Dexterity Research Articles

Effect of goal-directed perceptual-motor exercise on children with specific learning difficulties: a randomized controlled trial

BackgroundAlthough perceptual interventions focus on sensory and cognitive skills, they significantly enhance the effectiveness of motor interventions by improving coordination, decision-making, and overall engagement in physical activities. A comprehensive literature review has demonstrated that incorporating perceptual interventions into motor exercises is beneficial. While there are several treatment strategies for SLD-diagnosed children, the potential role of goal-directed perceptual-motor exercises has not been studied. This study examined the effectiveness of goal-directed perceptual-motor training on attention, motor skills, and quality of life in children with Specific Learning Disorder (SLD).MethodsThis was a randomized clinical study with 38 children diagnosed with SLD between September 2021 and April 2022. The control group (n = 19) received a standard intervention protocol, and the intervention group (n = 19) additionally received a perceptual-motor training program. Bourdon Attention Test, the Bruininks-Oseretsky Test 2–Short Form (BOT2- SF), and the Pediatric Quality of Life Inventory (PEDSQL) were used as outcome measures.ResultsThe intervention significantly improved attention, fine and gross motor skills, and life quality as evidenced by the within- and between-group comparisons at the end of therapy.ConclusionsGoal-directed perceptual-motor physical training with cognitive aspects may enhance academic performance, social participation, and life quality for children with SLD by improving basic motor skills. Therefore, the inclusion of physical and task-specific perceptual-motor exercises in educational programs may offer several avenues for cognitive skill development in SLD children.Trial registrationThe protocol is retrospectively registered with http://clinicaltrials.gov/ (16/August/2023, Clinical Trial, NCT05998083).

The Use of the Parents’ Evaluation of Developmental Status and Developmental Milestones in Screening Children for Developmental Delay in India

Background/Objectives: The Parents’ Evaluation of Developmental Status (PEDS) and Developmental Milestones (PEDS:DM) are cost-effective, self-report tools that can be conveniently utilized in low- and middle-income countries to screen for developmental delays in children. This study assessed the diagnostic accuracy of PEDS and PEDS:DM in distinguishing children with typical development (TD) from those with developmental disabilities (DD). It also examined the relationship between parents’ general concerns and specific developmental concerns about their children. Method: The study included 407 children with TD and 59 children with DD, recruited from diverse socioeconomic backgrounds in Chandigarh, Himachal Pradesh, and the National Capital Region of India. Parents of children aged 4 to 8 years completed the PEDS and PEDS:DM online. Results: The PEDS demonstrated high sensitivity (91%) but low specificity (47%), whereas the PEDS:DM showed poor sensitivity (17%) and specificity (6%). Parents of TD children who expressed general developmental concerns were likely to report specific concerns related to behavior, self-help skills, health, and cognitive development. Parents of DD children with general concerns reported specific issues with fine motor skills, behavior, school performance, cognitive development, and health. Conclusions: These findings suggest that while PEDS and PEDS:DM can support early detection of developmental delays, their interpretation should be approached with caution. The study provides preliminary insights into the applicability of these screening tools for children aged 4–8 years in India.

The Association Between Motor Competence and Inhibitory Control in Preschool Children

Background: Inhibitory control is a higher-order cognitive function that affects children’s lives and learning, and the development of inhibitory control plays a vital role in the overall development of preschool children. However, most studies have paid more attention to inhibitory and physical fitness, but less focus on motor competence. Therefore, the purpose of this study was to explore the association between motor competence and inhibitory control in preschool children. Methods: A total of 160 preschool children aged 3 to 6 years were selected using a stratified random sampling method, and both motor ability and inhibitory control were assessed. Motor competence was assessed via the Children’s Motor Assessment Battery, Version 2 (MABC-2). Inhibitory control was assessed using the one-on-one iPad-based Early Year Toolbox and reflected by reaction time and accuracy. Results: A total of 153 preschoolers were included in the final statistical analysis. After adjusting the confounders, motor competence was associated with accuracy (β = 0.010, 95% CI: 0.003, 0.017). Similarly, a negative association was observed between motor competence and reaction time (β = −0.008, 95% CI: −0.014, −0.002). Compared with the participants in the lowest group, motor competence (β = 0.051 95% CI: 0.003, 0.098), manual dexterity (β = 0.106 95% CI: 0.043, 0.170), and balance (β = 0.065 95% CI: 0.002, 0.129) were all positively associated with accuracy of those in the highest group. Conclusions: A positive relationship between motor competence and the accuracy of inhibitory control was observed in preschoolers, whereas a negative relationship between motor competence and the reaction time of inhibitory control was also identified. Enhancing preschool children’s motor competence is likely to facilitate their development of inhibitory control.

Mental imagery for addressing mechanisms underlying motor impairments in children with attention deficit hyperactivity disorder (ADHD)

Children with attention deficit hyperactivity disorder (ADHD) exhibit various degrees of motor and cognitive impairments in fine and gross motor skills. These impairments impact social functioning, while also hindering academic achievement, self-esteem, and participation. Specifically, motor impairments are not fully addressed by current therapies. For example, approximately 50% of children with ADHD exhibit significant motor impairments, as per clinical measures, while the other 50% experience more impairments in motor planning, execution and control than do typically developed (TD) children. Such findings indicate that ADHD-specific mechanisms may be underpinning motor impairments. In this paper, we outline ADHD impairments in motor planning, execution, and control, and the potential role of two such mechanisms: internal motor representation and timing perception. Next, we suggest mental imagery as an approach for treating ADHD motor impairments, potentially through addressing internal motor representation and timing perception.

Development of fine motor skills in elementary school students: Gender and age effects

Fine motor skills are a good indicator of a child’s overall development. They underpin almost all everyday activities from self-care skills such as dressing to academic skills such as writing and drawing. In this study we examined the development of fine motor skills of early elementary school children. The sample for this study consisted of 175 children (93 boys, 82 girls, mean age= 120 months; SD = 10.7 months). attending 3rd, 4th, and 5th grades. We used Grooved Pegboard test for measuring fine motor skills. We found a medium, statistically significant, correlation between age and motor skills, with stronger correlation at younger age. In relation to child’s grade, there were statistically significant differences in motor skills between children attending 3rd and 4th grade, but no differences between children in 4th and 5th grade. As for the gender, there were no mean differences between boys and girls in the 3rd grade, but there were differences in 4th and 5th grade with girls achieving statistically significantly better scores on Grooved Pegboard test. Fine motor skills should routinely be examined in children and appropriate remediation programs should be set if a child falls behind in motor skills. We concluded a paper with several ways how elementary schools can include fine motor exercises in their curricula.

Evaluation and comparison of the antimicrobial efficacy of three commercially available denture cleansing agents against different microorganisms: An in vitro study

Heat cured poly methyl methacrylate denture base acrylic resins are most commonly used material for fabrication of complete dentures. In certain situations, denture hygiene is compromised both due to the constraints of the denture material and/or non-compliance from the patients owing to lack of manual dexterity. This leads to formation of microbial biofilm on the intaglio surface of the denture and if left untreated, it can cause denture stomatitis. Denture cleansing tablets are of great help in such cases.The primary goal of this in vitro experiment was to assess and compare the effects of commercially available and common household denture cleansing tablets viz. Polident, Fittydent and Clinsodent against Staphylococcus aureus, Streptococcus mutans and Candida albicansA total of 100 heat polymerized acrylic resin samples were divided into 4 groups of 25 each to evaluate the antimicrobial effectiveness of commercially available denture cleansing agents.The results of this study showed that there was significant reduction in colony forming units in three commercially available denture cleansing agents (Clinsodent, Fittydent and Polident denture cleansing tablets) as compared to distilled water. All three commercially available denture cleansing agents used in the study were capable of reducing the colony forming units per ml of the heat cure acrylic resin denture base samples. The order of efficacy was Clinsodent tablets > Fittydent tablets > Polident tablets > Distilled water.

Comparison of the Effects of Oral Hygiene Instruction Methods on Oral Hygiene and Self-Perception in Older Adults: A Randomized Controlled Trial

Background: Age-related conditions, such as being misinformed, having limited oral health literacy, and the loss of manual dexterity, autonomy, or visual acuity, may act as barriers to oral health. The aim of this study was to evaluate the effectiveness of two different oral hygiene instruction methods on oral hygiene and the self-perception of oral health in older adults. Methods: This randomized controlled trial included participants aged 65 and older who completed a questionnaire on socio-economic factors, self-perceived oral health, and oral hygiene behaviours. Oral hygiene status was assessed using the Oral Hygiene Index—Simplified (OHI-S). Participants were randomly allocated into two different groups, according to the method of oral hygiene instruction: a “General Approach” (GA) (n = 28) and a “Personalized Technique” (PT) (n = 26). After two months, a follow-up session was conducted. Data were analysed using descriptive and inferential methodologies. Results: The GA and PT methods were effective in promoting oral hygiene behaviours, with a significant increase in the use of interdental devices, but no significant differences were found between the two methods. Self-perceived oral health did not change significantly, neither after the instruction nor between methods. Significant improvements were achieved with both methods for the OHI-S, with significant differences between the two methods for the Calculus Index, where the PT achieved better results. Conclusions: Oral hygiene education leads to improvements in the adoption of oral hygiene behaviours and clinical indicators. Furthermore, a personalized approach promoted better results in clinical indicators.

The Role of Visual Information Quantity in Fine Motor Performance

Background/Objectives: Fine motor movements are essential for daily activities, such as handwriting, and rely heavily on visual information to enhance motor complexity and minimize errors. Tracing tasks provide an ecological method for studying these movements and investigating sensorimotor processes. To date, our understanding of the influence of different quantities of visual information on fine motor control remains incomplete. Our study examined how variations in the amount of visual feedback affect motor performance during handwriting tasks using a graphic pen tablet projecting on a monitor. Methods: Thirty-seven right-handed young adults (20 to 35 years) performed dot-to-dot triangle tracing tasks under nine experimental conditions with varying quantities of visual cues. The conditions and triangle shape rotations were randomized to avoid motor training or learning effects. Motor performance metrics, including absolute error, time of execution, speed, smoothness, and pressure, were analyzed. Results: As visual information increased, absolute error (from 6.64 mm to 2.82 mm), speed (from 99.28 mm/s to 57.19 mm/s), and smoothness (from 4.17 mm2/s6 to 0.80 mm2/s6) decreased, while time of execution increased (from 12.68 s to 20.85 s), reflecting a trade-off between accuracy and speed. Pressure remained constant across conditions (from 70.35 a.u. to 74.39). Spearman correlation analysis demonstrated a moderate to strong correlation between absolute error and time of execution across conditions. The Friedman test showed significant effects of experimental conditions on all motor performance metrics except for pressure, with Kendall’s W values indicating a moderate to strong effect size. Conclusion: These findings deepen our understanding of sensorimotor integration processes and could potentially have implications for optimizing motor skills acquisition and training and developing effective rehabilitation strategies.

How occupational therapists, physiotherapists, and speech and language therapists can benefit from precision teaching

Purpose This paper aims to discuss how precision teaching holds great promise in enhancing the skills of occupational therapists, physiotherapists and speech and language therapists. Precision teaching plays a significant role in developing fluency in foundational motor and speech skills, leading to improved performance in complex skills. Design/methodology/approach This paper reviews research focusing on precision teaching’s effectiveness in enhancing oral motor and fine motor skills, such as the Big 6 + 6, and its potential application in related skills. Findings Precision teaching provides a measurable and efficient approach to skill development, assisting therapists in improving the daily living and communication abilities of individuals with intellectual and developmental disabilities. Originality/value The broader implications of precision teaching’s application in therapeutic settings are discussed.

Association Between Visual Impairment and Daily Internet Use Among Older Japanese Individuals: Cross-Sectional Questionnaire Study.

Older adults might not use computers due to psychological barriers, environmental barriers such as not owning a computer or lack of internet access, and health-related barriers such as difficulties with fine motor skills, low cognitive function, or low vision. Given the health benefits of internet use among older adults, inadequate use of the internet is an urgent public health issue in many countries. We aimed to determine whether visual impairment is associated with internet use in a population-based sample of older adults. This cross-sectional study sourced data for the year 2016 from the Japan Gerontological Evaluation Study. It included functionally independent community-dwelling individuals aged ≥65 years (N=19,452) in Japan. The respondents reported their visual status by answering the question, "Is your eyesight (without or with usual glasses or corrective lenses) excellent, very good, good, fair, or poor?" We defined "internet user" as a person who uses the internet "almost daily." We used multivariate logistic regression with multiple imputations to analyze visual status, daily internet use, and any correlations between them. We observed that 23.6% (4599/19,452) of respondents used the internet almost daily. Respondents with good visual status notably tended to use the internet more frequently than those with poor visual status. Specifically, 13% and 31% of respondents with poor and excellent vision, respectively, used the internet almost daily. In contrast, 66% and 45% of respondents with poor and excellent vision, respectively, did not use the internet. Even after adjusting for several covariates (age, sex, equivalized income, years of education, marital status, depression, history of systemic comorbidities, frequency of meeting friends, and total social participation score), significant associations persisted between visual status and daily internet usage. The odds ratios (ORs) tended to increase as visual status improved (P for trend <.001). The adjusted ORs for individuals with excellent and very good visual status who used the internet almost daily were 1.38 (95% CI 1.22-1.56) and 1.25 (95% CI 1.15-1.36), respectively. Conversely, the adjusted OR for those with fair or poor visual status was 0.73 (95% CI 0.62-0.86). In this study, we reaffirmed what several previous studies have pointed out using a very large dataset; visual impairment negatively impacted daily internet use by older adults. This highlights the need to address visual impairments to promote web use as health care services become more easily accessed on the web.

The Relationship Between Manual Dexterity and Toothbrushing Efficiency in Preschool Children: A Crossover Study

Aim: The aim of this study was to evaluate the relationship between oral hygiene (OH) efficiency and manual dexterity skills in Spanish five-year-old children using two fine motor tests. Methods: A cross-sectional study with a pre–post evaluation was designed. The children’s OH was measured according to the Silness and Löe plaque index (PI) before toothbrushing upon arrival at school (pre) and after supervised toothbrushing (post). Motor skills (children’s dexterity) were determined with the Visual Motor Skills and Resistance to Fatigue test (VMSRF test) and the scale for the Behavioural Assessment of Preschool Skills (BAPS scale). Data were analysed with the SPSS® statistics software with a 95% confidence interval and bilateral significance. Results: One hundred and twenty-nine children were evaluated. The mean PI was 2.5, indicating generally poor OH in the sample. No difference in OH was observed between genders or in the brushing frequency categories. No significant differences in OH or the PI were found between right- and left-handed children either (p &gt; 0.05). Significant differences were found between the OH category pre and post toothbrushing in the total sample, as well as in the various sextants and surfaces evaluated. The results of the VMSRF and BAPS tests indicate moderate visuomotor skills and fatigue resistance and a poor average skill level. A statistically significant improvement in the PI was found in children with higher scores in the VMSRF and BAPS tests. Conclusions: A significantly higher OH efficacy was found in children with better motor skills, although five-year-old children showed moderate visuomotor skills and fatigue resistance and a poor average preschool skill level.

Biomechanical analysis and optimization of sports action training in virtual reality (VR) environment

Over the past years, virtual reality (VR) has become much more popular. VR combines several technologies to provide an immersive digital environment. This environment allows users to engage and react to their actions, creating a virtual world where users feel more present. In biomechanical analysis, researchers analyze the physical characteristics of biological tissues and model the relationship between tissue form and function. Utilizing VR headsets, motion-tracking apparatus, and realistic virtual worlds that simulate actual sports situations are all part of virtual sports training. VR lacks realism, which can be related to the absence of sensory input, making it unsuitable for training fine motor skills. The research aims to perform biomechanical analysis and optimize sports action training inside a VR setting. A mountain gazelle optimizer fine-tuned adjustable convolution neural network (MGO-ACNN) is proposed to examine the joint angle selections utilized by sports action. In this study, human motion image data are utilized to capture various angles of the training action. The data was preprocessed using a Wiener Filter (WF) for the obtained data. Analyzing spatial frequency and orientation in images for feature extraction is accomplished using the Gabor Filter (GF). This approach incorporates VR simulations to provide a more regulated and immersive setting for joint angle analysis during sports training. The proposed method is implemented using Python software. The result demonstrated by the proposed method significantly outperforms the existing algorithms. The performance parameters for accuracy (99.73%), precision (99.75%), recall (99.73%), and F1-score (99.72%) are assessed in this study. The VR experiments indicate that optimal sports preparation involves a sports action while maintaining a batting speed consistent with the joint to lower the center of gravity. This research highlights the more effective, personalized sports training system, leveraging VR to simulate real-world conditions while providing detailed biomechanical insights.

Grip force release is impaired in parkinson's disease during a force tracking task.

The controlled release of grasping forces underlies skilled dexterous interactions with objects. While declines in force generation and maintenance are well documented in people with Parkinson's disease (PwPD), limited data exist related to how PD impacts the motor control of grasping force release. The aim of this project was to determine how PD impacts grip force release relative to the generation and maintenance of force. It was hypothesized that PwPD would exhibit global deficits in force control relative to controls but would perform disproportionately worse during the controlled release of grip force. Ten PwPD and 10 age-matched controls completed a force-tracking paradigm requiring grip force generation, maintenance, and release. Compared to controls, PwPD were less accurate (i.e. less time within target range), had greater error (i.e. greater relative root mean squared error), and had more trial-to-trial variability in error during grip force release. Ongoing studies are examining the potential neural mechanism(s) underlying of force release impairments in PD, and the relationships between PD severity, manual dexterity, and force release declines.

Application of CUSUM analysis in assessing learning curves in robot-assisted sacrocolpopexy performed by experienced gynecologist

BackgroundThe aim of this study was to assess the learning curve of robotic-assisted sacrocolpopexy by applying CUSUM analysis based on operation time, complication rate and conversion rate to open laparotomy.MethodsA retrospective study was conducted with 50 consecutive robotic-assisted sacrocolpopexy surgeries performed from June 2018 and June 2023 by a single experienced gynecologist. Baseline patient demographics, intraoperative parameters and postoperative outcomes were collected. Cumulative sum (CUSUM) of robotic-assisted sacrocolpopexy operation time was analyzed to determine breakpoints between learning phases using piecewise linear regression. This allowed the detection of subtle shifts in surgical parameters and ultimately surgeon proficiency and competency. Continuous variables, such as age, length of hospitalization and op time, were reported as mean (standard deviation). One-way analysis of variance was employed to compare continuous variables. Categorical variables were expressed as percentages and analyzed using the chi-square test.ResultsThe regression identified breakpoints at case 8.47 (95% CI 8.0, 9.0) and case 34.41 (95% CI 32.7, 36.1), with an R2 value of 0.87, which agrees with that of the second-order polynomial equation. The breakpoints were rounded to the next whole number at case 9 and 35. The Learning, Proficiency, and Competency phases consisted of 9, 26, and 15 cases, respectively in this consecutive series. This suggests that the surgeon achieved proficiency after the first 9 cases and competency after 35 cases. There were no intraoperative nor short-term post-operative complications during the span of this study. Furthermore, there were no conversions to open laparotomy. CUSUM analysis based on complication and conversion rate, therefore, was not available.ConclusionAccording to CUSUM analysis, surgical proficiency of robotic-assisted sacrocolpopexy was attained after the first 9 cases, and stabilization of operation time was achieved after 35 cases. This statistical tool has proven to be useful in objectively assessing learning curves for new surgical techniques, and the transition from laparoscopic sacrocolpopexy to robotic-assisted sacrocolpopexy seems achievable. This, however, may vary with each surgeon’s manual dexterity and experience level. Further investigation with several surgeons and institutions is needed to define a more accurate and generalized learning curve of robotic-assisted sacrocolpopexy.

Investigating the relationship between manual dexterity and auditory spatial processing

BackgroundManual dexterity, referring to fine motor skills and hand–eye coordination, has been suggested to influence various cognitive processes, including attention. Attention has been shown to be strongly related to auditory spatial processing, which primarily involves the perception and interpretation of sound locations in the environment. This study aimed to investigate the potential association between manual dexterity and auditory spatial processing abilities.MethodA total of 30 participants, aged 19–25 years (mean age: 22.06 ± 1.85 years), were assessed for handedness using the Edinburgh Handedness Questionnaire (EHQ). They were divided into 2 groups: 15 right-handed (RH) and 15 left-handed (LH) individuals based on their EHQ scores. The virtual auditory space identification (VASI) test was administered for the assessment of auditory spatial skills. It consists of presenting a series of virtually presented sounds from 8 azimuths (0°, R45°, R90°, R135°, 180°, L90°, L135°, and L45°) randomly through TDH HDA 200 headphones. Correct responses and biased responses along with their corresponding reaction times were calculated.ResultsResults revealed that although the RH group displayed a slightly stronger leftward bias in both degrees of error and reaction compared to the LH group and vice-versa, these differences were not statistically significant.ConclusionThe study concluded that there is little to no association between handedness and an individual’s auditory spatial ability. The absence of a significant difference in auditory spatial performance between RH and LH individuals may contribute to more inclusive and equitable approaches in fields where auditory spatial abilities are important.Trial registrationSH/IRB/RP/08. Registered 12 January 2023.

School-age growth and development following infant feeding and/or water, sanitation, and hygiene interventions in rural Zimbabwe: long-term follow-up of a cluster-randomised trial

Few trials have explored long-term effects of interventions designed to reduce child stunting. We evaluated school-age outcomes in rural Zimbabwean children who received cluster-randomised water, sanitation and hygiene (WASH) and/or infant and young child feeding (IYCF) interventions from pregnancy up to 18 months of age. The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial enrolled pregnant women from two rural Zimbabwean districts (Chirumanzu and Shurugwi) between 2012 and 2015, and cluster-randomised them using a 2×2 factorial design to standard-of-care, WASH, IYCF, or combined WASH & IYCF, with a co-primary outcome of height-for-age Z-score and haemoglobin at 18 months (clinicaltrials.govNCT01824940). Children who were HIV-unexposed, age 7 years, and still living in Shurugwi district were eligible for this follow-up study (registered at PACTR 202201828512110) and measured between 1st April 2021 and 30th September 2022. The primary outcome at 7 years was cognitive function using the Kaufman Assessment Battery for Children (KABC-II). Secondary outcomes were executive function, literacy and numeracy, fine motor skills, socioemotional function, handgrip strength, broad jump distance, shuttle-run test distance, anthropometry, lean mass index, and skinfold thicknesses. Study nurses conducting assessments were blinded to intervention arm. Analysis followed a pre-registered statistical analysis plan. Intention-to-treat analyses using generalized estimating equations were used to assess the long-term effects of WASH and IYCF on each outcome, leveraging the factorial trial design. A pre-specified subgroup analysis by child sex was also performed. Among 3989 HIV-negative women, 3676 children were assessed at age 18 months; of these, 1002 (510 female) were assessed at mean (SD) age 7.3 (0.2) years. There was no effect of IYCF or WASH on the KABC-II score or secondary cognitive outcomes, except a small improvement in socioemotional function in WASH arms (-0.98 points, 95% CI-1.73,-0.22, p=0.01). Children in IYCF arms had higher handgrip strength (0.28Kg, 95% CI 0.02, 0.53, p=0.03); however, in the pre-specified subgroup analysis, improved handgrip strength was seen only in boys (0.53Kg, 95% CI 0.19, 0.87 p=0.002). There were no significant effects of either intervention on other outcomes. Early-life IYCF and WASH led to few functional benefits by school-age. Interventions that are more comprehensive, delivered for longer, and include nurturing care should be considered to improve long-term cognitive and physical function. Wellcome [220671/Z/20/Z, 108065/Z/15/Z]; NIH [R61HD103101]; Thrasher [15250]; and IMMANA [3.02].

A longitudinal study of the role of fingers in the development of early number and arithmetic skills in children with Apert syndrome.

This paper discusses a longitudinal study with children with Apert syndrome aged between 4 and 11 years. There has long been an interest in the role of fingers in the development of early number skills and arithmetic. As children with Apert syndrome are born with complex fusions of their fingers, they have to undergo several surgical procedures in order to obtain individuated fingers. This has implications for their finger mobility and finger awareness. It has been suggested that children with Apert syndrome have specific difficulties with early number and arithmetic activities. The findings from this study suggest that engaging children with Apert syndrome in activities that develop finger awareness (finger gnosis) and finger mobility (fine motor skills) may have a positive impact on their ability to engage with appropriate mathematics curricula at school. This is relevant to all those involved in the care of children with Apert syndrome and will be of particular relevance to those involved in early childhood and primary education. This study also provides new insights into the role of finger use in the development of skills and understanding in early number and arithmetic.

Advancements in Dexterity Measurements: the digital Nine Hole Peg Test

Abstract Digitalization in the healthcare sector is progressing rapidly. In the field of measuring instruments for manual dexterity, digitization has resulted in major limitations in terms of ease of use and usability. This study describes the development of a digital nine-hole peg test (dNHPT) for assessing hand dexterity that can be used just as easily and quickly as the original nine-hole peg test. The extensive validation of the dNHPT includes the investigation of validity, reliability, clinical utility and user-friendliness This paper presents the validation of clinical utility and usability of the dNHPT. The comparison of the original ninehole peg test (NHPT) und the dNHPT show similar clinical utility of the dNHPT and the NHPT (74% of all ratings of dNHPT are equal to or better than the NHPT) and good to excellent System Usability Scale Scores of 78 (CI95: 75;81) and 85 (CI95: 80;89). Several recommendations for further development of the dNHPT were identified. The newly developed dNHPT presented here supports the quality of data collection through automated time measurement and result presentation and shows good usability and clinical utility ratings.

Awareness and Knowledge of Developmental Coordination Disorder Among Healthcare Professionals in the Eastern Province of Saudi Arabia: A Cross-Sectional Study

Developmental coordination disorder (DCD) is a lifelong neurological disorder impairing the coordination and planning of motor and sensory tasks. Its functional manifestation includes difficulties in various aspects of daily living, making early diagnosis and management essential. This cross-sectional, questionnaire-based study targeted healthcare providers in Saudi Arabia’s Eastern Province who work with children under the age of 18. The questionnaire was completed through field visit interviews and electronically via social platforms from October 2023 to March 2024, collecting data on demographics, professional experience, familiarity with related disorders, and awareness of dyspraxia symptoms. Of the participants, 21.2% had previously diagnosed at least one child with dyspraxia, with family physicians comprising 30% of those diagnoses. The overall mean knowledge score was 17%, ranging from 8.3% to 23.1%. The most recognized symptom was motor learning difficulties (22.7%), followed by gross and fine motor skill delays (22.3%). Notably, 65.15% of respondents were unsure about the gender distribution of dyspraxia. The findings align with international studies, showing significant knowledge gaps among healthcare providers in the Eastern Province. These findings also emphasize the need for targeted health promotion programs, promotional activities, and media involvement for enhancing public health outcomes, early identification, and better management of DCD.

KeyGAN: Synthetic keystroke data generation in the context of digital phenotyping

Objective:This paper aims to introduce and assess KeyGAN, a generative modeling-based keystroke data synthesizer. The synthesizer is designed to generate realistic synthetic keystroke data capturing the nuances of fine motor control and cognitive processes that govern finger-keyboard kinematics, thereby paving the way to support biomarker development for psychomotor impairment due to neurodegeneration. Methods:KeyGAN is designed with two primary objectives: (i) to ensure high realism in the synthetic distributions of the keystroke features and (ii) to analyze its ability to replicate the subtleties of natural typing for enhancing biomarker development. The quality of synthetic keystroke data produced by KeyGAN is evaluated against two keystroke-based applications, TypeNet and nQiMechPD, employed as’referee’ controls. The performance of KeyGAN is compared with a reference random Gaussian generator, testing its ability to fool the biometric authentication method TypeNet, and its ability to characterize fine motor impairment in Parkinson’s Disease using nQiMechPD. Results:KeyGAN outperformed the reference comparator in fooling the biometric authentication method TypeNet. It also exhibited a superior approximation to real data than the reference comparator when using nQiMechPD, showcasing its adaptability and versatility in mimicking early signs of Parkinson’s Disease in natural typing. KeyGAN’s synthetic data demonstrated that almost 20% of real PD samples could be replaced in the training set without a decline in classification performance on the real test set. Low Fréchet Distance (<0.03) and Kullback–Leibler Divergence (<700) between KeyGAN outputs and real data distributions underline the high performance of KeyGAN. Conclusion:KeyGAN presents strong potential as a realistic keystroke data synthesizer, displaying impressive capability to reproduce complex typing patterns relevant to biomarkers for neurological disorders, like Parkinson’s Disease. The ability of its synthetic data to effectively supplement real data for training algorithms without affecting performance implies significant promise for advancing research in digital biomarkers for neurodegenerative and psychomotor disorders.