Kinematic Assessment of Fine Motor Skills in Children: Comparison of a Kinematic Approach and a Standardized Test

Deficits in fine motor skills have been reported in some children with neurodevelopmental disorders such as amblyopia or strabismus. Therefore, monitoring the development of motor skills and any potential improvement due to therapy is an important clinical goal. The aim of this study was to test the feasibility of performing a kinematic assessment within an optometric setting using inexpensive, portable, off-the-shelf equipment. The study also assessed whether kinematic data could enhance the information provided by a routine motor function screening test (the Movement Assessment Battery for Children, MABC). Using the MABC-2, upper limb dexterity was measured in a cohort of 47 typically developing children (7-15 years old), and the Leap motion capture system was used to record hand kinematics while children performed a bead-threading task. Two children with a history of amblyopia were also tested to explore the utility of a kinematic assessment in a clinical population. For the typically developing children, visual acuity and stereoacuity were within the normal range; however, the average standardized MABC-2 scores were lower than published norms. Comparing MABC-2 and kinematic measures in the two children with amblyopia revealed that both assessments provide convergent results and revealed deficits in fine motor control. In conclusion, kinematic assessment can augment standardized tests of fine motor skills in an optometric setting and may be useful for measuring visuomotor function and monitoring treatment outcomes in children with binocular vision anomalies.

Investigation of Camera-Free Eye-Tracking Glasses Compared to a Video-Based System

Technological advances in eye-tracking have resulted in lightweight, portable solutions that are capable of capturing eye movements beyond laboratory settings. Eye-tracking devices have typically relied on heavier, video-based systems to detect pupil and corneal reflections. Advances in mobile eye-tracking technology could facilitate research and its application in ecological settings; more traditional laboratory research methods are able to be modified and transferred to real-world scenarios. One recent technology, the AdHawk MindLink, introduced a novel camera-free system embedded in typical eyeglass frames. This paper evaluates the AdHawk MindLink by comparing the eye-tracking recordings with a research "gold standard", the EyeLink II. By concurrently capturing data from both eyes, we compare the capability of each eye tracker to quantify metrics from fixation, saccade, and smooth pursuit tasks-typical elements in eye movement research-across a sample of 13 adults. The MindLink system was capable of capturing fixation stability within a radius of less than 0.5∘, estimating horizontal saccade amplitudes with an accuracy of 0.04∘± 2.3∘, vertical saccade amplitudes with an accuracy of 0.32∘± 2.3∘, and smooth pursuit speeds with an accuracy of 0.5 to 3∘s, depending on the pursuit speed. While the performance of the MindLink system in measuring fixation stability, saccade amplitude, and smooth pursuit eye movements were slightly inferior to the video-based system, MindLink provides sufficient gaze-tracking capabilities for dynamic settings and experiments.

The effects of task difficulty on gaze behaviour during landing with visual flight rules in low-time pilots

Eye movements have been used to examine the cognitive function of pilots and understand how information processing abilities impact performance. Traditional and advanced measures of gaze behaviour effectively reflect changes in cognitive load, situational awareness, and expert-novice differences. However, the extent to which gaze behaviour changes during the early stages of skill development has yet to be addressed. The current study investigated the impact of task difficulty on gaze behaviour in low-time pilots (N=18) while they completed simulated landing scenarios. An increase in task difficulty resulted in longer fixation of the runway, and a reduction in the stationary gaze entropy (gaze dispersion) and gaze transition entropy (sequence complexity). These findings suggest that pilots' gaze became less complex and more focused on fewer areas of interest when task difficulty increased. Additionally, a novel approach to identify and track instances when pilots restrict their attention outside the cockpit (i.e., gaze tunneling) was explored and shown to be sensitive to changes in task difficulty. Altogether, the gaze-related metrics used in the present study provide valuable information for assessing pilots gaze behaviour and help further understand how gaze contributes to better performance in low-time pilots.

Path Configuration Complexity Affects Spatial Memory Span on the eCorsi Task but Does Not Influence Performance of a Concurrent Auditory Discrimination Task

Visuospatial working memory is often assessed using the Corsi block-tapping task where set size is used to estimate capacity. It is well established that characteristics of the Corsi task path configuration such as length, crossings, and angles influence recall accuracy suggesting that more complex path configurations increase the load on working memory. However, the interaction between set size and path configuration is not well understood. Here we used a secondary auditory task to probe if set size and path configuration impose a similar type of load on the system. Nineteen participants (age = 25.3 ± 3.9 years) performed a computerized version of the Corsi test either alone (single) or simultaneously with an auditory tone discrimination task (dual). The eCorsi task involved a set of simple (no crosses, shorter lengths, larger angles) or complex (>2 crosses, longer lengths, smaller angles) paths at set sizes of five to eight blocks. Results showed significantly lower recall accuracy for the complex compared to the simple paths (63.32% vs. 86.38%, p < 0.001) at all set sizes, regardless of task condition (single, dual). Auditory performance (accuracy and response time) was significantly lower in the dual compared to single task (85.34% vs. 99.67%, p < 0.001), but performance was not affected by the complexity of the eCorsi path configuration. These findings suggest that set size and path complexity impose a different type of load on the working memory system and may rely on different resources.

The role of binocular vision in the control and development of visually guided upper limb movements

Vision provides a key sensory input for the performance of fine motor skills, which are fundamentally important to daily life activities, as well as skilled occupational and recreational performance. Binocular visual function is a crucial aspect of vision that requires the ability to combine inputs from both eyes into a unified percept. Summation and fusion are two aspects of binocular processing associated with performance advantages, including more efficient visuomotor control of upper limb movements. This paper uses the multiple processes model of limb control to explore how binocular viewing could facilitate the planning and execution of prehension movements in adults and typically developing children. Insight into the contribution of binocularity to visuomotor control also comes from examining motor performance in individuals with amblyopia, a condition characterized by reduced visual acuity and poor binocular function. Overall, research in this field has advanced our understanding of the role of binocular vision in the development and performance of visuomotor skills, the first step towards developing assessment tools and targeted rehabilitation for children with neurodevelopment disorders at risk of poor visuomotor outcomes. This article is part of a discussion meeting issue 'New approaches to 3D vision'.

EEG reveals deficits in sensory gating and cognitive processing in asymptomatic adults with a history of concussion

OBJECTIVE

Individuals with a concussion history tend to perform worse on dual-tasks compared controls but the underlying neural mechanisms contributing to these deficits are not understood. This study used event-related potentials (ERPs) to investigate sensory gating and cognitive processing in athletes with and without a history of concussion while they performed a challenging dual-task.

METHODS

We recorded sensory (P50, N100) and cognitive (P300) ERPs in 30 athletes (18 no previous concussion; 12 history of concussion) while they simultaneously performed an auditory oddball task and a working memory task that progressively increased in difficulty.

RESULTS

The concussion group had reduced auditory performance as workload increased compared to the no-concussion group. Sensory gating and cognitive processing were reduced in the concussion group indicating problems with filtering relevant from irrelevant information and appropriately allocating resources. Sensory gating (N100) was positively correlated with cognitive processing (P300) at the hardest workload in the no-concussion group but negatively correlated in the concussion group.

CONCLUSION

Concussions result in long-term problems in behavioral performance, which may be due to poorer sensory gating that impacts cognitive processing.

SIGNIFICANCE

Problems effectively gating sensory information may influence the availability or allocation of attention at the cognitive stage in those with a concussion.

Gaze behaviour: A window into distinct cognitive processes revealed by the Tower of London test

The analysis of gaze behaviour during complex tasks provides a promising non-invasive method to examine how specific eye movement patterns relate to various aspects of cognition and action. Notably, the association between aspects of gaze behaviour and subsequent goal-directed action during high-level visuospatial problem solving remains elusive. Therefore, the current study comprehensively examined gaze behaviour using traditional and entropy-based gaze analyses in healthy adults (N = 27) while they performed the Freiburg version of the Tower of London task. Results demonstrated that both gaze analyses provided crucial temporal and spatial information related to planning, solution elaboration and execution. Specifically, gaze biases toward task-relevant areas (i.e., the work space) and an increase in gaze complexity (i.e., gaze transition entropy) during optimal performance reflected changes in cognitive demands as task difficulty increased. A comparison between optimal and non-optimal performance revealed sub-optimal gaze patterns that occurred in the early stages of planning, which were taken to reflect poor information extraction from the task environment and impaired maintenance of information in visuospatial working memory. Gaze behaviour during movement execution indicated an increased need to extract and process information from the goal space. Consequently, movement execution time increased in order to reverse erroneous movements and re-sequence the problem solution. Taken together, the traditional and entropy-based gaze analyses applied in the present study provide a promising approach to identify eye movement patterns that support neurocognitive performance on tasks relying on visuospatial planning and problem solving.

Binocular Viewing Facilitates Size Constancy for Grasping and Manual Estimation

A prerequisite for efficient prehension is the ability to estimate an object’s distance and size. While most studies demonstrate that binocular viewing is associated with a more efficient grasp programming and execution compared to monocular viewing, the factors contributing to this advantage are not fully understood. Here, we examined how binocular vision facilitates grasp scaling using two tasks: prehension and manual size estimation. Participants (n = 30) were asked to either reach and grasp an object or to provide an estimate of an object’s size using their thumb and index finger. The objects were cylinders with a diameter of 0.5, 1.0, or 1.5 cm placed at three distances along the midline (40, 42, or 44 cm). Results from a linear regression analysis relating grip aperture to object size revealed that grip scaling during monocular viewing was reduced similarly for both grasping and estimation tasks. Additional analysis revealed that participants adopted a larger safety margin for grasping during monocular compared to binocular viewing, suggesting that monocular depth cues do not provide sufficient information about an object’s properties, which consequently leads to a less efficient grasp execution.

Reach Kinematics During Binocular Viewing in 7- to 12-Year-Old Children With Strabismus

Purpose

Eye–hand coordination is essential for normal development and learning. Discordant binocular experience from childhood strabismus results in sensory and ocular motor impairments that can affect eye–hand coordination. We assessed reach kinematics during visually guided reaching in children treated for strabismus compared with controls.

Methods

Thirty-six children aged 7 to 12 years diagnosed with esotropia, a form of strabismus, and a group of 35 age-similar control children were enrolled. Reach movements during visually guided reaching were recorded using the LEAP Motion Controller. While viewing binocularly, children reached out and touched a small dot that appeared randomly in one of four locations (±5° or ±10°). Kinematic measures were reach reaction time, total reach duration, peak velocity, acceleration duration, and deceleration duration. Touch accuracy and factors associated with impaired reach kinematics were evaluated.

Results

Strabismic children had longer total reach duration (545 ± 60 ms vs. 504 ± 43 ms; P = 0.002), had longer deceleration duration (343 ± 54 ms vs. 312 ± 45 ms; P = 0.010), and were less accurate (93% ± 6% vs. 96% ± 5%, P = 0.007) than controls. No differences were found for reach reaction time, peak velocity, or acceleration duration (all Ps ≥ 0.197). Binocular dysfunction was more related to slow reaching than amblyopic eye visual acuity.

Conclusions

Strabismus affects visually guided reaching in children, with slower reaching in the final approach and reduced endpoint accuracy. Binocular dysfunction was predictive of slow reaching. Unlike strabismic adults who show longer acceleration duration, longer deceleration in the final approach in strabismic children indicates a difference in control that could be due to reduced ability to use visual feedback.

Development of eye-hand coordination in typically developing children and adolescents assessed using a reach-to-grasp sequencing task

Eye-hand coordination is required to accurately perform daily activities that involve reaching, grasping and manipulating objects. Studies using aiming, grasping or sequencing tasks have shown a stereotypical temporal coupling pattern where the eyes are directed to the object in advance of the hand movement, which may facilitate the planning and execution required for reaching. While the temporal coordination between the ocular and manual systems has been extensively investigated in adults, relatively little is known about the typical development of eye-hand coordination. Therefore, the current study addressed an important knowledge gap by characterizing the profile of eye-hand coupling in typically developing school-age children (n = 57) and in a cohort of adults (n = 30). Eye and hand movements were recorded concurrently during the performance of a bead threading task which consists of four distinct movements: reach to bead, grasp, reach to needle, and thread. Results showed a moderate to high correlation between eye and hand latencies in children and adults, supporting that both movements were planned in parallel. Eye and reach latencies, latency differences, and dwell time during grasping and threading, showed significant age-related differences, suggesting eye-hand coupling becomes more efficient in adolescence. Furthermore, visual acuity, stereoacuity and accommodative facility were also found to be associated with the efficiency of eye-hand coordination in children. Results from this study can serve as reference values when examining eye and hand movement during the performance of fine motor skills in children with neurodevelopmental disorders.

Stereopsis contributes to the predictive control of grip forces during prehension

Binocular viewing is associated with a superior prehensile performance, which is particularly evident in the latter part of the reach as the hand approaches and makes contact with the target object. However, the visuomotor mechanisms through which binocular vision serves prehension are not fully understood. This study assessed the role of stereopsis in the predictive control of grasping by measuring grip force. Twenty participants performed a precision reach-to-grasp task in four viewing conditions: binocular, monocular, and with reduced stereoacuity (200 arc sec, > 400 arc sec). Monocular, compared to binocular viewing, was associated with a fourfold increase in grasp errors, a 56% increase in grasp duration, 22% decrease in grip force at 50 ms following grasp initiation, and the time of peak force occurred 40% later after grasp initiation (all p < 0.05). Grasp performance was also disrupted when viewing with reduced stereoacuity. Notably, grip force at the time of object lift-off was comparable between all viewing conditions. These results demonstrate that binocular stereopsis contributes to the efficient programming of grip forces. Specifically, stereopsis may provide important sensory information that enables the central nervous system to engage in predictive control of grasping.

Age-Related Deficits in Binocular Vision Are Associated With Poorer Inhibitory Control in Healthy Older Adults

A robust association between reduced visual acuity and cognitive function in older adults has been revealed in large population studies. The aim of this work was to assess the relation between stereoacuity, a key aspect of binocular vision, and inhibitory control, an important component of executive functions. Inhibition was tested using the antisaccade task in older adults with normal or reduced stereopsis (study 1), and in young adults with transiently reduced stereopsis (study 2). Older adults with reduced stereopsis made significantly more errors on the antisaccade task in comparison to those with normal stereopsis. Specifically, there was a significant correlation between stereoacuity and antisaccade errors (r = 0.27, p = 0.019). In contrast, there were no significant differences in antisaccade errors between the normal and reduced stereopsis conditions in the young group. Altogether, results suggest that the association between poorer stereopsis and lower inhibitory control in older adults might arise due to central nervous system impairment that affects the processing of binocular disparity and antisaccades. These results add to a growing body of literature, which highlights the interdependence of sensory and cognitive decline in older adults.

Effects of blocked vs. interleaved administration mode on saccade preparatory set revealed using pupillometry

Eye movements have been used extensively to assess information processing and cognitive function. However, significant variability in saccade performance has been observed, which could arise from methodological variations across different studies. For example, prosaccades and antisaccades have been studied using either a blocked or interleaved design, which has a significant influence on error rates and latency. This is problematic as it makes it difficult to compare saccade performance across studies and may limit the ability to use saccades as a behavioural assay to assess neurocognitive function. Thus, the current study examined how administration mode influences saccade related preparatory activity by employing pupil size as a non-invasive proxy for neural activity related to saccade planning and execution. Saccade performance and pupil dynamics were examined in eleven participants as they completed pro- and antisaccades in blocked and interleaved paradigms. Results showed that administration mode significantly modulated saccade performance and preparatory activity. Reaction times were longer for both pro- and antisaccades in the interleaved condition, compared to the blocked condition (p < 0.05). Prosaccade pupil dilations were larger in the interleaved condition (p < 0.05), while antisaccade pupil dilations did not significantly differ between administration modes. Additionally, ROC analysis provided preliminary evidence that pupil size can effectively predict saccade directional errors prior to saccade onset. We propose that task-evoked pupil dilations reflect an increase in preparatory activity for prosaccades and the corresponding cognitive demands associated with interleaved administration mode. Overall, the results highlight the importance that administration mode plays in the design of neurocognitive tasks.

A History of Concussion Affects Relevancy-Based Modulation of Cortical Responses to Tactile Stimuli

Modulating cortical excitability based on a stimulus’ relevance to the task at hand is a component of sensory gating, and serves to protect higher cortical centers from being overwhelmed with irrelevant information (McIlroy et al., 2003; Kumar et al., 2005; Wasaka et al., 2005). This study examined relevancy-based modulation of cortical excitability, and corresponding behavioral responses, in the face of distracting stimuli in participants with and without a history of concussion (mean age 22 ± 3 SD years; most recent concussion 39.1 ± 30 SD months). Participants were required to make a scaled motor response to the amplitudes of visual and tactile stimuli presented individually or concurrently. Task relevance was manipulated, and stimuli were occasionally presented with irrelevant distractors. Electroencephalography (EEG) and task accuracy data were collected from participants with and without a history of concussion. The somatosensory-evoked N70 event-related potential (ERP) was significantly modulated by task relevance in the control group but not in those with a history of concussion, and there was a significantly greater cost to task accuracy in the concussion history group when relevant stimuli were presented with an irrelevant distractor. This study demonstrated that relevancy-based modulation of electrophysiological responses and behavioral correlates of sensory gating differ in people with and without a history of concussion, even after patients were symptom-free and considered recovered from their injuries.

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.

The role of somatosensory input in target localization during binocular and monocular viewing while performing a high precision reaching and placement task

Binocular vision provides the most accurate and precise depth information; however, many people have impairments in binocular visual function. It is possible that other sensory inputs could be used to obtain reliable depth information when binocular vision is not available. However, it is currently unknown whether depth information from another modality improves target localization in depth during action execution. Therefore, the goal of this study was to assess whether somatosensory input improves target localization during the performance of a precision placement task. Visually normal young adults (n = 15) performed a bead threading task during binocular and monocular viewing in two experimental conditions where needle location was specified by 1) vision only, or 2) vision and somatosensory input, which was provided by the non-dominant limb. Performance on the task was assessed using spatial and temporal kinematic measures. In accordance with the hypothesis, results showed that the interval spent placing the bead on the needle was significantly shorter during monocular viewing when somatosensory input was available in comparison to a vision only condition. In contrast, results showed no evidence to support that somatosensory input about the needle location affects trajectory control. These findings demonstrate that the central nervous system relies predominately on visual input during reach execution, however, somatosensory input can be used to facilitate the performance of the precision placement task.

Evaluation of the Leap Motion Controller during the performance of visually-guided upper limb movements

Kinematic analysis of upper limb reaching provides insight into the central nervous system control of movements. Until recently, kinematic examination of motor control has been limited to studies conducted in traditional research laboratories because motion capture equipment used for data collection is not easily portable and expensive. A recently developed markerless system, the Leap Motion Controller (LMC), is a portable and inexpensive tracking device that allows recording of 3D hand and finger position. The main goal of this study was to assess the concurrent reliability and validity of the LMC as compared to the Optotrak, a criterion-standard motion capture system, for measures of temporal accuracy and peak velocity during the performance of upper limb, visually-guided movements. In experiment 1, 14 participants executed aiming movements to visual targets presented on a computer monitor. Bland-Altman analysis was conducted to assess the validity and limits of agreement for measures of temporal accuracy (movement time, duration of deceleration interval), peak velocity, and spatial accuracy (endpoint accuracy). In addition, a one-sample t-test was used to test the hypothesis that the error difference between measures obtained from Optotrak and LMC is zero. In experiment 2, 15 participants performed a Fitts’ type aiming task in order to assess whether the LMC is capable of assessing a well-known speed-accuracy trade-off relationship. Experiment 3 assessed the temporal coordination pattern during the performance of a sequence consisting of a reaching, grasping, and placement task in 15 participants. Results from the t-test showed that the error difference in temporal measures was significantly different from zero. Based on the results from the 3 experiments, the average temporal error in movement time was 40±44 ms, and the error in peak velocity was 0.024±0.103 m/s. The limits of agreement between the LMC and Optotrak for spatial accuracy measures ranged between 2–5 cm. Although the LMC system is a low-cost, highly portable system, which could facilitate collection of kinematic data outside of the traditional laboratory settings, the temporal and spatial errors may limit the use of the device in some settings.

The effects of task-relevant saccadic eye movements performed during the encoding of a serial sequence on visuospatial memory performance

Visuospatial working memory (VSWM) is a set of cognitive processes used to encode, maintain and manipulate spatial information. One important feature of VSWM is that it has a limited capacity such that only few items can be actively stored and manipulated simultaneously. Given the limited capacity, it is important to determine the conditions that affect memory performance as this will improve our understanding of the architecture and function of VSWM. Previous studies have shown that VSWM is disrupted when task-irrelevant eye movements are performed during the maintenance phase; however, relatively fewer studies examined the role of eye movements performed during the encoding phase. On one hand, performing eye movements during the encoding phase could result in a stronger memory trace because the memory formation is reinforced by the activation of the motor system. On the other hand, performing eye movements to each target could disrupt the configural processing of the spatial array because the spatial representation has to be updated with each movement to maintain perceptual stability. Therefore, this work was conducted to examine whether task-relevant saccadic eye movements performed during the encoding phase of a visuospatial working memory task affect the recall of serially presented targets. Results from two experiments showed that average recall accuracy was significantly higher when the spatial array (set size ≥ 7) was encoded using a covert strategy-that is, while participants fixated on a central target, in comparison to an overt strategy-that is, while participants moved their eyes to fixate on each target. Furthermore, the improvement in accuracy was evident only for targets presented in the first half of the sequence, suggesting that the primacy effect is modulated by the presence of eye movements. We propose that executing saccades during encoding could interfere with the ability to use a chunking strategy or disrupt active visualization of the configuration. In conclusion, this is the first study to show that task-relevant saccadic eye movements performed during encoding may actually reduce the spatial span of VSWM. These results extend the current knowledge about the role of eye movements in VSWM, and have implications for future studies investigating the VSWM.

Abnormal visual experience during development alters the early stages of visual-tactile integration

Visual experience during the critical periods in early postnatal life is necessary for the normal development of the visual system. Disruption of visual input during this period results in amblyopia, which is associated with reduced activation of the striate and extrastriate cortices. It is well known that visual input converges with other sensory signals and exerts a significant influence on cortical processing in multiple association areas. Recent work in healthy adults has also shown that task-relevant visual input can modulate neural excitability at very early stages of information processing in the primary somatosensory cortex. Here we used electroencephalography to investigate visual-tactile interactions in adults with abnormal binocular vision due to amblyopia and strabismus. Results showed three main findings. First, in comparison to a visually normal control group, participants with abnormal vision had a significantly lower amplitude of the P50 somatosensory event related potential (ERP) when visual and tactile stimuli were presented concurrently. Second, the amplitude of the P100 somatosensory ERP was significantly greater in participants with abnormal vision. These results indicate that task relevant visual input does not significantly influence the excitability of the primary somatosensory cortex, instead, the excitability of the secondary somatosensory cortex is increased. Third, participants with abnormal vision had a higher amplitude of the P1 visual ERP when a tactile stimulus was presented concurrently. Importantly, these results were not modulated by viewing condition, which indicates that the impact of amblyopia on crossmodal interactions is not simply related to the reduced visual acuity as it was evident when viewing with the unaffected eye and binocularly. These results indicate that the consequences of abnormal visual experience on neurophysiological processing extend beyond the primary and secondary visual areas to other modality-specific areas.

Contribution of binocular vision to the performance of complex manipulation tasks in 5-13years old visually-normal children

Individual studies have shown that visuomotor coordination and aspects of binocular vision, such as stereoacuity and dynamic vergence control, continue to improve in normally developing children between birth and early teenage years. However, no study has systematically addressed the relationship between the development of binocular vision and fine manipulation skills. Thus, the aim of this cross-sectional study was to characterize performance of complex manipulation tasks during binocular and monocular viewing. Fifty-two children, between 5 and 13years old, performed 2 manipulation tasks: peg-board and bead-threading under randomized viewing conditions. Results showed that binocular viewing was associated with a significantly greater improvement in performance on the bead-threading task in comparison to the peg-board task and the youngest children showed the greatest decrement in task performance under the monocular viewing condition when performing the bead-threading task. Thus, the role of binocular vision in performance of fine manipulation skills is both task- and age-dependent. These findings have implications for assessment of visuomotor skills in children with abnormal binocular vision, which occurs in 2-3% of otherwise typically developing children.

Binocular advantage for prehension movements performed in visually enriched environments requiring visual search

The purpose of this study was to examine the role of binocular vision during a prehension task performed in a visually enriched environment where the target object was surrounded by distractors/obstacles. Fifteen adults reached and grasped for a cylindrical peg while eye movements and upper limb kinematics were recorded. The complexity of the visual environment was manipulated by varying the number of distractors and by varying the saliency of the target. Gaze behavior (i.e., the latency of the primary gaze shift and frequency of gaze shifts prior to reach initiation) was comparable between viewing conditions. In contrast, a binocular advantage was evident in performance accuracy. Specifically, participants picked up the wrong object twice as often during monocular viewing when the complexity of the environment increased. Reach performance was more efficient during binocular viewing, which was demonstrated by shorter reach reaction time and overall movement time. Reaching movements during the approach phase had higher peak velocity during binocular viewing. During monocular viewing reach trajectories exhibited a direction bias during the acceleration phase, which was leftward during left eye viewing and rightward during right eye viewing. This bias can be explained by the presence of esophoria in the covered eye. The grasping interval was also extended by ~20% during monocular viewing; however, the duration of the return phase after the target was picked up was comparable across viewing conditions. In conclusion, binocular vision provides important input for planning and execution of prehension movements in visually enriched environments. Binocular advantage was evident, regardless of set size or target saliency, indicating that adults plan their movements more cautiously during monocular viewing, even in relatively simple environments with a highly salient target. Nevertheless, in visually-normal adults monocular input provides sufficient information to engage in online control to correct the initial errors in movement planning.

Effects of strabismic amblyopia and strabismus without amblyopia on visuomotor behavior: III. Temporal eye-hand coordination during reaching

PURPOSE

To examine the effects of strabismic amblyopia and strabismus only, without amblyopia, on the temporal patterns of eye-hand coordination during both the planning and execution stages of visually-guided reaching.

METHODS

Forty-six adults (16 with strabismic amblyopia, 14 with strabismus only, and 16 visually normal) executed reach-to-touch movements toward targets presented randomly 5° or 10° to the left or right of central fixation. Viewing conditions were binocular, monocular viewing with the amblyopic eye, and monocular viewing with the fellow eye (dominant and nondominant viewing for participants without amblyopia). Temporal coordination between eye and hand movements was examined during reach planning (interval between the initiation of saccade and reaching, i.e., saccade-to-reach planning interval) and reach execution (interval between the initiation of saccade and reach peak velocity [PV], i.e., saccade-to-reach PV interval). The frequency and dynamics of secondary reach-related saccades were also examined.

RESULTS

The temporal patterns of eye-hand coordination prior to reach initiation were comparable among participants with strabismic amblyopia, strabismus only, and visually normal adults. However, the reach acceleration phase of participants with strabismic amblyopia and those with strabismus only were longer following target fixation (saccade-to-reach PV interval) than that of visually normal participants (P < 0.05). This effect was evident under all viewing conditions. The saccade-to-reach planning interval and the saccade-to-reach PV interval were not significantly different among participants with amblyopia with different levels of acuity and stereo acuity loss. Participants with strabismic amblyopia and strabismus only initiated secondary reach-related saccades significantly more frequently than visually normal participants. The amplitude and peak velocity of these saccades were significantly greater during amblyopic eye viewing in participants with amblyopia who also had negative stereopsis.

CONCLUSIONS

Adults with strabismic amblyopia and strabismus only showed an altered pattern of temporal eye-hand coordination during the reach acceleration phase, which might affect their ability to modify reach trajectory using early online control. Secondary reach-related saccades may provide a compensatory mechanism with which to facilitate the late online control process in order to ensure relatively good reaching performance during binocular and fellow eye viewing.

Effects of strabismic amblyopia on visuomotor behavior: part II. Visually guided reaching

PURPOSE

To examine the effects of impaired spatiotemporal vision on reaching movements in participants with strabismic amblyopia and to compare their performance to those with strabismus only without amblyopia and to visually normal participants.

METHODS

Sixteen adults with strabismic amblyopia, 14 adults with strabismus only, and 16 visually normal adults were recruited. Participants executed reach-to-touch movements toward targets presented randomly 5° or 10° to the left or right of central fixation in three viewing conditions: both eyes, monocular amblyopic eye (nondominant eye for participants without amblyopia), and monocular fellow eye (dominant eye for participants without amblyopia). Visual feedback of the target was removed on 50% of the trials at the initiation of reaching.

RESULTS

Both groups with abnormal binocular vision (strabismic amblyopia and strabismus only) had reach latency, accuracy, and precision comparable to visually normal participants when viewing with both eyes and fellow (dominant) eye. Latencies were significantly delayed by more than 30 ms in all participants with reduced binocularity during amblyopic eye or nondominant eye viewing compared with controls (P < 0.0001). Participants with strabismic amblyopia and negative stereopsis also had reduced reach precision (i.e., increased variability) during amblyopic eye viewing. In contrast, participants with strabismus only and negative stereopsis had comparable precision across all viewing conditions. Participants with strabismus only and those with strabismic amblyopia used a similar motor strategy; regardless of viewing condition, reach peak acceleration was significantly reduced (P < 0.05) and the duration of acceleration phase was extended in comparison with visually normal participants. There were no significant differences for the deceleration phase.

CONCLUSIONS

Participants with strabismic amblyopia and those with strabismus only attain relatively normal reach accuracy and precision. However, they use a different reach strategy that involves changing the motor plan. A similar compensatory strategy was reported previously in participants with anisometropic amblyopia. Our results provide further support that normal binocular vision during development provides important input for the development of visually guided reaching movements.

Error correcting mechanisms during antisaccades: contribution of online control during primary saccades and offline control via secondary saccades

Errors in eye movements can be corrected during the ongoing saccade through in-flight modifications (i.e., online control), or by programming a secondary eye movement (i.e., offline control). In a reflexive saccade task, the oculomotor system can use extraretinal information (i.e., efference copy) online to correct errors in the primary saccade, and offline retinal information to generate a secondary corrective saccade. The purpose of this study was to examine the error correction mechanisms in the antisaccade task. The roles of extraretinal and retinal feedback in maintaining eye movement accuracy were investigated by presenting visual feedback at the spatial goal of the antisaccade. We found that online control for antisaccade is not affected by the presence of visual feedback; that is whether visual feedback is present or not, the duration of the deceleration interval was extended and significantly correlated with reduced antisaccade endpoint error. We postulate that the extended duration of deceleration is a feature of online control during volitional saccades to improve their endpoint accuracy. We found that secondary saccades were generated more frequently in the antisaccade task compared to the reflexive saccade task. Furthermore, we found evidence for a greater contribution from extraretinal sources of feedback in programming the secondary “corrective” saccades in the antisaccade task. Nonetheless, secondary saccades were more corrective for the remaining antisaccade amplitude error in the presence of visual feedback of the target. Taken together, our results reveal a distinctive online error control strategy through an extension of the deceleration interval in the antisaccade task. Target feedback does not improve online control, rather it improves the accuracy of secondary saccades in the antisaccade task.

Effects of induced monocular blur versus anisometropic amblyopia on saccades, reaching, and eye-hand coordination

PURPOSE

We previously showed that anisometropic amblyopia affects the programming and execution of saccades and reaching movements. In our current study, we investigated whether these amblyopia-related changes simply are due to a reduction in visual acuity alone by inducing artificial blur in one eye in visually-normal participants.

METHODS

Twelve visually-normal participants performed saccades and reach-to-touch movements to targets presented on a computer screen during binocular and monocular viewing. A contact lens was used to blur the vision of one eye to a mean acuity level of 20/50. Saccades and reaching kinematics were compared before blur, immediately after blur, and 5 hours after blur was induced. The 5 hours after blur kinematic data from visually-normal participants also were compared to those from 12 patients with anisometropic amblyopia who had comparable acuity in the amblyopic eye.

RESULTS

Primary saccades (latency, amplitude, peak velocity), reaching movements (reaction time, movement time, peak acceleration, duration of the acceleration phase), and eye-hand coordination (saccade-to-reach planning interval, saccade-to-reach peak velocity interval) were not affected by induced monocular blur in visually-normal participants, either immediately or 5 hours after blur. Compared to visually-normal participants after 5 hours of blur, patients with anisometropic amblyopia had significantly longer and more variable saccade latency during amblyopic eye viewing, lower peak acceleration, and a longer acceleration phase during reaching, and a different temporal pattern of eye-hand coordination.

CONCLUSIONS

Artificially-induced monocular blur in visually-normal participants did not affect saccades, reaching movements, and eye-hand coordination during a simple reach-to-touch task even after a period of blur exposure. In contrast, patients with anisometropic amblyopia demonstrated significantly different kinematics while performing the same task. These results indicate that loss of visual acuity alone cannot explain the kinematic changes seen in patients with mild anisometropic amblyopia.

The effect of sensory uncertainty due to amblyopia (lazy eye) on the planning and execution of visually-guided 3D reaching movements

BACKGROUND

Impairment of spatiotemporal visual processing in amblyopia has been studied extensively, but its effects on visuomotor tasks have rarely been examined. Here, we investigate how visual deficits in amblyopia affect motor planning and online control of visually-guided, unconstrained reaching movements.

METHODS

Thirteen patients with mild amblyopia, 13 with severe amblyopia and 13 visually-normal participants were recruited. Participants reached and touched a visual target during binocular and monocular viewing. Motor planning was assessed by examining spatial variability of the trajectory at 50-100 ms after movement onset. Online control was assessed by examining the endpoint variability and by calculating the coefficient of determination (R(2)) which correlates the spatial position of the limb during the movement to endpoint position.

RESULTS

Patients with amblyopia had reduced precision of the motor plan in all viewing conditions as evidenced by increased variability of the reach early in the trajectory. Endpoint precision was comparable between patients with mild amblyopia and control participants. Patients with severe amblyopia had reduced endpoint precision along azimuth and elevation during amblyopic eye viewing only, and along the depth axis in all viewing conditions. In addition, they had significantly higher R(2) values at 70% of movement time along the elevation and depth axes during amblyopic eye viewing.

CONCLUSION

Sensory uncertainty due to amblyopia leads to reduced precision of the motor plan. The ability to implement online corrections depends on the severity of the visual deficit, viewing condition, and the axis of the reaching movement. Patients with mild amblyopia used online control effectively to compensate for the reduced precision of the motor plan. In contrast, patients with severe amblyopia were not able to use online control as effectively to amend the limb trajectory especially along the depth axis, which could be due to their abnormal stereopsis.

Measuring Balance and Mobility after Traumatic Brain Injury: Validation of the Community Balance and Mobility Scale (CB&M)

PURPOSE

To further investigate the construct validity of the Community Balance and Mobility Scale (CB&M), developed for ambulatory individuals with traumatic brain injury (TBI).

METHODS

A convenience sample of 35 patients with TBI (13 in-patients, 22 outpatients) was recruited. Analyses included a comparison of CB&M and Berg Balance Scale (BBS) admission and change scores and associations between the CB&M and measures of postural sway, gait, and dynamic stability; the Community Integration Questionnaire (CIQ); and the Activities-specific Balance Confidence (ABC) Scale.

RESULTS

Mean admission scores on the BBS and the CB&M were 53.6/56 (SD=4.3) and 57.8/96 (SD=23.3) respectively. Significant correlations were demonstrated between the CB&M and spatiotemporal measures of gait, including walking velocity, step length, step width, and step time; measures of dynamic stability, including variability in step length and step time; and the ABC (p<0.05). Significant correlations between the CB&M and CIQ were revealed with a larger data set (n=47 outpatients) combined from previous phases of research.

CONCLUSIONS

In patients with TBI, the CB&M is less susceptible to a ceiling effect than the BBS. The construct validity of the CB&M was supported, demonstrating associations with laboratory measures of dynamic stability, measures of community integration, and balance confidence.

Effects of anisometropic amblyopia on visuomotor behavior, part 2: visually guided reaching

PURPOSE

The effects of impaired spatiotemporal vision in amblyopia on visuomotor skills have rarely been explored in detail. The goal of this study was to examine the influences of amblyopia on visually guided reaching.

METHODS

Fourteen patients with anisometropic amblyopia and 14 control subjects were recruited. Participants executed reach-to-touch movements toward targets presented randomly 5° or 10° to the left or right of central fixation in three viewing conditions: binocular, monocular amblyopic eye, and monocular fellow eye viewing (left and right monocular viewing for control subjects). Visual feedback of the target was removed on 50% of the trials at the initiation of reaching.

RESULTS

Reaching accuracy was comparable between patients and control subjects during all three viewing conditions. Patients' reaching responses were slightly less precise during amblyopic eye viewing, but their precision was normal during binocular or fellow eye viewing. Reaching reaction time was not affected by amblyopia. The duration of the acceleration phase was longer in patients than in control subjects under all viewing conditions, whereas the duration of the deceleration phase was unaffected. Peak acceleration and peak velocity were also reduced in patients.

CONCLUSIONS

Amblyopia affects both the programming and the execution of visually guided reaching. The increased duration of the acceleration phase, as well as the reduced peak acceleration and peak velocity, might reflect a strategy or adaptation of feedforward/feedback control of the visuomotor system to compensate for degraded spatiotemporal vision in amblyopia, allowing patients to optimize their reaching performance.

Effects of anisometropic amblyopia on visuomotor behavior, I: saccadic eye movements

PURPOSE

Impairment of spatiotemporal visual processing is the hallmark of amblyopia, but its effects on eye movements during visuomotor tasks have rarely been studied. Here the authors investigate how visual deficits in anisometropic amblyopia affect saccadic eye movements.

METHODS

Thirteen patients with anisometropic amblyopia and 13 control subjects participated. Participants executed saccades and manual reaching movements to a target presented randomly 5° or 10° to the left or right of fixation in three viewing conditions: binocular, amblyopic, and fellow eye viewing. Latency, amplitude, and peak velocity of primary and corrective saccades were measured.

RESULTS

Initiation of primary saccades was delayed and more variable when patients viewed monocularly with their amblyopic eye. During binocular viewing, saccadic latency exhibited increased variability and no binocular advantage in patients (i.e., mean latency was similar to that during fellow eye viewing). Mean amplitude and peak velocity of primary saccades were comparable between patients and control subjects; however, patients exhibited greater variability in saccade amplitude. The frequency of corrective saccades was greater when patients viewed with their fellow eye than it was with binocular or amblyopic eye viewing. Latency, amplitude, and peak velocity of corrective saccades in patients were normal in all viewing conditions.

CONCLUSIONS

Saccades had longer latency and decreased precision in amblyopia. Once saccades were initiated, however, the dynamics of saccades were not altered. These findings suggest that amblyopia is associated with slower visual processing in the afferent (sensory) pathway rather than a deficit in the efferent (motor) pathway of the saccadic system.

Localization in the frontal plane is not susceptible to manipulation of afferent feedback via the Jendrassik Maneuver

We have previously shown that registered vergence eye position is altered while participants perform the Jendrassik Maneuver (JM). We proposed that the altered eye position signal registration is due to the effect of the JM which changes the gain of the sensory feedback from the eye muscles, possibly via the activity of non-twitch motoneurons. We conducted two studies to further extend and clarify one of our previous findings by examining whether the JM also affects registered eye position during localization in the frontal plane. Since the non-twitch motoneurons do not receive premotor input from areas involved in the programming of saccades, we hypothesized that localization responses associated with the saccadic system should not be affected by the JM. The data confirmed our prediction. We propose that the non-twitch motoneurons are involved in parametric adjustment of the proprioceptive feedback loops of the vergence but not the version eye movements.

Manipulation of extraocular muscle afference has no effect on higher order perceptual judgments

Observers perceive targets as farther while performing the Jendrassik Maneuver (JM) suggesting that eye position is registered as more divergent. We examined the effects of the JM perturbation in three studies of perceptual judgment that rely on accurate registration of absolute distance: size constancy, stereoscopic depth, and the magnitude of the Pulfrich illusion. The data showed no significant differences between the JM and control conditions. The lack of an effect may be due to the fact that vergence is not a perfect cue to distance. Furthermore, the relative contribution of extraocular muscle afference to registered eye position may be less significant for higher order perceptual judgments.

Changes in gait variability during different challenges to mobility in patients with traumatic brain injury

Postural stability may be compromised in patients who have sustained a traumatic brain injury (TBI). The purpose of the present study was to examine dynamic stability during gait by measuring spatial and temporal variability of foot placement, and to determine the effect of increased difficulty of the walking task on gait variability in patients with TBI. It was hypothesized that patients with TBI will show increased variability in step time, step length, and step width in comparison to healthy controls and that such differences would be accentuated by increased task difficulty. Participants (patients: n=20, controls: n=20) were asked to walk across a pressure sensitive mat at their preferred pace (PW), as fast as possible (FW), and with their eyes closed (EC). In accordance with the hypotheses, patients had significantly greater variability in step time and step length in comparison to healthy controls, and when the complexity of the gait task increased (FW and EC tasks). Although step width variability showed no significant difference between the groups, both control and patient groups had increased step width variability in the EC task. It is proposed that such increases in variability reflect greater challenges to maintaining dynamic stability during gait among individuals with TBI and when performing more difficult tasks.