Fine Motor Movements Research Articles

Analyzing Typical Mobile Gestures in mHealth Applications for Users with Down Syndrome

Mobile technology has provided many advantages for all members of the Information Society. Communication, Organization, Transportation, Health, and Entertainment are just a few areas of mobile technology application. Nevertheless, there are still some people who find difficulties using it. Although there are a lot of applications of mHealth available for almost any kind of mobile device, there is still a lack of understanding and attending users’ needs, especially those of users with disabilities. People with Down syndrome have the potential to function as active members of our society, taking care of themselves and their own, having jobs, voting, and so on, but their physical limitations prevent them from handling correctly technological tools that could enhance their performance, including mobile technology. In this paper, we had analyzed how suitable the mHealth applications are for users with Down syndrome. We tested 24 users and analyzed their physical performance in fine-motor movements while developing a set of tasks over a mHealth application. Results showed that the design of a mHealth application for users with Down syndrome must center its interaction with simple gestures as tap and swipe avoiding more complex ones as spread and rotate. This research is a starting point to understand the fundamentals of people with Down syndrome interacting with mobile technology.

Consolidation of complex motor skill learning: evidence for a delayed offline process.

Following initial acquisition, studies across domains have shown that memories stabilize through consolidation processes, requiring a post-acquisition temporal interval to allow their occurrence. In procedural skill memories, consolidation not only stabilizes the memory, but also simultaneously enhances it by accumulating additional gains in performance. In addition, explicit skill tasks were previously shown to consolidate through sleep, whereas implicit tasks were consolidated following a time interval which did not include a period of sleep. Although previous research has been instrumental in utilizing simple motor tasks designed to model skill learning, whether and how skill consolidation processes operate in complex real-life environments remains to be determined. Here, we tested consolidation in a complex motor skill, used to train execution of fine-motor movements. Since the complex task was explicit, we hypothesized that consolidation will be evident immediately following sleep, as in simple explicit motor skills. However, results show that even though participants were aware of the goal of the complex skill task, consolidation was evident only 24 hr following skill acquisition, and not following a shorter 12 hr interval, even when the latter included sleep. An additional experiment verified that without a temporal interval longer than 12hr, the same skill training does not undergo complete consolidation. These results suggest that task complexity is a crucial characteristic determining the proper terms allowing full consolidation. Due to the enhanced ecological validity of this study, revealing the differences between complex and simple motor skills could enable the facilitation of advanced rehabilitation methods following neurological injuries.

Development and validation of exercise rehabilitation program for cognitive function and activity of daily living improvement in mild dementia elderly.

We investigated the effect of exercise rehabilitation based on fine motor movement for the elderly with mild dementia. Using electroencephalogram (EEG), the change of brain wave of them based on fine motor movement and comparing the improvement level of cognitive ability and performance capability in daily living activity was recorded. The subjects were the elderly with mild dementia living in a sanatorium in Incheon city. Mini-Mental Status Examination, activity of daily living (ADL), and the influence on depression were examined. After 8-week exercise program, significant difference in cognitive function and ADL was observed, however, and there was no significant difference in depression. In the EEG, there was a significant difference in α-wave. This study suggests the chance to remind the necessity of exercise programs for improving cognitive function and ADL of the elderly with dementia.

Lead Exposure in the Special Operations Shooter How to Prevent Cognitive Decline and Permanent Disability.

Lead toxicity is an important environmental disease and its effects on the human body can be devastating. Unique exposures to Special Operations Forces personnel may include use of firing ranges, use of automotive fuels, production of ammunition, and bodily retention of bullets. Toxicity may degrade physical and psychological fitness, and cause long-term negative health outcomes. Specific effects on fine motor movements, reaction times, and global function could negatively affect shooting skills and decision-making. Biologic monitoring and chelation treatment are poor solutions for protecting this population. Through primary prevention, Special Operations Forces personnel can be protected, in any environment, from the devastating effects of lead exposure. This article offers tools to physicians, environmental service officers, and Special Operations Medics for primary prevention of lead poisoning in the conventional and the austere or forward deployed environments.

Centruroides sculpturatus envenomation in three adult patients requiring treatment with antivenom

Context: Envenomation by Centruroides sculpturatus can manifest with cranial nerve dysfunction and neuromuscular hyperactivity. While these symptoms are most commonly seen in young children, they may also be seen in adults.Case details: Three cases of adult patients are presented with grades III & IV scorpion envenomation. They reported symptoms including disconjugate, roving eye movements, and motor involvement. Also reported were hyposmia, difficulty with fine motor movements, and dysgeusia. All were first treated with benzodiazepines with little to no effect. They then received a three vial antivenom bolus with resolution of severe symptoms within 30–60 min.Discussion: Severe Centruroides envenomation can occur in adults as well as children. These three cases demonstrate the usefulness, safety, and effectiveness of antivenom therapy to quickly relieve symptoms in adult patients with grades III & IV envenomations.

Handedness effects of imagined fine motor movements

ABSTRACTPrevious studies of movement imagery have found inter-individual differences in the ability to imagine whole-body movements. The majority of these studies have used subjective scales to measure imagery ability, which may be confounded by other factors related to effort. Madan and Singhal [2013. Introducing TAMI: An objective test of ability in movement imagery. Journal of Motor Behavior, 45(2), 153–166. doi:10.1080/00222895.2013.763764] developed the Test of Ability in Movement Imagery (TAMI) to address these confounds by using a multiple-choice format with objectively correct responses. Here we developed a novel movement imagery questionnaire targeted at assessing movement imagery of fine-motor hand movements. This questionnaire included two subscales: Functionally-involved Movement (i.e., tool-related) and Isolated Movement (i.e., hand-only). Hand-dominance effects were observed, such that right-handed participants were significantly better at responding to right-hand questions compared to left-hand questions for both imagery types. A stronger handedness effect was observed for Functionally-involved Movement imagery, and it did not correlate with the Edinburgh Handedness Inventory. We propose that the Functionally-involved Movement imagery subscale provides an objective hand imagery test that induces egocentric spatial processing and a greater involvement of memory processes, potentially providing a better skill-based measure of handedness.

Influence of L-dopa on subtle motor signs in heterozygous Parkin- and PINK1 mutation carriers

IntroductionA latent nigrostriatal deficit and its possible clinical consequences in asymptomatic heterozygous Parkin and PINK1 mutation carriers (AMC) have been a matter of investigation in recent years. Notably, mild Parkinsonian signs in heterozygous mutation carriers can be so subtle that they may be missed if not specifically investigated. MethodsWe studied 15 heterozygous Parkin and PINK1 AMC and 18 age- and sex-matched mutation-negative controls using a standardized video, instructing the probands to perform relevant parts of the UPDRS III to investigate fine motor movements at baseline and after first-time L-Dopa administration. Additionally, available UPDRS III scores of mutation carriers from the past ten years were reviewed. ResultsAMC showed a reduced number of fine motor movements per second compared to controls at baseline (p = 0.04). L-Dopa improved motor performance numerically but non-significantly in AMC (p = 0.2301), but significantly in healthy controls (p = 6.1·10–5). Although none of the AMC reported symptoms, nine showed rigidity, bradykinesia, tremor, and postural instability when the UPDRS III was applied. Mean UPDRSIII scores significantly decreased after L-Dopa administration (p = 0.005), but did not increase over the past ten years. Conclusions(i) Heterozygous AMC show subtle motor abnormalities when a detailed, specialized motor examination is applied and compared to mutation-negative matched control subjects. (ii) The mild motor deficit present in a subgroup of heterozygous Parkin and PINK1 AMC appears to be non-progressive and responsive to L-dopa administration. (iii) Evaluating motor changes, their progression, and treatment response in AMC can provide valuable insights into possible early disease stages and compensatory mechanisms.

FUNCTIONAL MRI OF TABLET-BASED COMPUTERIZED PAIRED ASSOCIATE LEARNING (PAL) WITH IMPROVED ECOLOGICAL VALIDITY

Administered with a computerized touch-screen display, PAL assists in characterizing memory and learning deficits in patients with probable early Alzheimer's disease (AD) (Blackwell Dement-Geriatr-Cogn-Disord 2003). FMRI may clarify the relationship between PAL performance and brain activity, but ecological validity is a concern during complex motor tasks. Previously, we developed an fMRI-compatible tablet including visual feedback of hand position (VFHP) and an augmented reality display (Tam HBM-2011; Karimpoor Frontiers-2015) to address this issue for AD patients with impaired motor planning (Ghilardi BrainRes-2000). The purpose of the present work is to characterize brain activity for an ecologically valid fMRI computerized PAL test. Prior to testing AD patients, initial work involved young adults. The PAL test involves making associative judgements of an increasing number of patterns (1–6 patterns) and their locations on the screen (Fig.1). Each task is repeated twice in a mixed fMRI design interspersed with baseline visual fixation. Ten young healthy right-handed adults performed PAL at 3T. The PRONTO toolkit was used to optimize fMRI preprocessing pipelines (Churchill PloSone-2015), and obtain Z-scored maps of retrieval phase vs. baseline, using a uni-variate Gauss Naïve Base (GNB) model. Principal Component Analysis (PCA) was performed on the Z-scored activation maps to obtain brain patterns explaining maximum variance across the group. Fig 2.a shows group maps during retrieval of 3 patterns (3pat) vs. baseline. Fig 2.b shows 6 patterns (6pat) vs. baseline. Increased activity in medial temporal lobe and dorsolateral prefrontal cortex is observed during 6pat compared to 3pat, consistent with the different difficulty levels. Activation of left ventral premotor cortex is consistent with visually-guided hand actions. Extensive activation of the left middle frontal gyrus, superior parietal lobule, and basal ganglia is observed during 6pat, compared to 3pat; consistent with differences in complex motor planning and visuospatial understanding. Results suggest that the fMRI-compatible tablet with VFHP enables PAL tests with good ecological validity involving complex fine motor movements. These methods and findings are relevant to future fMRI studies of AD patients; involving batteries of tasks required to probe different cognitive domains during limited scan time. fMRI-compatible PAL test. The first principal component depicting brain activity for 10 subjects performing PAL. a) Retrieval 3 patterns vs. baseline. b) Retrieval 6 patterns vs. baseline.

Cultural entrainment of motor skill development: Learning to write hiragana in Japanese primary school.

The aim of the present study was to examine how the social norms shared in a classroom environment influence the development of movement dynamics of handwriting of children who participate in the environment. To look into this issue, the following aspects of the entire period of classroom learning of hiragana letters in Japanese 1st graders who had just entered primary school were studied: First, the structure of classroom events and the specific types of interaction and learning within such environment were described. Second, in the experiment involving 6‐year‐old children who participated in the class, writing movements of children and their changes over the period of hiragana education were analyzed for each stroke composing letters. It was found that writing movement of children became differentiated in a manner specific to the different types of stroke endings, to which children were systematically encouraged to attend in the classroom. The results provide a detailed description of the process of how dynamics of fine motor movement of children is modulated by the social norms of a populated, classroom environment in a non‐Latin alphabet writing system.

Non-magnetic compliant finger sensor for continuous fine motor movement detection.

A non-magnetic MEG compatible device has been developed that provides continuous force and velocity information. Combined with MEG, this device may find utility in characterizing brain regions associated with force and velocity relative to individual digits or movement pattern. 15 healthy right-handed participants were given visual cues to perform random finger movements on the prototype finger sensor for 21s and then rest for 21s (7 times). Respective finger flexion data were obtained, during 151-channel MEG brain scanning, by feeding the signal from finger sensor into four input Analog to Digital Converter (ADC) channels in the MEG hardware. The source activity was reconstructed in beta band using a Linearly Constrained Minimum Variance (LCMV) beamformer in the beta band. The ADC channels were used as regressors for a continuous time General Linear Model (GLM) and a Region of Interest (ROI) was identified to examine activity. MEG analysis showed bilateral activation in the primary motor cortex region. Because individual digits could be isolated in the ADC data, somatotopy of the fingers were observed consistent with the homunculus except pinky finger. The total span was calculated to be 5.5662mm. The study confirms that the finger sensor is magnetically compatible with MEG measurements and may potentially provide a means to study complex sensorimotor functions. Improved isolation of individual digit information along with the use of machine learning algorithms can help retrieve more accurate results.

Intermediate-Term Outcomes and Complications of Long Segment Urethroplasty with Lingual Mucosa Grafts

We evaluated outcomes and donor site complications in male patients with complex urethral strictures who underwent urethroplasty using with long strip oral mucosal grafts. We also analyzed whether a lingual mucosa graft is a good substitute for repairing long segment urethral strictures. This retrospective study was done in 81 male patients with complex urethral strictures who underwent oral mucosal graft urethroplasty. Patients with long segment (8 cm or greater) anterior urethral strictures who were considered candidates for long strip lingual mucosa graft urethroplasty were included in study. Oral mucosal graft urethroplasty was performed in 81 patients with complex urethral strictures between August 2006 and December 2014. Mean urethral stricture length was 12.1 cm (range 8 to 20). A single 9 to 12 cm long strip lingual mucosa graft was used in 52 patients, a lingual mucosa graft greater than 12 cm was placed in 17 and a lingual mucosa graft combined with a buccal mucosal graft was used in 12. Mean followup was 41 months (range 15 to 86) postoperatively. The overall urethroplasty success rate was 82.7%. Urethral complications developed in 14 patients (17.3%), including urethral strictures in 10 and urethrocutaneous fistulas in 4. At 12 months 5 patients (6.2%) reported minimal difficulty with fine motor movement of the tongue. Lingual mucosa harvested from the ventrolateral surface of the tongue can provide a wide and long graft that is an excellent urethral substitute. Donor site complications are primarily limited to postoperative year 1. Our study confirms that the lingual mucosa graft is a good substitute for urethral reconstruction and lingual mucosa graft urethroplasty is a valuable procedure to treat long anterior urethral strictures.

Caring for adults with impaired physical mobility.

THE WORD MOBILITY is associated with physical movement, including both simple gross motor movements and more complex fine motor movements, along with associated coordination of those movements. Physical mobility requires sufficient muscle strength and energy, along with adequate skeletal stability,

An Interactive System for Fine Motor Rehabilitation

Abstract Purpose: One of the most important aspects in neuromotor rehabilitation is the need of feedback for patients. The rehabilitation system’s efficiency relies on the therapist’s judgment; the therapist tells the patient whether he/she is performing the exercises correctly. This process may be quite subjective, because it depends on the therapist’s personal opinion. On the other hand, recent studies have shown that vibrotactile biofeedback can improve the effectiveness of interaction as it is a very helpful tool in the physiological process of neuromotor rehabilitation. Design: We designed an interactive system focused on rehabilitation of the upper limbs using active markers and image processing, which consists of drawing activities in both augment and virtual reality. Methods: The system gives the user a correction through multimodal stimuli feedback (vibrotactile, visual, and sound stimulus) and force measurement to let the patients know if they are not achieving the tasks’ goals. Findings: The developed system could be used by nursing assistants to better help patients. The purpose of this system was assisting patients with injuries in shoulders, elbows, or wrists, providing an audio-vibrotactile feedback as a factor of correction in the movements of the patient. To examine our system, 11 participants were asked to participate in an experiment where they performed activities focused to strengthen their fine motor movements. Conclusions and Clinical Relevance: Results showed show that patients’ fine motor skills improved 10% on average by comparing their error rates throughout the sessions.

A study of wrist-worn activity measurement as a potential real-world biomarker for late-life depression.

Late-life depression (LLD) is associated with a decline in physical activity. Typically this is assessed by self-report questionnaires and, more recently, with actigraphy. We sought to explore the utility of a bespoke activity monitor to characterize activity profiles in LLD more precisely. The activity monitor was worn for 7 days by 29 adults with LLD and 30 healthy controls. Subjects underwent neuropsychological assessment and quality of life (QoL) (36-item Short-Form Health Survey) and activities of daily living (ADL) scales (Instrumental Activities of Daily Living Scale) were administered. Physical activity was significantly reduced in LLD compared with controls (t = 3.63, p < 0.001), primarily in the morning. LLD subjects showed slower fine motor movements (t = 3.49, p < 0.001). In LLD patients, activity reductions were related to reduced ADL (r = 0.61, p < 0.001), lower QoL (r = 0.65, p < 0.001), associative learning (r = 0.40, p = 0.036), and higher Montgomery-Åsberg Depression Rating Scale score (r = -0.37, p < 0.05). Patients with LLD had a significant reduction in general physical activity compared with healthy controls. Assessment of specific activity parameters further revealed the correlates of impairments associated with LLD. Our study suggests that novel wearable technology has the potential to provide an objective way of monitoring real-world function.

Visual-spatial sequence learning and memory in trained musicians.

Previous research has shown that musicians have enhanced visual-spatial abilities and sensorymotor skills. As a result of their long-term musical training and their experience-dependent activities, musicians may learn to associate sensory information with fine motor movements. Playing a musical instrument requires musicians to rapidly translate musical symbols into specific sensory-motor actions while also simultaneously monitoring the auditory signals produced by their instrument. In this study, we assessed the visual-spatial sequence learning and memory abilities of long-term musicians. We recruited 24 highly trained musicians and 24 nonmusicians, individuals with little or no musical training experience. Participants completed a visual-spatial sequence learning task as well as receptive vocabulary, nonverbal reasoning, and short-term memory tasks. Results revealed that musicians have enhanced visual-spatial sequence learning abilities relative to nonmusicians. Musicians also performed better than nonmusicians on the vocabulary and nonverbal reasoning measures. Additional analyses revealed that the large group difference observed on the visualspatial sequencing task between musicians and nonmusicians remained even after controlling for vocabulary, nonverbal reasoning, and short-term memory abilities. Musicians' improved visualspatial sequence learning may stem from basic underlying differences in visual-spatial and sensorymotor skills resulting from long-term experience and activities associated with playing a musical instrument.

AYURVEDIC MANAGEMENT OF AMYOTROPHIC LATERAL SCLEROSIS: A CASE REPORT

Amyotrophic lateral sclerosis (ALS) is the most common adult motor neuron disease and it is characterized by selective death of upper and lower motor neurons causing muscle atrophy, weakness and spasticity. The present report deals with a case of ALS diagnosed as kapha avrita praana, udaana and vyaana vata according to Ayurveda. Efficacy of treatment was calculated by using Amyotrophic Lateral Sclerosis Functional Rating Scale – Revised (ALSFRS-R). Before treatment, total score of ALSFRS-R was 17 and at the time of discharge the score was 29. Various panchakarma procedures panchakarma procedures like udwartana, sarvanga abhyanga, bashpa sweda, shashtika shali pinda sweda and vasti were implemented along with internal Ayurvedic medicines. Good improvement was observed in items like ‘speech’, ‘excessive salivation’, ‘deglutition’, ‘ability to walk’, and ‘shortness of breath’. No change was noticed in fine motor movements, tremors of both hands and in fasciculation of the tongue. Ayurvedic panchakarma therapy along with internal medication has provided promising results in present case.

PGE2-EP3 signaling exacerbates intracerebral hemorrhage outcomes in 24-mo-old mice.

With the population aging at an accelerated rate, the prevalence of stroke and financial burden of stroke-related health care costs are expected to continue to increase. Intracerebral hemorrhage (ICH) is a devastating stroke subtype more commonly affecting the elderly population, who display increased mortality and worse functional outcomes compared with younger patients. This study aimed to investigate the contribution of the prostaglandin E2 (PGE2) E prostanoid (EP) receptor subtype 3 in modulating anatomical outcomes and functional recovery following ICH in 24-mo-old mice. EP3 is the most abundant EP receptor in the brain and we have previously shown that signaling through the PGE2-EP3 axis exacerbates ICH outcomes in young mice. Here, we show that EP3 receptor deletion results in 17.9 ± 6.1% less ICH-induced brain injury (P < 0.05) and improves neurological functional recovery (P < 0.01), as identified by lower neurological deficit scores, decreased resting time, and more gross and fine motor movements. Immunohistological staining was performed to investigate possible mechanisms of EP3-mediated neurotoxicity. Identified mechanisms include reduced blood accumulation and modulation of angiogenic and astroglial responses. Using this aged cohort of mice, we have confirmed and extended our previous results in young mice demonstrating the deleterious role of the PGE2-EP3 signaling axis in modulating brain injury and functional recovery after ICH, further supporting the notion of the EP3 receptor as a putative therapeutic avenue for the treatment of ICH.

Fine motor movements while drawing during the encoding phase of a serial verbal recall task reduce working memory performance

The time-based resource-sharing (TBRS) model of working memory indicates that secondary tasks that capture attention for relatively long periods can result in the interference of working memory processing and maintenance. The current study investigates if discrete and continuous movements have differing effects on a concurrent, verbal serial recall task. In the listening condition, participants were asked to recall spoken words presented in lists of six. In the drawing conditions, participants performed the same task while producing discrete (star) or continuous (circle) movements. As hypothesised, participants recalled more words overall in the listening condition compared to the combined drawing conditions. The prediction that the continuous movement condition would reduce recall compared to listening was also supported. Fine-grained analysis at each serial position revealed significantly more words were recalled at mid serial positions in the listening condition, with worst recall for the continuous condition at position 5 compared to the listening and discrete conditions. Kinematic analysis showed that participants increased the size and speed of the continuous movements resulting in a similar duration and number of strokes for each condition. The duration of brief pauses in the discrete condition was associated with the number of words recalled. The results indicate that fine motor movements reduced working memory performance; however, it was not merely performing a movement but the type of the movement that determined how resources were diverted. In the context of the TBRS, continuous movements could be capturing attention for longer periods relative to discrete movements, reducing verbal serial recall.

Speech changes after coordinative training in patients with cerebellar ataxia: a pilot study.

Although rehabilitative training is a necessary adjunct in the management of gait ataxia, it remains unknown whether the possible beneficial effect of intensive coordinative training may translate to activities of daily living, which are closely connected with postural alignment. The aim of the present study was to examine the effectiveness of a 2-week intensive coordinative motor training on speech production. Speech and motor performances in a cohort of ten individuals with cerebellar degeneration were examined three times; before the introduction of training, directly and 4 weeks after the last training session. Each patient was instructed to perform a speaking task of fast syllable repetition and monologue. Objective acoustic analyses were used to investigate six key aspects of speech production disturbed in ataxic dysarthria including accuracy of consonant articulation, accuracy of vowel articulation, irregular alternating motion rates, prolonged phonemes, slow alternating motion rates and inappropriate segmentation. We found that coordinative training had a mild beneficial effect on speech in cerebellar patients. Immediately after the last training session, slight speech improvements were evident in all ten patients. Furthermore, follow-up assessment performed 4 weeks later revealed that 90 % of the patients showed better speech performance than before initiation of the therapy. The present study supports evidence that the intensive rehabilitative training may positively affect fine-motor movements such as speech in patients with cerebellar ataxia.

Motor Cortex Activity During Functional Motor Skills: An fNIRS Study.

Assessments of brain activity during motor task performance have been limited to fine motor movements due to technological constraints presented by traditional neuroimaging techniques, such as functional magnetic resonance imaging. Functional near-infrared spectroscopy (fNIRS) offers a promising method by which to overcome these constraints and investigate motor performance of functional motor tasks. The current study used fNIRS to quantify hemodynamic responses within the primary motor cortex in twelve healthy adults as they performed unimanual right, unimanual left, and bimanual reaching, and stepping in place. Results revealed that during both unimanual reaching tasks, the contralateral hemisphere showed significant activation in channels located approximately 3 cm medial to the C3 (for right-hand reach) and C4 (for left-hand reach) landmarks. Bimanual reaching and stepping showed activation in similar channels, which were located bilaterally across the primary motor cortex. The medial channels, surrounding Cz, showed significantly higher activations during stepping when compared to bimanual reaching. Our results extend the viability of fNIRS to study motor function and build a foundation for future investigation of motor development in infants during nascent functional behaviors and monitor how they may change with age or practice.