, no systematic reviews or meta-analyses have been conducted to summarize the main evidence regarding the effects of these programs on the players and identify the magnitude of the effects compared to control groups.

Objective

This systematic review (with meta-analysis) was conducted to assess the effects of training programs on the DM of youth team sports players.

Data Sources

The data sources utilized were PubMed, PsycINFO, Scopus, SPORTDiscus, and Web of Science.

Study eligibility criteria

The criteria included the following: (i) youth (≤ 18 years old) team sports players with no restriction on sex or competitive level; (ii) players subjected to training programs to develop DM; (iii) control groups; (iv) pre–post outcomes related to tactical behavior, technical execution, reaction, and decision time; and (v) controlled trials.

Results

The database search initially identified 2497 titles. From these, six articles were eligible for the systematic review and meta-analysis. The results showed a significant beneficial effect of DM interventions on tactical behavior (ES = 1.12; p = 0.035; I² = 80.0%; Egger’s test p = 0.066), whereas no significant effect of DM interventions on technical execution was found (ES = 0.74; p = 0.180; I² = 69.1%; Egger’s test p = 0.873).

Conclusion

The DM interventions were significantly effective in improving tactical behavior in youth team sports players independently from the number of sessions to which players were exposed. In addition, DM interventions were significantly effective in improving technical execution. However, the results should be carefully interpreted due to the heterogeneity of the articles’ overall methodological quality. Future DM interventions should consider using combined approaches that allow players to develop both tactical behavior and technical execution.

Association between motor proficiency and oral health in people with intellectual disabilities

BACKGROUND

People with intellectual disabilities (IDs) may be at increased risk of developing periodontal diseases and dental caries due to poor oral hygiene. Our aim was to investigate motor proficiency factors associated with presence of visible plaque and gingival bleeding in people with IDs. We were particularly interested in the level of dependence, manual coordination and fine manual control of people with ID, as well as the level of exhaustion of the primary caregiver.

METHODS

In this cross-sectional study, 299 people with ID were evaluated for oral hygiene using the simplified Visible Plaque Index and for gum inflammation using the Gingival Bleeding Index. The Bruininks-Oseretsky Motor Proficiency Test assessed motor proficiency through fine manual control (fine motor integration and fine motor precision) and manual coordination (manual dexterity and upper limb coordination). The level of dependence was assessed by the Katz dependency index, and the caregiver was tested for exhaustion using the fatigue severity scale. Prevalence ratios [and 95% confidence intervals (CI)] were calculated using crude and adjusted Poisson regression with robust variance.

RESULTS

The exhaustion of the caregiver was associated positively to visible plaque [prevalence ratio (PR) = 1.36; 95% CI 1.06-1.65]. For gingival bleeding, people with IDs that had better fine motor integration (PR = 0.49; 95% CI 0.33-0.75) and precision (PR = 0.50; 95% CI 0.26-0.94), as well as manual dexterity (PR = 0.62, 95% CI 0.49-0.77), presented better results.

CONCLUSION

Poor oral hygiene and gum inflammation were associated with motor proficiency of people with IDs and caregivers' exhaustion. Interventions to improve the oral health of people with IDs should take into account such conditions.

The Myelin Content of the Human Precentral Hand Knob Reflects Interindividual Differences in Manual Motor Control at the Physiological and Behavioral Level

The primary motor cortex hand area (M1_HAND) and adjacent dorsal premotor cortex (PMd) form the so-called motor hand knob in the precentral gyrus. M1_HAND and PMd are critical for dexterous hand use and are densely interconnected via corticocortical axons, lacking a sharp demarcating border. In 24 young right-handed volunteers, we performed multimodal mapping to delineate the relationship between structure and function in the right motor hand knob. Quantitative structural magnetic resonance imaging (MRI) at 3 tesla yielded regional R1 maps as a proxy of cortical myelin content. Participants also underwent functional MRI (fMRI). We mapped task-related activation and temporal precision, while they performed a visuomotor synchronization task requiring visually cued abduction movements with the left index or little finger. We also performed sulcus-aligned transcranial magnetic stimulation of the motor hand knob to localize the optimal site (hotspot) for evoking a motor evoked potential (MEP) in two intrinsic hand muscles. Individual motor hotspot locations varied along the rostrocaudal axis. The more rostral the motor hotspot location in the precentral crown, the longer were corticomotor MEP latencies. “Hotspot rostrality” was associated with the regional myelin content in the precentral hand knob. Cortical myelin content also correlated positively with task-related activation of the precentral crown and temporal precision during the visuomotor synchronization task. Together, our results suggest a link among cortical myelination, the spatial cortical representation, and temporal precision of finger movements. We hypothesize that the myelination of cortical axons facilitates neuronal integration in PMd and M1_HAND and, hereby, promotes the precise timing of movements.

SIGNIFICANCE STATEMENT Here we used magnetic resonance imaging and transcranial magnetic stimulation of the precentral motor hand knob to test for a link among cortical myelin content, functional corticomotor representations, and manual motor control. A higher myelin content of the precentral motor hand knob was associated with more rostral corticomotor presentations, with stronger task-related activation and a higher precision of movement timing during a visuomotor synchronization task. We propose that a high precentral myelin content enables fast and precise neuronal integration in M1 (primary motor cortex) and dorsal premotor cortex, resulting in higher temporal precision during dexterous hand use. Our results identify the degree of myelination as an important structural feature of the neocortex that is tightly linked to the function and behavior supported by the cortical area.

Effects of Mental Fatigue in Total Running Distance and Tactical Behavior During Small-Sided Games: A Systematic Review With a Meta-Analysis in Youth and Young Adult's Soccer Players

Background: Mental fatigue can impact physical demands and tactical behavior in sport-related contexts. Small-sided games (SSGs) are often used to develop a specific sport-related context. However, the effects of mental fatigue on physical demands and tactical behaviors during soccer SSGs have not been aggregated for systematical assessment.

Objective: This systematic review (with a meta-analysis) was conducted to compare the effects of mental fatigue vs. control conditions in terms of the total running distance and tactical behavior of soccer players during SSGs.

Methods: The data sources utilized were PubMed, PsycINFO, Scielo, Scopus, SPORTDiscus, and Web of Science. The study eligibility criteria were established based on PICOS: (i) Population: healthy youth and young adult men soccer players with regular training practice and belonging to teams with regular competitions; (ii) Intervention: exposed to mental fatigue-induced protocols only before SSGs; (iii) Comparator: control conditions (passive or active not promoting mental fatigue) before SSGs; (iv) Outcomes: physical demands (total running distance) and tactical behavior (attacking behavior accuracy, pass decision-making accuracy, and space exploration index); (v) Study design: counterbalanced cross-over design; and (vi) only full-text and original articles written in English.

Results: The database search initially identified 111 titles. From those, six articles were eligible for the systematic review and meta-analysis. Results showed no significant effect of fatigue on total running distance (ES = 0.13; p = 0.307) and tactical behavior (ES = 0.56; p = 0.079).

Conclusions: A non-significant effect of mental fatigue on total running distance and tactical behaviors performed by soccer players during SSGs was found in this systematic review.

Effects of attentional focus on upper extremity motor performance in post stroke patients: A randomized pilot study

INTRODUCTION

To facilitate the command to the learner, therapist can use verbal cues for guidance: internal focus (own body) and external focus (consequence of movement in the environment).

OBJECTIVE

To examine the effects of different attentional focus on upper limb motor performance in post-stroke.

METHODS

Randomized controlled trial with 2 groups. Study realized at Integrated Clinic of the Faculty of Health Science at Trairi (Santa Cruz, Rio Grande do Norte, Brazil). Twelve participants allocated into 2 groups. Two motor tasks were used: task 1, reach-point; task 2, reach-grasp-fit, with the paretic extremity, using verbal commands directed by a trained therapist. In the first phase, Group 1 received commands with internal focus, while Group 2 was instructed with commands with external focus. After 1 week, the command type was changed between groups. The variables collected was movement time, velocity and number of peaks velocity.

RESULTS

Both attentional focus promoted significant differences in movement time and velocity, however, only Internal Focus provided significant results in both tasks of the same variables.

DISCUSSION

The benefits of 1 attentional focus on the other are not fully confirmed. However, not receiving any kind of attention guidance compromises motor performance. The results support the hypothesis that the benefits of the External Focus are accentuated when preceded by the Internal Focus.

CLINICAL TRIAL REGISTRATION

Research Ethics Committee of the Faculty of Helth Science at Trairi (Facisa - UFRN)- Number CAAE 2.625.609, approved on April 13, 2018; Brazilian Registry of Clinical Trials - RBR-4995cr approved on July 4, 2019 retrospectively registered (http://www.ensaiosclinicos.gov.br/rg/RBR-4995cr/).

Acceleration Gait Measures as Proxies for Motor Skill of Walking: A Narrative Review

In adults 65 years or older, falls or other neuromotor dysfunctions are often framed as walking-related declines in motor skill; the frequent occurrence of such decline in walking-related motor skill motivates the need for an improved understanding of the motor skill of walking. Simple gait measurements, such as speed, do not provide adequate information about the quality of the body motion's translation during walking. Gait measures from accelerometers can enrich measurements of walking and motor performance. This review article will categorize the aspects of the motor skill of walking and review how trunk-acceleration gait measures during walking can be mapped to motor skill aspects, satisfying a clinical need to understand how well accelerometer measures assess gait. We will clarify how to leverage more complicated acceleration measures to make accurate motor skill decline predictions, thus furthering fall research in older adults.

Corrigendum: Effectiveness of Physical Activity Intervention on ADHD Symptoms: A Systematic Review and Meta-Analysis

[This corrects the article DOI: 10.3389/fpsyt.2021.706625.].

Effectiveness of Physical Activity Intervention on ADHD Symptoms: A Systematic Review and Meta-Analysis

Objective: To assess the effectiveness of physical activity (PA) intervention on attention-deficit/hyperactivity disorder (ADHD)-related symptoms. Method: Studies that investigated PA intervention for ADHD-related symptoms were identified through searching PubMed, Web of Science, Cochrane Library, and Embase databases from inception through June 2021. Standardized mean difference (SMD) with 95% confidence interval (CI) was used to assess the effectiveness of PA intervention on improving ADHD-related symptoms. The meta-analyses were conducted using fixed-effect or random-effect models according to the heterogeneity of the studies. Results: Nine before-after studies (232 participants) and 14 two-group control studies (162 participants/141 controls) were included in this meta-analysis. Combined results for before-after studies indicated significant improvements on all studied ADHD-related symptoms (inattention: SMD = 0.604, 95% CI: 0.374-0.834, p < 0.001; hyperactivity/impulsivity: SMD = 0.676, 95% CI: 0.401-0.950, p < 0.001; emotional problems: SMD = 0.416, 95% CI: 0.283-0.549, p < 0.001; behavioral problems: SMD = 0.347, 95% CI: 0.202-0.492, p < 0.001). Meta-analyses for two-group control studies further confirmed that PA intervention significantly improved the inattentive symptom (SMD = 0.715, 95% CI: 0.105, 1.325, p = 0.022). Subgroup analyses suggested significant beneficial effect on inattention symptoms in children. Moreover, closed motor skills were beneficial for hyperactive/impulsive problems (SMD = 0.671, p < 0.001), while open motor skills were beneficial for attention problems (SMD = 0.455, p = 0.049). When excluding studies with combined medication, the studies in unmedicated participants in before-after studies still showed significant results in all studied ADHD-related symptoms as in the overall analysis. Given the limited sample size, the best frequency and intensity of PA intervention need further investigation. Conclusion: Our results suggested that PA intervention could possibly improve ADHD-related symptoms, especially inattention symptoms. Closed-skill and open-skill activities could be beneficial for hyperactivity/impulsivity and inattention symptoms, respectively. Further high-quality randomized clinical trials with large sample size are needed.

Altered Inferior Parietal Functional Connectivity is Correlated with Praxis and Social Skill Performance in Children with Autism Spectrum Disorder

Children with autism spectrum disorder (ASD) have difficulties perceiving and producing skilled gestures, or praxis. The inferior parietal lobule (IPL) is crucial to praxis acquisition and expression, yet how IPL connectivity contributes to autism-associated impairments in praxis as well as social-communicative skill remains unclear. Using resting-state functional magnetic resonance imaging, we applied independent component analysis to test how IPL connectivity relates to praxis and social-communicative skills in children with and without ASD. Across all children (with/without ASD), praxis positively correlated with connectivity of left posterior-IPL with the left dorsal premotor cortex and with the bilateral posterior/medial parietal cortex. Praxis also correlated with connectivity of right central-IPL connectivity with the left intraparietal sulcus and medial parietal lobe. Further, in children with ASD, poorer praxis and social-communicative skills both correlated with weaker right central-IPL connectivity with the left cerebellum, posterior cingulate, and right dorsal premotor cortex. Our findings suggest that IPL connectivity is linked to praxis development, that contributions arise bilaterally, and that right IPL connectivity is associated with impaired praxis and social-communicative skills in autism. The findings underscore the potential impact of IPL connectivity and impaired skill acquisition on the development of a range of social-communicative and motor functions during childhood, including autism-associated impairments.

Dexterity and technique in termite fishing by chimpanzees (Pan troglodytes troglodytes) in the Goualougo Triangle, Republic of Congo

Although the phenomenon of termite fishing by chimpanzees (Pan troglodytes) has historical and theoretical importance for primatology, we still have a limited understanding of how chimpanzees accomplish this activity, and in particular, about details of skilled actions and the nature of individual variation in fishing techniques. We examined movements, hand positions, grips, and other details from remote video footage of seven adult and subadult female chimpanzees using plant probes to extract Macrotermes muelleri termites from epigeal nests. Six chimpanzees used exclusively one hand (left or right) to grip the probe during termite fishing. All chimpanzees used the same repertoire of actions to insert, adjust, and withdraw the probe but differed in the frequency of use of particular actions. Chimpanzees have been described as eating termites in two ways—directly from the probe or by sweeping them from the probe with one hand. We describe a third technique: sliding the probe between the digits of one stationary hand as the probe is extracted from the nest. The sliding technique requires complementary bimanual coordination (extracting with one hand and grasping lightly with the other, at the same time). We highlight the importance of actions with two hands—one gripping, one assisting—in termite fishing and discuss how probing techniques are correlated with performance. Additional research on digital function and on environmental, organismic, and task constraints will further reveal manual dexterity in termite fishing.

‐

Using remote video footage from camera traps in Goualougo Triangle, Republic of Congo, we describe chimpanzees' manual actions, postures, and positions, and movements of the probe while they fished for termites in epigeal termite nests.

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Chimpanzees used diverse grips, with and without the thumb, and two hands—one gripping, one assisting—to handle the probe delicately and to move it precisely.

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We describe a new technique for recovering termites: sliding the probe between the digits of one stationary hand as the probe is extracted from the nest with the other hand, and a new action: oscillatory movements of the probe while it was inserted in the nest.

On the Issue of Developing Creative Players in Team Sports: A Systematic Review and Critique From a Functional Perspective

Driven by the practical goal of developing creative players, several approaches to training creativity have been proposed and underpinned by empirical studies in sport science. However, the scope of these studies encompasses various aspects, which have all been subsumed under the singular label of "creativity." Therefore, this systematic review aims to disentangle the pursued lines of thought in order to facilitate the derivation of well-grounded recommendations for sports practice. To this end, 38 studies are presented and characterized in terms of their underlying conceptualizations and measures of creativity. In most studies, creativity is conceptualized as a player's domain-specific divergent thinking (DT) ability, reflected by individual differences in the number, variety and originality of ideas he or she is able to generate in response to game situations. Empirical studies indicate that DT can be improved by practice. However, the critical assumption that an enhanced DT ability transfers to creative on-field actions has yet to be tested. On the basis of the reviewed literature, an alternative point of view is proposed. In line with a relational understanding of creativity and a functional approach to behavioral control, it is hypothesized that an enhanced repertoire of sensorimotor skills increases the probability for performing functional solutions that, within a specific social and cultural frame of reference, go beyond the expected and consequently appear creative to the observer. In the context of sports practice, the proposed conceptual re-orientation would then suggest, rather than seeking ways to improve players' DT ability, to target sensorimotor skills that allow players to perform a variety of task-solutions and thus to act less predictably to the opponent-or in other words, more creative.

An Acute Application of Cerebellar Transcranial Direct Current Stimulation Does Not Improve Motor Performance in Parkinson's Disease

Transcranial direct current stimulation of the cerebellum (c-tDCS) improves motor performance in young and old adults. Based on the cerebellar involvement in Parkinson’s disease (PD), c-tDCS could have potential to improve motor function in PD. The purpose was to determine the effects of c-tDCS on motor performance in PD while participants were on medications. The study was a randomized, double-blind, SHAM-controlled, between-subjects design. Twenty-two participants with PD were allocated to either a c-tDCS group or a SHAM group. All participants completed one experimental session and performed two motor tasks with their most affected hand in a Baseline condition (no stimulation) and an Experimental condition. The motor tasks were a visuomotor isometric precision grip task (PGT) and a rapid arm movement task (AMT). The primary dependent variables were force error and endpoint error in the PGT and AMT, respectively. There were no significant differences in force error or endpoint error in the Experimental condition between the c-tDCS and SHAM groups. These results indicate that an acute application of c-tDCS does not enhance motor performance in hand and arm tasks in PD. Longer-term c-tDCS application over multiple days may be needed to enhance motor function in PD.

The effect of instruction on motor skill learning

Many motor skills are learned with the help of instructions. In the context of complex motor sequences, instructions often break down the movement into chunks that can then be practiced in isolation. Thus, instructions shape an initial cognitive representation of the skill, which in turn guides practice. Are there ways of breaking up a motor sequence that are better than others? If participants are instructed in a way that hinders performance, how much practice does it take to overcome the influence of the instruction? To answer these questions, we used a paradigm in which participants were asked to perform finger sequences as fast and accurately as possible on a keyboard-like device. In the initial phases of training, participants had to explicitly remember and practice two- or three-digit chunks. These chunks were then combined to form seven 11-digit sequences that participants practiced for the remainder of the study. Each sequence was broken up into chunks in a way such that the instruction was either aligned or misaligned with the basic execution-level constraints. We found that misaligned chunk instruction led to an initial performance deficit compared with the aligned chunk instruction. Overall, instructions still influenced the temporal pattern of performance after 10 days of subsequent training, with shorter interpress intervals within a chunk compared with between chunks. However, for the misaligned instructed sequences, this temporal pattern was altered more rapidly, such that participants could overcome the induced performance deficit in the last week. At the end of training, participants found idiosyncratic, but interindividually stable, ways of performing each sequence.NEW & NOTEWORTHY Instructions often break down motor sequences into smaller parts, such that they can be more easily remembered. Here, we show that different ways of breaking down a finger sequence can subsequently lead to better or worse performance. The initial instruction still influenced the temporal performance pattern after 10 days of practice. The results demonstrate that the initial cognitive representation of a motor skill strongly influences how a skill is learned and performed.

Enhanced Performance Stabilization Increases Performance Variability in a Virtual Interception Task

Performing a motor task depends on the level of performance stabilization and movement control, and both aspects of motor behavior are related to motor learning (retention and transfer) and adaptation (predictable and unpredictable perturbations). Yet few studies have further investigated the underlying dynamics that may elicit these benefits. In this study, we investigated the effects of two levels of performance stabilization on motor performance and control while learning to intercept a virtual moving target. We randomly divided 40 participants of both sexes (M_age = 26.02 years, SD = 2.02) into a Stabilization Group (SG) and a Superstabilization Group (SSG). We considered the performance stabilized when a moving target was intercepted three times in a row and superstabilized when the same criterion was repeated six times. We analyzed outcome variables related to performance accuracy (absolute spatial error) and variability(coefficient of variation) and motor control (relative time to peak velocity-tPV% and its coefficient of variation) on both the first and last blocks of practice trials. Both groups showed comparable increases in performance accuracy from the first to the last block (p = .001, η_p² = 1.00), but SSG presented higher variability than SG (p = .05, η_p² = .70). Concerning motor control, both groups started the experiment with low tPV% and finished with comparably high tPV% and variability. Thus, although practicing two levels of performance stabilization led to similar performance accuracy and movement control, superstabilization resulted in higher performance variability with no loss of accuracy. Enhanced stabilization may increase the ability to adapt to environmental changes, but more research is needed to demonstrate this. These findings add to an understanding of the relationship between levels of performance stabilization and performance variability and may have implications for professional interventions (e.g. sports, rehabilitation) in considering the benefits of practice beyond performance stabilization.

Effect of prostheses on children with congenital upper limb deficiencies

BACKGROUND

Individual weaknesses in motor skills are a characteristic of children with congenital upper limb deficiencies. These weaknesses increase with age. In Japan, however, prosthetic prescription and subsequent rehabilitation approaches for children with upper limb deficiencies are insufficient and often delayed. This study aimed to elucidate whether rehabilitation approaches, including prostheses prescription and occupational therapy, improve these children's adaptive behaviors, especially their motor skills.

METHODS

The study included nine children, aged 0-6 years, with unilateral transradial or transcarpal upper limb deficiencies. We measured their adaptive behaviors and motor skills at the beginning of prosthetic therapy and after 1.5 years, using the Vineland Adaptive Behavior Scales - Second Edition.

RESULTS

The score for the motor skills domain was significantly lower than the median score of the domains at the beginning of prosthetic therapy. The motor skill weaknesses significantly improved after 1.5 years of prosthetic therapy.

CONCLUSIONS

Although children with congenital upper limb deficiencies have individual weaknesses in their motor skill behavior, it was shown that these weaknesses can be improved through rehabilitation approaches, including occupational and prosthetic therapies. Issuing the appropriate prostheses and implementing the appropriate training to use the prostheses for congenital upper limb deficiencies are reasonable and meaningful interventions to improve quality of life.

Association between body mass index, physical activity and motor competence in children: moderation analysis by different environmental contexts

BACKGROUND

Although the association between body mass index (BMI), physical activity (PA) and motor competence (MC) has been widely investigated, the influence of different environmental contexts is not well defined.

AIM

To analyse the relationship between BMI, PA and MC and the moderating role of the environmental context.

SUBJECTS AND METHODS

A cross-sectional study was performed with 668 children (318 boys) aged 5-7 years (north-eastern district - Brazil). MC (Körper koordination test fur Kinder; KTK), BMI and PA (parent reporting) were assessed. To classify three contexts of the environment a variable was created based on the presence of a sports court in school and/or environment for play or sports practice out of school. Multilevel mixed-effects linear regressions, interaction test and estimation of coefficients in moderation analysis were used.

RESULTS

BMI (β = -2.93; p < .01) and age (β = 19.02; p < .01) were associated, and PA was not associated (β = 0.07; p = .05) with MC. The strength of the association between BMI and MC changed based on the environmental contexts. The better the environment context the weaker the association between BMI and MC (β = -2.93, p < .01 to β = -2.38, p = .33 to β = 0.26, p = .94).

CONCLUSIONS

The association between BMI and MC is moderated by environmental contexts.