Motor Skill Acquisition Research Articles

Optimising motor development in the hospitalised infant with CHD: factors contributing to early motor challenges and recommendations for assessment and intervention.

Neurodevelopmental challenges are the most prevalent comorbidity associated with a diagnosis of critical CHD, and there is a high incidence of gross and fine motor delays noted in early infancy. The frequency of motor delays in hospitalised infants with critical CHD requires close monitoring from developmental therapies (physical therapists, occupational therapists, and speech-language pathologists) to optimise motor development. Currently, minimal literature defines developmental therapists' role in caring for infants with critical CHD in intensive or acute care hospital units. This article describes typical infant motor skill development, how the hospital environment and events surrounding early cardiac surgical interventions impact those skills, and how developmental therapists support motor skill acquisition in infants with critical CHD. Recommendations for healthcare professionals and those who provide medical or developmental support in promotion of optimal motor skill development in hospitalised infants with critical CHD are discussed. Infants with critical CHD requiring neonatal surgical intervention experience interrupted motor skill interactions and developmental trajectories. As part of the interdisciplinary team working in intensive and acute care settings, developmental therapists assess, guide motor intervention, promote optimal motor skill acquisition, and support the infant's overall development.

Implicit Motor Learning Strategies Benefit Dual-Task Performance in Patients with Stroke.

Background and Objectives: In stroke rehabilitation, the use of either implicit or explicit learning as a motor learning approach during dual tasks is common, but it is unclear which strategy is more beneficial. This study aims to determine the benefits of implicit versus explicit motor learning approaches in patients with stroke. Materials and Methods: Seventeen patients with stroke and 21 control participants were included. Motor learning was evaluated using the Serial Reaction Time Task (SRTT) in the context of dual-task conditions. The SRTT was conducted on two separate days: one day for implicit learning conditions and the other day for explicit learning conditions. Under the explicit learning conditions, a task rule was given to the participants before they started the task, but not under the implicit learning conditions. Learning scores were calculated for both implicit and explicit learning, and these scores were then compared within groups for patients with stroke and controls. We calculated the difference in learning scores between implicit and explicit learning and conducted a correlation analysis with the Trail Making Test (TMT) Parts A and B. Results: Learning scores on the SRTT were not different between implicit and explicit learning in controls but were significantly greater in patients with stroke for implicit learning than for explicit learning. The difference in learning scores between implicit and explicit learning in patients with stroke was correlated with TMT-A and showed a correlation trend with TMT-B. Conclusions: Implicit learning approaches may be effective in the acquisition of motor skills with dual-task demands in post-stroke patients with deficits in attention and working memory.

Cortical changes during the learning of sequences of simultaneous finger presses

Abstract The cortical alterations underpinning the acquisition of motor skills remain debated. In this longitudinal study in younger adults, we acquired performance and neuroimaging (7 T MRI) measures weekly over the course of 6 weeks to investigate neural changes associated with learning sequences of simultaneous finger presses executed with the non-dominant hand. Both the intervention group (n = 33), which practiced the finger sequences at home, and the control group (n = 30, no home practice) showed general performance improvements, but performance improved more and became more consistent for sequences that were intensively trained by the intervention group, relative to those that were not. Brain activity for trained sequences decreased compared with untrained sequences in the bilateral parietal and premotor cortices. No training-related changes in the primary sensorimotor areas were detected. The similarity of activation patterns between trained and untrained sequences decreased in secondary, but not primary, sensorimotor areas, while the similarity of the activation patterns between different trained sequences did not show reliable changes. Neither the variability of activation patterns across trials, nor the estimates of brain structure displayed practice-related changes that reached statistical significance. Overall, the main correlate of learning configural sequences was a reduction in brain activity in secondary motor areas.

Repetitive paired-pulse TMS increases motor cortex excitability and visuomotor skill acquisition in young and older adults.

Transcranial magnetic stimulation (TMS) over primary motor cortex (M1) recruits indirect (I) waves that can be modulated by repetitive paired-pulse TMS (rppTMS). The purpose of this study was to examine the effect of rppTMS on M1 excitability and visuomotor skill acquisition in young and older adults. A total of 37 healthy adults (22 young, 18-32yr; 15 older, 60-79yr) participated in a study that involved rppTMS at early (1.4ms) and late (4.5ms) interstimulus intervals (ISIs), followed by the performance of a visuomotor training task. M1 excitability was examined with motor-evoked potential (MEP) amplitudes and short-interval intracortical facilitation (SICF) using posterior-anterior (PA) and anterior-posterior (AP) TMS current directions. We found that rppTMS increased M1 excitability in young and old adults, with the greatest effects for PA TMS at the late ISI (4.5ms). Motor skill acquisition was improved by rppTMS at an early (1.4ms) but not late (4.5ms) ISI in young and older adults. An additional study using a non-I-wave interval (3.5ms) also showed increased M1 excitability and visuomotor skill acquisition. These findings show that rppTMS at both I-wave and non-I-wave intervals can alter M1 excitability and improve visuomotor skill acquisition in young and older adults.

Manual Rhythmic Sequencing Skills in Children With Childhood Apraxia of Speech.

Rhythm is one procedural mechanism that underlies language and motor skill acquisition and has been implicated in children with childhood apraxia of speech (CAS). The purpose of this study is to investigate manual rhythmic sequencing skills in children with a history of or current CAS (hx/CAS) compared to children with typical development (TD). Thirty-eight children (18 with hx/CAS, 20 with TD), ages 5;0-12;8 (years;months), from across the United States participated in an online study. Participants imitated two rhythms in two different conditions, clapping and tapping. We assessed overall accuracy, mean number of beats, pause marking, and rhythmic sequence variability using the Mann-Whitney U test. Effect sizes were calculated to examine the influence of coordinative complexity on performance. Compared to children with TD, children with hx/CAS marked fewer trials with a pause in both conditions of the easier rhythm and showed lower overall accuracy and more variable rhythmic sequences in both rhythms and conditions. The mean number of beats produced by children with hx/CAS and children with TD did not differ in three out of four rhythms/conditions. Unlike children with TD, children with hx/CAS showed little improvement from clapping to tapping across most dependent measures; reducing coordination demands did not improve performance in children with hx/CAS. We found that children with hx/CAS show manual rhythmic deficits that are similar to the deficits they display in speech. These findings provide support for a domain-general cognitive mechanisms account of the rhythmic deficits observed across linguistic and nonlinguistic tasks in children with hx/CAS. https://doi.org/10.23641/asha.24052821.

The Effect of Modeling Methods on Mirror Neuron Activity and a Motor Skill Acquisition and Retention.

Mirror neurons have been suggested as a potential neural mechanism of observational learning. This study aims to investigate the effect of self-modeling, skilled model, and learning model on mu rhythm suppression and golf putting acquisition and retention. The study was conducted on 45 male volunteer students (aged 19.4±0.37 years) in three experimental groups, self-modeling, skilled, and learning models with six sessions of physical and observational training in three periods of pre-test, acquisition, and retention. In the pre-test, after the initial familiarity with the skill, participants performed 10 golf putting actions while scores were recorded. Then, electrical brain waves in C3, C4, and Cz regions were recorded during the observation of 10 golf putting actions by their group-related models. The acquisition period consisted of golf putting training during six sessions, each consisting of six blocks of 10 trials. Before each training block, participants observed golf putting related to their group 10 times in the form of a video. Acquisition and delayed retention tests were also performed by recording scores of 10 golf putting actions, as well as recording electrical brain waves while observing the skill performed by the related model. Mixed analysis of variance (ANOVA) showed that the mu rhythm suppression in the pre-test was more in the self-modeling group compared to the skilled model and learning model groups, but this suppression was not significantly different in all three groups in the acquisition and retention tests. In putting task variables, all three groups that had no significant difference in the pre-test period made considerable progress in learning the desired skill from the pre-test to the acquisition test, and this progress was somewhat stable until the retention test. Also, both in the acquisition and retention periods, the self-modeling group showed better performance than the other two groups; however, no significant difference was observed between these groups. These results suggest that the model-observer similarity is a crucial factor in modeling interventions and can affect the rate of mu rhythm suppression.

The Positive Impact of Combining Motor Imagery, Action Observation and Coach's Feedback on Archery Accuracy of Young Athletes.

In recent years, learning and motor control researchers have examined, in diverse ways, the practical strategies that enhance motor skill acquisition in sport. In this study we investigated the impact of combining Motor Imagery (MI), Feedback (F), and Action Observation (AO) on the quality of archery longbow shooting at a 10-meter target. We randomly assigned 60 young athletes to (a) a Control group (Control), (b) a Feedback and Motor Imagery group (F + MI), and (c) a Feedback, Motor Imagery, and Action Observation group (F + MI + AO). Over an 8-week intervention period athletes performed two training sessions per week. During each session, all participants engaged in two blocks of ten effective shots. Performance improvement was significantly greater in the F + MI + AO group than in the two other groups, confirming the beneficial impact of combining all three methods of improving archery accuracy. These findings suggest practical recommendations for athletes and trainers for delivering optimal mental training to improve shooting accuracy for these archers.

WTP6.14 The Effectiveness of Mental Practice in Surgical Skills Practice and Acquisition: A Review

Abstract Aims Mental practice (MP) is an established method to enhance performance in other disciplines. The aim of this review is to assess whether the principles of MP are transferable to surgery and describe how it has been applied in our field so far. Methods A narrative review was conducted according to the four steps described by Demiris et. al. Results This review describes the different types of MP and their role on motor skill acquisition. The process of preparation, delivery and assessment of a MP session is described here in a reproducible manner; providing a ‘user guide’ to surgeons. MP has been shown in several reports to be an effective means in learning surgical skills, from basic surgical technique to the steps of a procedure. It has also been described as a technique applicable to both surgical trainees and established surgeons. Ten RCTs demonstrated a favourable effect of MP on technical skills and one trial showed that MP with MI is equivalent to additional physical practice. On the contrary two RCTs showed MP to be inferior or have no impact compared to other types of preparation. Reduced MP duration was identified as one of the possible reasons for a lack of positive results. Conclusion Mental practice is a feasible method for rehearsing surgical skills and procedures that has been demonstrated to enhance skills acquisition and surgical performance. Larger scale, randomised controlled trials are needed to standardise the duration, number of repetitions, and practical considerations for mental practice in surgery.

Defining and measuring motor imagery in children: mini review.

Motor imagery (MI) is the ability to engage in the mental representation of a task consciously or automatically without generating a voluntary movement. While the construct of MI and its various dimensions have been comprehensively studied in adults, research remains limited in children. Children as young as 5 years old can engage in MI, and this engagement is crucial to their motor development and skill acquisition. Further, the degree of skill achievement is directly linked to MI responsiveness. Clinicians and researchers often measure MI responsiveness in children to facilitate skill development and retention. However, few measures exist that can appropriately assess MI responsiveness in children. To date, a focused review examining the MI dimensions in children as well as comparing the characteristics of MI measures in children is lacking, and thus a research gap exists. This paper examines past and current research describing MI ability in children from the theoretical, developmental, and neurological lens and systematically analyzes the properties of three widely used operations - the movement imagery questionnaire in children (MIQ-C), the Florida praxis imaginary questionnaire (FPIQ-C), and the mental chronometry paradigm (MCP) - to measure MI and its dimensions in children.

Placebo effects of transcranial direct current stimulation on motor skill acquisition

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique used in neurorehabilitation to enhance motor training. However, its benefits to motor training can be difficult to reproduce across research studies. It is possible that the observed benefits of tDCS are not directly related to the intervention itself but rather to the brain-mind responses elicited by the treatment context, commonly known as a placebo effect. This study investigated the presence of a placebo effect of tDCS on motor training and explored potential underlying factors. Sixty-eight participants who were right-handed were randomly assigned to active tDCS, sham tDCS, or a no-stimulation control group. Double-blind active or sham tDCS was applied to the right primary motor cortex, while the unblinded control group received no stimulation. All participants completed 30 training trials of a functional upper-extremity motor task. Participants’ beliefs of tDCS, along with their prior knowledge of tDCS, were also collected. There was no significant difference in the amount of improvement on the motor task between the active and sham tDCS groups; however, both active and sham tDCS groups improved more than the control group, indicating a placebo effect. More motor task improvement was also associated with higher beliefs of tDCS (regardless of whether active or sham tDCS was received). This demonstrates a measurable placebo effect of tDCS on motor training, driven at least in part by treatment expectations or beliefs. Future tDCS studies should control for beliefs and other placebo-related factors.

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

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

Observational learning of atypical biological kinematics in autism.

Observing and voluntarily imitating the biological kinematics displayed by a model underpins the acquisition of new motor skills via sensorimotor processes linking perception with action. Differences in voluntary imitation in autism could be related to sensorimotor processing activity during action-observation of biological motion, as well as how sensorimotor integration processing occurs across imitation attempts. Using an observational practice protocol, which minimized the active contribution of the peripheral sensorimotor system, we examined the contribution of sensorimotor processing during action-observation. The data showed that autistic participants imitated both the temporal duration and atypical kinematic profile of the observed movement with a similar level of accuracy as neurotypical participants. These findings suggest the lower-level perception-action processes responsible for encoding biological kinematics during the action-observation phase of imitation are operational in autism. As there was no task-specific engagement of the peripheral sensorimotor system during observational practice, imitation difficulties in autism are most likely underpinned by sensorimotor integration issues related to the processing of efferent and (re)afferent sensorimotor information during trial-to-trial motor execution.

Learning complex upper-limb movements through practicing movement elements

Upper-limb complex movements constitute a major part of our daily activities. Research shows complex movements are generated by sequences of movement elements represented by a unimodal bell-shaped velocity curve. We utilized this understanding in the field of motor skill acquisition and hypothesized that practicing a movement element of a complex movement trajectory will facilitate the performance on the respective complex movement trajectory. To test this, we designed an experiment where the control group learned a full complex trajectory, whereas the two elemental groups learned two different movement elements of the complex trajectory. The two main outcome measures explaining the performance were accuracy and speed. The elemental groups, after training on movement elements, significantly improved their speed and accuracy when tested on the full complex trajectory. The result illustrated that training on a movement element of a complex trajectory benefited the performance of the full complex trajectory. The two elemental groups showed similar improvements in the performance of the complex motor skill, despite obtaining training on different movement elements of the same complex movement. The findings show that complex movements can be learned by practicing their movement elements.

A randomized parent-mediated physical activity intervention for autistic children.

The purpose of this study was to examine the immediate and post effects of a parent-mediated physical activity intervention on the fundamental motor skills of autistic children. We randomly assigned parent-child dyads (n = 31) of autistic children aged 4-11 years into three groups (workshop, an online, or control group). Each dyad participated in a 12-week intervention and was given adapted physical activity equipment and over 200 activities via a mobile application. Children were tested at the start and end of the intervention. The effect size (Cohen's ) of the control group for pre-post locomotor and ball skill scores were 0.12 and 0.06, respectively, indicating small effect size. The effect size of the online group for pre-post locomotor and ball skill scores were 49 and 0.26, respectively, indicating medium and small effect sizes. The effect size of the in-person group for pre-post locomotor and ball skill scores were 1.18 and 0.82, respectively, indicating large effect sizes. The outcomes of this physical activity intervention suggest that parents may facilitate the acquisition of fundamental motor skills of their autistic children. Although these results are positive, there is a need to further identify effective interventions for fundamental motor skill development in autistic children. Clinical Trials ID: NCT05159102.

Motor learning in developmental coordination disorder: behavioral and neuroimaging study.

Developmental coordination disorder (DCD) is characterized by motor learning deficits that are poorly understood within whole-body activities context. Here we present results of one of the largest non-randomized interventional trials combining brain imaging and motion capture techniques to examine motor skill acquisition and its underpinning mechanisms in adolescents with and without DCD. A total of 86 adolescents with low fitness levels (including 48 with DCD) were trained on a novel stepping task for a duration of 7 weeks. Motor performance during the stepping task was assessed under single and dual-task conditions. Concurrent cortical activation in the prefrontal cortex (PFC) was measured using functional near-infrared spectroscopy (fNIRS). Additionally, structural and functional magnetic resonance imaging (MRI) was conducted during a similar stepping task at the beginning of the trial. The results indicate that adolescents with DCD performed similarly to their peers with lower levels of fitness in the novel stepping task and demonstrated the ability to learn and improve motor performance. Both groups showed significant improvements in both tasks and under single- and dual-task conditions at post-intervention and follow-up compared to baseline. While both groups initially made more errors in the Stroop task under dual-task conditions, at follow-up, a significant difference between single- and dual-task conditions was observed only in the DCD group. Notably, differences in prefrontal activation patterns between the groups emerged at different time points and task conditions. Adolescents with DCD exhibited distinct prefrontal activation responses during the learning and performance of a motor task, particularly when complexity was increased by concurrent cognitive tasks. Furthermore, a relationship was observed between MRI brain structure and function measures and initial performance in the novel stepping task. Overall, these findings suggest that strategies that address task and environmental complexities, while simultaneously enhancing brain activity through a range of tasks, offer opportunities to increase the participation of adolescents with low fitness in physical activity and sports.

Does Cognitive Impairment Impact Motor Learning? A Scoping Review of Elderly Individuals With Alzheimer's Disease and Mild Cognitive Impairment.

Individuals with cognitive impairment may have motor learning deficits due to the high engagement of cognitive mechanisms during motor skill acquisition. We conducted a scoping review to address the quality of current research on the relationship between cognitive impairments (i.e., deficits in attention, memory, planning and executive functions) and motor learning among older adults with Alzheimer's Disease or Mild Cognitive Impairment. After screening thousands of articles, we selected 15 studies describing cognitive assessment tools, experimental designs, and the severity of cognitive impairment. Although seven studies reported that cognitive impairment impaired motor learning, most studies included a high risk of bias. We identified multiple assessment tools across these studies that make comparisons among findings difficult. Future research in this area should focus on the influence of increased practice days during motor learning acquisition and incorporate both retention and transfer tests. Cognitive assessments should target the specific cognitive skills or deficits most closely related to the motor learning process.

What Else Can Be Done by the Spinal Cord? A Review on the Effectiveness of Transpinal Direct Current Stimulation (tsDCS) in Stroke Recovery.

Since the spinal cord has traditionally been considered a bundle of long fibers connecting the brain to all parts of the body, the study of its role has long been limited to peripheral sensory and motor control. However, in recent years, new studies have challenged this view pointing to the spinal cord's involvement not only in the acquisition and maintenance of new motor skills but also in the modulation of motor and cognitive functions dependent on cortical motor regions. Indeed, several reports to date, which have combined neurophysiological techniques with transpinal direct current stimulation (tsDCS), have shown that tsDCS is effective in promoting local and cortical neuroplasticity changes in animals and humans through the activation of ascending corticospinal pathways that modulate the sensorimotor cortical networks. The aim of this paper is first to report the most prominent tsDCS studies on neuroplasticity and its influence at the cortical level. Then, a comprehensive review of tsDCS literature on motor improvement in animals and healthy subjects and on motor and cognitive recovery in post-stroke populations is presented. We believe that these findings might have an important impact in the future making tsDCS a potential suitable adjunctive approach for post-stroke recovery.

Sound and Movement Hands-on Workshop as a Sensorimotor Stimulation Tool during Child Development

Children interact with the world through sensations and movements, which generate different perceptions and allow the construction of knowledge and motor skills acquisition. This study shows a rhythmic and sound stimulatory hands-on workshop elaboration and application, which involves the use of musical resources with sensorimotor stimulation techniques that constitute an instrument for preventing, facilitating, or correcting child neuropsychomotor development. Four activities were elaborated (Slave of Jo Chain, Body Music, Making Rhythm, and Color/Sound Memory Game) taken together as the “Sound and Movement” workshop applied during the Museum of Neurosciences traveling actions in formal and non-formal teaching spaces of Rio de Janeiro, Brazil. Musical instruments and accessories were used to help specific skills development such as body, directional, spatial, and temporal awareness. We observed a wide public adherence to activities with broad participation from children to elderly people, as well as people with disabilities, totaling 7,680 participants.

USING OF EUROPEAN EXPERIENCE IN THE ELABORATING OF NEW CONCEPTUAL APPROACHES TO PHYSICAL EDUCATION OF UKRAINIAN HIGH SCHOOL PUPILS

The relevance of the problems presented in the research article is the need to elaborate new conceptual approaches to the physical education of Ukrainian high school pupils against the background of the war and granting Ukraine the status of a candidate for EU membership. The purpose of the article is to study the best practice of school physical education in European countries and outline the ways of its using in Ukraine. The article uses such research methods as methods of information collection and processing, comparative analysis, classification and typology, specification and generalization. The specifics of different concepts of physical education in the EU countries are shown on the example of Germany, France and Italy. The author proved that the German model does not involve state intervention in the regulation of relations in the area of physical education and sports. At the same time, France and Italy represent a model of state regulation of these relations, in the framework of which physical culture is recognizing as having a fundamental social importance for ensuring national-cultural identity. From the pedagogical point of view, in these countries, the health-adaptive model of school physical education takes the leading place, and the sports-recreational model is used as a companion. Germany, as well as the Anglo-Saxon world as a whole, is characterized by a combination of person-oriented and health-adaptive models. Ukraine after gaining independence moved from socially-oriented to a personal-oriented model of school physical education with certain elements of health-adaptive model, which was an imitation of the Anglo-Saxon tradition. Today, solving the task of increasing the level of health and physical readiness of school youth against the background of satisfaction of the public need for reliable provision of national security and protection of the state from aggressive encroachments involves a transition to a socially-oriented model with new content. This model involves the intensification of the educational process, stricter approaches to the physical education of high school pupils in the context of their preparation for potential military service, and emphasis attention on the acquisition of military-applied motor skills. At the same time, it is necessary to preserve the elements of the existing trend towards the liberalization of school physical education, to avoid excessive utilitarian character of the educational process and directive methods of managing educational activity. To implement such a reform, it is important to use European experience. It is primarily about strengthening state support for the industry, expanding the social component in the physical education of high school pupils, developing flexible curricula to which teachers could add their author's components, ensuring the formation of high moral qualities and patriotism in physical culture lessons.

Effects of active and sham tDCS on the soleus H-reflex during standing

Weak transcranial direct current stimulation (tDCS) is known to affect corticospinal excitability and enhance motor skill acquisition, whereas its effects on spinal reflexes in actively contracting muscles are yet to be established. Thus, in this study, we examined the acute effects of Active and Sham tDCS on the soleus H-reflex during standing. In fourteen adults without known neurological conditions, the soleus H-reflex was repeatedly elicited at just above M-wave threshold throughout 30 min of Active (N = 7) or Sham (N = 7) 2-mA tDCS over the primary motor cortex in standing. The maximum H-reflex (Hmax) and M-wave (Mmax) were also measured before and immediately after 30 min of tDCS. The soleus H-reflex amplitudes became significantly larger (by 6%) ≈1 min into Active or Sham tDCS and gradually returned toward the pre-tDCS values, on average, within 15 min. With Active tDCS, the amplitude reduction from the initial increase appeared to occur more swiftly than with Sham tDCS. An acute temporary increase in the soleus H-reflex amplitude within the first minute of Active and Sham tDCS found in this study indicates a previously unreported effect of tDCS on the H-reflex excitability. The present study suggests that neurophysiological characterization of Sham tDCS effects is just as important as investigating Active tDCS effects in understanding and defining acute effects of tDCS on the excitability of spinal reflex pathways.