Motor Learning In Individuals Research Articles

The Potential Role of Sleep in Post-stroke Motor Learning

Stroke is the primary contributor to the commencement of adult disability in the United Kingdom, and individuals who survive a stroke frequently encounter challenges in reacquiring motor abilities, which has a substantial influence on their overall well-being. Sleep disturbance is a prevalent issue affecting approximately 50% of those who have experienced a stroke. The established literature demonstrates the advantageous impacts of sleep on motor learning in individuals without health complications. However, the precise contribution of sleep to motor learning in individuals recovering from stroke remains inadequately comprehended. The objective of this review was to analyze and consolidate the available research pertaining to motor learning after stroke, with the intention of ascertaining the presence and mechanisms of this association. Sleep-induced motor learning has two distinct phases, namely sleep preceding learning (SBL) and sleep after learning (SAL). These stages facilitate the consolidation of memory and reinforce the connections between different regions of the cerebral cortex, thereby decreasing the need for the medial temporal lobe (MTL) to bind information. There is a limited yet promising body of evidence suggesting that sleep has a role in modulating motor learning and rehabilitation outcomes following a stroke. There is evidence suggesting that sleep has a positive impact on motor learning following a stroke. Several studies have shown that stroke patients exhibit increased tracking accuracy after a night of sleep compared to those who do not sleep. Sleep disruptions have an adverse effect on the functional recovery of those who have experienced a stroke, with a special emphasis on those who have suffered from moderate strokes. There exists a correlation between suboptimal sleep patterns and impaired motor recovery following a stroke, however the use of sedative medications does not yield substantial enhancements in sleep quality or rehabilitation outcomes. Moreover, the utilization of sedatives may potentially have adverse effects on memory function and neural connectivity. Although the current research shows promise, it is important to acknowledge its limitations, which include the use of subjective sleep assessments and cross-sectional study designs. In order to demonstrate a more conclusive relationship between sleep and post-stroke motor recovery, future research endeavors should incorporate objective sleep assessment techniques, longitudinal methodologies, and randomized crossover designs. In summary, the current body of research suggests a potentially beneficial impact of sleep on motor learning following a stroke. However, it is important to exercise caution when interpreting these findings due to limitations in the methodologies employed. In order to comprehensively comprehend the influence of sleep on post-stroke motor recovery, it is imperative to conduct further research employing robust study designs and objective sleep assessment techniques. Such investigations have the potential to enhance rehabilitation efforts and mitigate healthcare expenses.

Direction of attentional focus in prosthetic training: Current practice and potential for improving motor learning in individuals with lower limb loss.

Adopting an external focus of attention has been shown to benefit motor performance and learning. However, the potential of optimizing attentional focus for improving prosthetic motor skills in lower limb prosthesis (LLP) users has not been examined. In this study, we investigated the frequency and direction of attentional focus embedded in the verbal instructions in a clinical prosthetic training setting. Twenty-one adult LLP users (8 female, 13 male; 85% at K3 level; mean age = 50.5) were recruited from prosthetic clinics in the Southern Nevada region. Verbal interactions between LLP users and their prosthetists (mean experience = 10 years, range = 4-21 years) during prosthetic training were recorded. Recordings were analyzed to categorize the direction of attentional focus embedded in the instructional and feedback statements as internal, external, mixed, or unfocused. We also explored whether LLP users' age, time since amputation, and perceived mobility were associated with the proportion of attentional focus statements they received. We recorded a total of 20 training sessions, yielding 904 statements of instruction from 338 minutes of training. Overall, one verbal interaction occurred every 22.1 seconds. Among the statements, 64% were internal, 9% external, 3% mixed, and 25% unfocused. Regression analysis revealed that female, older, and higher functioning LLP users were significantly more likely to receive internally-focused instructions (p = 0.006, 0.035, and 0.024, respectively). Our results demonstrated that verbal instructions and feedback are frequently provided to LLP users during prosthetic training. Most verbal interactions are focused internally on the LLP users' body movements and not externally on the movement effects. While more research is needed to explore how motor learning principles may be applied to improve LLP user outcomes, clinicians should consider adopting the best available scientific evidence during treatment. Overreliance on internally-focused instructions as observed in the current study may hinder prosthetic skill learning.

Participants with mildly-disabling chronic neck pain perform differently during explicit compared to implicit motor learning of a reaching task.

Chronic musculoskeletal (CMSK) pain associated with musculoskeletal disorders like low back pain or neck pain are the leading causes of disability. While CMSK pain has the potential to negatively influence motor learning, there is limited research to understand the impact of CMSK on motor learning. In order to examine differences in motor learning between individuals with and without CMSK we modified a serial reaction time task to assess motor learning of a repetitive reaching task. The paradigm was used to assess both explicit and implicit motor learning. In a cross-sectional study design, seventeen participants with chronic neck pain (CNP) (5 males) and 21 controls (8 males) were recruited. In addition, physical, cognitive, sensorimotor, disability and pain assessments were used to examine differences between individuals with and without CNP. All participants with CNP were categorized as having mild disability. There was no difference in cognitive assessments and minimal differences in physical measures between groups. Examining motor learning, groups with and without CNP demonstrated similar outcomes in both explicit and implicit motor learning. There was one notable performance difference between groups in the reaching task, the group with CNP demonstrated slower reaching movements outward and inward during blocks without explicit information. This may suggest a cautious approach to movement with reduced explicit information. Findings from this study provide insight on motor learning in individuals with mildly-disabling CNP, further research is necessary to examine how instruction can impact peak performance in people with CMSK pain.

The Effect of Virtual Reality-Based Therapy on Improving Upper Limb Functions in Individuals With Stroke: A Randomized Control Trial.

Background: Stroke is a common cause of motor disability. The recovery of upper limb after stroke is poor, with few stroke survivors regaining some functional use of the affected upper limb. This is further complicated by the fact that the prolonged rehabilitation is accompanied by multiple challenges in using and identifying meaningful and motivated treatment tasks that may be adapted and graded to facilitate the rehabilitation program. Virtual reality-based therapy is one of the most innovative approaches in rehabilitation technology and virtual reality systems can provide enhanced feedback to promote motor learning in individuals with neurological or musculoskeletal diseases.Purpose: This study investigated the effect of virtual reality-based therapy on improving upper limb functions in individuals with chronic stroke.Methods: Forty Saudi individuals with chronic stroke (6–24 months following stroke incidence) and degree of spasticity ranged between 1, 1 + and 2 according to Modified Ashworth Scale were included in this study. Participants were randomly assigned into two groups, experimental and control, with the experimental group undertaking a conventional 1-h functional training program, followed by another hour of virtual reality-based therapy using Armeo Spring equipment and the control group received 2 h of a conventional functional training program. The treatment program was conducted three times per week for three successive months. The change in the scores of Action Research Arm Test (ARAT), Wolf Motor Function Test (WMFT), WMFT-Time (time required to complete the test) and Hand Grip Strength (HGS) were recorded at baseline and after completion of the treatment. Parametric (paired and unpaired t-tests) non-parametric (Wilcoxon and Mann–Whitney tests) statistical tests were used to identify the differences within and between groups (experimental group and control group) and evaluation times (pre- and immediately post-treatment).Results: Both groups showed significant differences (all, P < 0.05) in all measured variables after 3 months of the treatment. Individuals with stoke in the experimental group had a better improvement in ARAT (P < 0.01), WMFT (P < 0.01) and WMFT-Time (P < 0.01) scores after completion of the treatment compared to the control group. No significant difference in HGS scores was detected between groups after completion of the treatment (P = 0.252).Conclusion: The use of combined treatment of virtual reality-based therapy and conventional functional training program is more effective for improving upper limb functions in individuals with chronic stroke than the use of the conventional program alone.

Enhancing motor learning in people with stroke via memory reactivation during sleep.

Investigate the use of repetitive delivery of task-related auditory cues, known as targeted memory reactivation (TMR), throughout a 1-hour daytime nap to enhance motor learning in individuals with chronic stroke. Participants with a history of stroke at least 6 months prior were recruited to perform a novel overhand throwing task to randomly appearing target locations using the nonparetic upper extremity immediately before and after a 1-hour daytime nap. Half of the participants received TMR during the nap. Participants who received TMR demonstrated a greater overall reduction in absolute and variable spatial errors relative to the NoTMR control group. Both groups demonstrated similar generalization of skill to 2 untrained variants of the trained task, but not to a novel untrained task. This study suggests that TMR may enhance motor learning after stroke. Future studies should investigate whether TMR can lead to improvements of the paretic upper extremity during clinically based rehabilitation interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Cognition and motor learning in a Parkinson's disease cohort: importance of recall in episodic memory.

Impaired motor learning in individuals with Parkinson's disease is often attributed to deficits in executive function, which serves as an important cognitive process supporting motor learning. However, less is known about the role of other cognitive domains and its association with motor learning in Parkinson's disease. The objective of this study was to investigate the associations between motor learning and multiple domains of cognitive performance in individuals with Parkinson's disease. Twenty-nine participants with Parkinson's disease received comprehensive neuropsychological testing, followed by practice of a bimanual finger sequence task. A retention test of the finger sequence task was completed 24 h later. Hierarchical linear regressions were used to examine the associations between motor learning (acquisition rate and retention) and cognitive performance in five specific cognitive domains, while controlling for age, sex, and years of Parkinson's disease diagnosis. We found that a higher acquisition rate was associated with better episodic memory, specifically better recall in visual episodic memory, in individuals with Parkinson's disease. No significant associations were observed between retention and cognitive performance in any domains. The association between motor acquisition and episodic memory indicates an increased dependency on episodic memory as a potential compensatory cognitive strategy used by individuals with Parkinson's disease during motor learning.

Resting State Connectivity Is Modulated by Motor Learning in Individuals After Stroke

Objective Activity patterns across brain regions that can be characterized at rest (ie, resting-state functional connectivity [rsFC]) are disrupted after stroke and linked to impairments in motor function. While changes in rsFC are associated with motor recovery, it is not clear how rsFC is modulated by skilled motor practice used to promote recovery. The current study examined how rsFC is modulated by skilled motor practice after stroke and how changes in rsFC are linked to motor learning. Methods Two groups of participants (individuals with stroke and age-matched controls) engaged in 4 weeks of skilled motor practice of a complex, gamified reaching task. Clinical assessments of motor function and impairment, and brain activity (via functional magnetic resonance imaging) were obtained before and after training. Results While no differences in rsFC were observed in the control group, increased connectivity was observed in the sensorimotor network, linked to learning in the stroke group. Relative to healthy controls, a decrease in network efficiency was observed in the stroke group following training. Conclusions Findings indicate that rsFC patterns related to learning observed after stroke reflect a shift toward a compensatory network configuration characterized by decreased network efficiency.

Motivational Effects of Enhanced Expectancies for Motor Learning in Individuals With High and Low Self-Efficacy.

Previous research has shown that enhanced expectancies can foster a person’s motivational state and facilitate motor learning. However, the effects of enhanced expectancies on motivational state and subsequent motor learning in individuals with varied motivational states (e.g., self-efficacy; SE) are not well understood. This study examined the effects of enhanced expectancies on motivational state and motor learning in individuals with high and low SE by manipulating the type of knowledge of results (KR). We selected 60 participants from 251 male undergraduate students, based on their SE level, and assigned them to four groups: (a) Good Performance KR and High SE, (b) Poor Performance KR and High SE, (c) Good Performance KR and Low SE, and (d) Poor Performance KR and Low SE. We asked participants to throw beanbags at a target with their nondominant hand during an acquisition phase (10 blocks of six trials each) and during subsequent retention and transfer tests. During acquisition, the Good KR groups received KR from their three most accurate trials in each training block, whereas the Poor KR groups received KR from their three poorest attempts in each block. We measured accuracy scores and changes in SE as dependent variables. Results showed that KR from good trials, relative to KR from poor trials, led to better accuracy scores during acquisition and retention and transfer tests, independent of participants’ initial SE levels. Moreover, KR on good trials enhanced SE in the Good KR and Low SE group and kept SE at a high level in the Good KR and High SE group during acquisition and on the retention and transfer tests. These results provide support for the OPTIMAL (optimizing performance through intrinsic motivation and attention for learning) theory of motor learning, and we discuss results in terms of the potential effects of positive feedback on motor performance in professional athletes.

Motor Learning in Individuals With Lower Limb Loss and Chronic Diabetes

Motor Learning in Individuals With Lower Limb Loss and Chronic Diabetes

Vestibular Physical Therapy in Individuals With Cognitive Impairment: A Theoretical Framework.

Falls are a major health care concern in individuals with Alzheimer disease (AD) and their caregivers. Vestibular impairment is a known risk factor for falls, and individuals with AD have been shown to have an increased prevalence of vestibular loss compared with age-matched controls. Vestibular physical therapy (VPT) is effective in improving balance and reducing fall risk in cognitively-intact persons with vestibular impairment. However, the effectiveness of VPT in improving balance and reducing falls in individuals with AD who have vestibular loss has never been explored. SUMMARY OF KEY POINTS:: In this article, we apply prevailing ideas about rehabilitation and motor learning in individuals with cognitive impairment (IwCI) to VPT. RECOMMENDATIONS FOR CLINICAL PRACTICE:: We propose a modification of current evidence-based VPT protocols for IwCI using the strength-based theoretical framework that emphasizes the motor learning abilities of IwCI. In addition, we highlight the importance of establishing an excellent rapport with IwCI, and present key strategies for optimizing the therapeutic relationship. In ongoing work, we are assessing the efficacy of this modified VPT protocol in IwCI to improve balance and reduce falls.

Effects of extrinsic feedback on the motor learning after stroke

Abstract Aim: This study aims to investigate the effects of the type of extrinsic feedback provided equally in terms of timing and frequency of delivery on the motor learning after stroke. Methods: Twenty post-stroke individuals were distributed randomly into two groups according to the type of feedback provided: knowledge of performance experimental group (KPEG) and knowledge of results experimental group (KREG). Additionally, a control group (CG) was consisted of 20 healthy individuals age- and feedback-matched with the experimental groups. The task was a pointing skill performed in a virtual reality system. The acquisition phase consisted of 3 days/ 75 trials per day. Two retention tests (ret1 and ret2) were run after four days from the acquisition phase. Dependent variable measures were defined by motor performance and movement pattern. Results: The statistical analysis showed interaction effect F(3,108 = 49.13, p = 0.01) among KPEG and KREG. Based on the motor performance parameters (score) the KPEG improved performance significantly from pre to post (p = 0.001), and maintain it from pre to ret1 (p = 0.002), and from the pre to ret2 (p = 0.001). However, the KREG only showed a difference in motor performance from the pre to post (p = 0.003). Compared to the KREG, the KPEG showed improvement on the movement pattern based on the smoothness (p = 0.004), which suggests that the KPEG performed more corrections of movements in relation to the CG and KREG groups. Conclusion: These findings suggest that KP allowed better motor learning in individuals after stroke.

Executive Function Is Associated With Off-Line Motor Learning in People With Chronic Stroke.

Sleep has been shown to promote off-line motor learning in individuals following stroke. Executive function ability has been shown to be a predictor of participation in rehabilitation and motor recovery following stroke. The purpose of this study was to explore the association between executive function and off-line motor learning in individuals with chronic stroke compared with healthy control participants. Seventeen individuals with chronic stroke (>6 months poststroke) and 9 healthy adults were included in the study. Participants underwent 3 consecutive nights of polysomnography, practiced a continuous tracking task the morning of the third day, and underwent a retention test the morning after the third night. Participants underwent testing on 4 executive function tests after the continuous tracking task retention test. Participants with stroke showed a significant positive correlation between the off-line motor learning score and performance on the Trail-Making Test from Delis-Kaplan Executive Function System (r = 0.652; P = 0.005), while the healthy control participants did not. Regression analysis showed that the Trail-Making Test-Delis-Kaplan Executive Function System is a significant predictor of off-line motor learning (P = 0.008). This is the first study to demonstrate that better performance on an executive function test of attention and set-shifting predicts a higher magnitude of off-line motor learning in individuals with chronic stroke. This emphasizes the need to consider attention and set-shifting abilities of individuals following stroke as these abilities are associated with motor learning. This in turn could affect learning of activities of daily living and impact functional recovery following stroke.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A166).

Perception of Biological Motion Speed in Individuals with Down Syndrome

The explanations for the motor learning deficits observed in individuals with Down Syndrome (DS) emphasize a complex interplay among the structural and functional body abnormalities of this population. To further comprehend how this pathological condition functions, researchers are now attempting to understand how visual and motor systems process information and how this processing correlates with the development of motor learning in individuals with DS. The purpose of the current study was to investigate whether individuals with DS are able to perceive and differentiate between visually presented sequences of biological motion that portrayed walking at different speeds. We tested 17 participants with DS and 17 typical develop individuals (CG) who were matched for age and gender on a task requiring subjects to make fine discriminations between biological motion stimuli in the form of point-lightwalkers that walked at different speeds. Individuals with DS were unable to recognize differences in walking speeds between walkers, and also demonstrated slower reaction times on the task than the CG. The CG was able to perform the task well above chance level and faster than DS subjects. These results shed light on the biological motion processing capabilities of people with DS, and provide insights for future research in this field.

Spiritual experiences as a mediator between faith as well as religious practices and hope among sex addicted individuals from Poland participating in Sex and Love Addicts Anonymous (SLAA)

Developmental disability in a growing child limits the attainment of certain functions such as motor, communication, perpetual and cognitive skills. Cerebral Palsy (CP) is one such developmental disability that hinders the movement and activities of daily living of the affected child. In order to treat this disorder, several interventional tools are available which has its own pros and cons. Repetitive Transcranial magnetic stimulation (rTMS) is a new noninvasive tool employed for the treatment of CP due to its neuromodulatory effect that facilitates motor memory formation, motor performance and motor learning in individuals. In this report, a promising effect of rTMS therapy is discussed wherein a wheelchair ridden patient was able to crawl, kneel and move after two rounds of treatment procedure.

Working Memory Models: Insights From Neuroimaging.

FIGURE 1. The Atkinson and Shiffrin Model of memory is diagramed in the gray panel. Sensory information is perceived and suppressed via selective attention processes, then briefly held in the limited-capacity modality-specific sensory register. Information enhanced by selective attention enters into short term memory (STM). The process of rehearsal (maintenance) can sustain information in STM. Information in STM is automatically encoded (stored, consolidated) into long term memory (LTM). Although flawed, this model continues to provide a simple and easy approach to understanding memory. Assumptions that proved to be inconsistent with research included that any information in STM will transfer to LTM and that STM is required

Effects of Physical and Mental Practice on Motor Learning in Individuals with Cerebral Palsy

In this study we investigated the effects of physical and mental practice in acquisition, retention, and transfer of a motor skill in individuals with cerebral palsy (CP). For this reason, 29 males diagnosed with CP type I (18.51 ± 5.03 years of age) were chosen and, according to a pretest, were assigned to three homogenous groups; physical practice (n = 10), mental practice (n = 10), and control (n = 9). The experimental groups practiced for 5 sessions (6 blocks of 5 trials in each session). The acquisition test was run immediately at the end of each practice session and the retention and transfer tests were run approximately 48 h following the acquisition phase. Analyses of variance with repeated measures and post hoc tests suggest individuals with CP have the ability to acquire and retain a new motor skill with either physical or mental practice. This finding replicates studies involving typically developing individuals and extends previous research by demonstrating the benefits of mental practice for people with CP. Implications for clinical practice and directions for future research are discussed.

Remote limb ischemic conditioning enhances motor learning in healthy humans.

Brief bouts of sublethal ischemia have been shown to protect exposed tissue (ischemic conditioning) and tissues at remote sites (remote ischemic conditioning) against subsequent ischemic challenges. Given that the mechanisms of this protective phenomenon are multifactorial and epigenetic, we postulated that remote limb ischemic conditioning (RLIC) might enhance mechanisms responsible for neural plasticity, and thereby facilitate learning. Specifically, we hypothesized that conditioning of the nervous system with RLIC, achieved through brief repetitive limb ischemia prior to training, would facilitate the neurophysiological processes of learning, thus making training more effective and more long-lasting. Eighteen healthy adults participated in this study; nine were randomly allocated to RLIC and nine to sham conditioning. All subjects underwent seven consecutive weekday sessions and 2-wk and 4-wk follow-up sessions. We found that RLIC resulted in significantly greater motor learning and longer retention of motor performance gains in healthy adults. Changes in motor performance do not appear to be due to a generalized increase in muscle activation or muscle strength and were not associated with changes in serum brain-derived neurotrophic factor (BDNF) concentration. Of note, RLIC did not enhance cognitive learning on a hippocampus-dependent task. While future research is needed to establish optimal conditioning and training parameters, this inexpensive, clinically feasible paradigm might ultimately be implemented to enhance motor learning in individuals undergoing neuromuscular rehabilitation for brain injury and other pathological conditions.

Motor learning in individuals with autism spectrum disorder: activation in superior parietal lobule related to learning and repetitive behaviors.

Motor-linked implicit learning is the learning of a sequence of movements without conscious awareness. Although motor symptoms are frequently reported in individuals with autism spectrum disorder (ASD), recent behavioral studies have suggested that motor-linked implicit learning may be intact in ASD. The serial reaction time (SRT) task is one of the most common measures of motor-linked implicit learning. The present study used a 3T functional magnetic resonance imaging scanner to examine the behavioral and neural correlates of real-time motor sequence learning in adolescents and adults with ASD (n = 15) compared with age- and intelligence quotient-matched individuals with typical development (n = 15) during an SRT task. Behavioral results suggested less robust motor sequence learning in individuals with ASD. Group differences in brain activation suggested that individuals with ASD, relative to individuals with typical development, showed decreased activation in the right superior parietal lobule (SPL) and right precuneus (Brodmann areas 5 and 7, and extending into the intraparietal sulcus) during learning. Activation in these areas (and in areas such as the right putamen and right supramarginal gyrus) was found to be significantly related to behavioral learning in this task. Additionally, individuals with ASD who had more severe repetitive behavior/restricted interest symptoms demonstrated greater decreased activation in these regions during motor learning. In conjunction, these results suggest that the SPL may play an important role in motor learning and repetitive behavior in individuals with ASD.

Effects of self-control and instructor-control feedback on motor learning in individuals with cerebral palsy

In this study we investigated the effects of "self-control and instructor-control feedback" on motor learning in individuals with cerebral palsy (CP). For this reason 22 boy students with CP type I (12.26±3.11 years of age) were chosen. They were put into self-control feedback, instructor-control feedback and control groups. All participants practiced dart throwing skill for 5 sessions (4 blocks of 5 trails each session). The self-control group received knowledge of results (KR) feedback for half of their trials whenever they wanted. The instructor-control group received KR feedback after half of both their good and bad trails. The control group received no feedback for any trails. The acquisition test was run immediately at the end of each practice session (the last block) and the retention and transfer tests were run 24h following the acquisition phase. Analyses of variance with repeated measures and Post hoc tests were used to analyze the data. According to the results of this study, individuals with CP have the ability of acquiring and retaining a new motor skill. Also, it was found that self-control feedback is effective than instructor-control feedback on learning of a motor task in individuals with CP as in the average population. These findings show that rules regarding feedback also apply to people afflicted with CP.

The Kinesthetic and Visual Imagery Questionnaire Is a Reliable Tool for Individuals With Parkinson Disease

It is not known whether individuals with Parkinson disease (PD) can practice movements mentally. Before this question can be addressed, a reliable imagery assessment tool must be established. The recently developed Kinesthetic and Visual Imagery Questionnaire (KVIQ) is valid for non-disabled individuals and individuals with stroke. We have extended this work by examining the test-retest reliability and concurrent validity of the KVIQ in individuals with PD. Eleven individuals with mild to moderate PD were assessed, while on medication, by the same examiner at 2 sessions (5-12 days apart). Test-retest reliability was measured using intraclass correlation coefficients (ICCs). To examine concurrent validity, KVIQ scores from the second session were compared with a gold standard, the revised Movement Imagery Questionnaire, using Spearman rank order correlation coefficients. There was no significant difference between total KVIQ scores for the test-retest sessions (P > 0.05). Overall, test-retest reliability of the KVIQ was good (ICC = 0.87), and reliability of the subscale of the KVIQ for indexing visual imagery and kinesthetic imagery was also good (ICC = 0.82 and 0.95, respectively). However, the subscale indexing axial visual imagery showed less reliability (ICC = 0.74), suggesting that individuals with PD were not as reliable when imagining axial visual movements as they were for imagining limb movements. Concurrent validity between the second session KVIQ score and the revised Movement Imagery Questionnaire score (gold standard) was excellent (rho = 0.93). Our data support the conclusion that the KVIQ is a reliable and valid test for indexing mental imagery ability in individuals with PD. The KVIQ is easy to administer, and the movements (both real and imagined) required are appropriate for individuals with neuropathology. Our data suggest that the KVIQ is a good choice for clinicians who may wish to index motor imagery ability before implementing imagery as a rehabilitation intervention.