Motor Training Group Research Articles

Effects of Augmented Reality Game-Based Cognitive-Motor Training on Restricted and Repetitive Behaviors and Executive Function in Patients with Autism Spectrum Disorder.

Restricted and repetitive behaviors (RRBs) and executive dysfunction are widely acknowledged as core features and hallmarks in patients with autism spectrum disorder (ASD). This study aimed to investigate the effects of augmented reality (AR) using motivational games with cognitive–motor exercises on RRBs, executive function (EF), attention, and reaction time in patients with ASD. Twenty-four patients (range from 6 to 18 years) diagnosed with ASD were recruited from local social welfare centers and randomly allocated to the AR game-based cognitive–motor training group (study group) or the conventional cognitive training group (control group). Both groups completed 30 min training sessions, twice a week for four weeks. Outcome measures were conducted before and after the intervention. As a result, improvements were observed in all the subscales of the RRBs in the study group except for self-injurious and ritualistic behavior. Significant improvements were observed in EF and reaction time in the study group, which was significantly higher compared to the control group. With the present findings, we can suggest that cognitive–motor training using AR game-based content generates positive effects on improving executive function reaction time and accuracy of responses and has a limited effect on RRBs in patients with ASD. This can be proposed as a complementary intervention associated with individualized daily management.

Effect of electroacupuncture combined with motor training on motor learning and motor cortex excitability

To compare the effect of electroacupuncture (EA), motor training (MT) and EA combined with MT on motor learning and motor cortex excitability in healthy subjects, and to explore the effect of EA combined with MT on synaptic metaplasticity. Using self-control design, 12 healthy subjects were assigned into an EA group, a motor training group (MT group) and an EA plus motor training group (EA+MT group) successively, wash-out period of at least 2 weeks was required between each group. EA was applied at left Hegu (LI 4) in the EA group for 30 min, with continuous wave, 2 Hz in frequency and 0.5-1 mA in density. Motor training of left hand was adopted in the MT group for 30 min. EA and motor training were adopted in the EA+MT group successively. The time of finishing grooved pegboard test (GPT) was observed, and the average amplitude of motor evoked potentials (MEPs), the rest motor threshold (rMT) and the latency were recorded by transcranial magnetic stimulation technique before intervention (T0), after intervention (T1) and 30 min after EA (T3) in the EA group and the EA+MT group, T0 and T1 in the MT group. Compared with T0, the time of finishing GPT was shortened at T1 in the MT group and at T2 in the EA group and the EA+MT group (P<0.01, P<0.05), the average amplitude of MEPs was increased at T1 in the 3 groups and at T2 in the EA group and the EA+MT group (P<0.05, P<0.01). Compared with T1, the time of finishing GPT at T2 was shortened in the EA group and the EA+MT group (P<0.05, P<0.01), the average amplitude of MEPs at T2 was increased in the EA group (P<0.05). The time of finishing GPT at T2 in the EA+MT group was shorter than the EA group (P<0.05). There were no statistical differences in rMT and latency at each time point among the 3 groups (P>0.05). In physiological state, electroacupuncture combined with motor training have a synergistic effect on motor learning, while have no such effect on excitability of cerebral motor cortex.

Head-fake perception in basketball: the relative contributions of expertise, visual or motor training, and test repetition

ABSTRACT The present study was conducted to disentangle the relative impact of visual and motor experience on the processing of the head fake in basketball. In a pre-test-intervention-post-test study, we investigated if the head-fake effect can be reduced with either a one-week visual-training intervention (visual-training group: N = 17, 10 females, 7 males, mean age = 21.2 years) or with a one-week motor-training intervention (motor-training group: N = 17, 10 females, 7 males, mean age = 20.9 years). Additionally, a waiting-control group (N = 17, 8 females, 9 males, mean age = 23.1 years) without any intervention and a group of experienced basketball players (N = 21, 9 females, 12 males, mean age = 23.9) was tested in the pre-post-test design (i.e., without intervention). The size of the head-fake effect was measured in a laboratory setting with a reaction time experiment, in which participants had to classify the pass direction of a faking or non-faking basketball player, who was shown in a video on a screen wall. The study revealed that the head-fake effect decreased after the training interventions. Surprisingly, the waiting-control group showed similar improvements. Thus, the reduced head-fake effect appears to be based on test-repetition effects. Moreover, after a single test session the head-fake effect approached a level that experts displayed from the outset. Even a small amount of practice (i.e., test-repetition) is sufficient to reduce, though not to abolish, the head-fake effect. We discuss this finding with regard to the common-coding approach and working memory capacity.

Is visuomotor training an effective intervention for children with autism spectrum disorders?

PurposeInvestigation of autism spectrum disorder (ASD) is somewhat dependent on addressing main core features of ASD. But it is not clear which kind of investigation can effect on more difficulties features. So, this study examines the effect of the visuomotor, motor, and computer-based training programs on social behavior, motor skills, and repetitive behaviors of children with ASD.Patients and methodsSixty children with ASD aged 6–12 years were recruited and assigned to one of the three experimental groups and the control group (each group n=15). Training was provided in 30 sessions, scheduled 3 times a week. Social behavior and repetitive behaviors were determined objectively using the observation method, and motor skills were evaluated by the Test of Gross Motor Development-2.ResultsOur results suggested that children in the visuomotor group showed a significant reduction in the repetitive behaviors and an increase in gross motor skill scores in the post-test and follow-up. Also, the results exhibited that motor training group significantly improved in social behavior either in the post-test or follow-up. Although the post-test illustrated a considerable improvement of gross motor skills, this difference was not significant in follow-up. Similarly, no significant change was observed in visual training and control groups in relation to study variables.ConclusionGiven the improvement of repetitive behaviors and gross motor skills in post-test and follow-up, it seems that this investigation had a positive effect with a good retention effect on two core features of children with ASD. But according to group-based training protocol in motor training group and improvement in social communication, and mutual effect on gross motor skills, it seems that group-based practice can also be used to achieve the benefits of social communication in the investigations.

Acute intermittent hypoxia and rehabilitative training following cervical spinal injury alters neuronal hypoxia- and plasticity-associated protein expression.

One of the most promising approaches to improve recovery after spinal cord injury (SCI) is the augmentation of spontaneously occurring plasticity in uninjured neural pathways. Acute intermittent hypoxia (AIH, brief exposures to reduced O2 levels alternating with normal O2 levels) initiates plasticity in respiratory systems and has been shown to improve recovery in respiratory and non-respiratory spinal systems after SCI in experimental animals and humans. Although the mechanism by which AIH elicits its effects after SCI are not well understood, AIH is known to alter protein expression in spinal neurons in uninjured animals. Here, we examine hypoxia- and plasticity-related protein expression using immunofluorescence in spinal neurons in SCI rats that were treated with AIH combined with motor training, a protocol which has been demonstrated to improve recovery of forelimb function in this lesion model. Specifically, we assessed protein expression in spinal neurons from animals with incomplete cervical SCI which were exposed to AIH treatment + motor training either for 1 or 7 days. AIH treatment consisted of 10 episodes of AIH: (5 min 11% O2: 5 min 21% O2) for 7 days beginning at 4 weeks post-SCI. Both 1 or 7 days of AIH treatment + motor training resulted in significantly increased expression of the transcription factor hypoxia-inducible factor-1α (HIF-1α) relative to normoxia-treated controls, in neurons both proximal (cervical) and remote (lumbar) to the SCI. All other markers examined were significantly elevated in the 7 day AIH + motor training group only, at both cervical and lumbar levels. These markers included vascular endothelial growth factor (VEGF), brain-derived neurotrophic factor (BDNF), and phosphorylated and nonphosphorylated forms of the BDNF receptor tropomyosin-related kinase B (TrkB). In summary, AIH induces plasticity at the cellular level after SCI by altering the expression of major plasticity- and hypoxia-related proteins at spinal regions proximal and remote to the SCI. These changes occur under the same AIH protocol which resulted in recovery of limb function in this animal model. Thus AIH, which induces plasticity in spinal circuitry, could also be an effective therapy to restore motor function after nervous system injury.

Effect of Implicit Perceptual-Motor Training on Decision-Making Skills and Underpinning Gaze Behavior in Combat Athletes.

This study investigated the effect of a 12-session, implicit perceptual-motor training program on decision-making skills and visual search behavior of highly skilled junior female karate fighters (M age = 15.7 years, SD = 1.2). Eighteen participants were required to make (physical or verbal) reaction decisions to various attacks within different fighting scenarios. Fighters' performance and eye movements were assessed before and after the intervention, and during acquisition through the use of video-based and on-mat decision-making tests. The video-based test revealed that following training, only the implicit perceptual-motor group (n = 6) improved their decision-making accuracy significantly compared to a matched motor training (placebo, n = 6) group and a control group (n = 6). Further, the implicit training group significantly changed their visual search behavior by focusing on fewer locations for longer durations. In addition, the session-by-session analysis showed no significant improvement in decision accuracy between training session 1 and all the other sessions, except the last one. Coaches should devote more practice time to implicit learning approaches during perceptual-motor training program to achieve significant decision-making improvements and more efficient visual search strategy with elite athletes.

Motor and mental training in older people: Transfer, interference, and associated functional neural responses

Learning new motor skills may become more difficult with advanced age. In the present study, we randomized 56 older individuals, including 30 women (mean age 70.6 years), to 6 weeks of motor training, mental (motor imagery) training, or a combination of motor and mental training of a finger tapping sequence. Performance improvements and post-training functional magnetic resonance imaging (fMRI) were used to investigate performance gains and associated underlying neural processes. Motor-only training and a combination of motor and mental training improved performance in the trained task more than mental-only training. The fMRI data showed that motor training was associated with a representation in the premotor cortex and mental training with a representation in the secondary visual cortex. Combining motor and mental training resulted in both premotor and visual cortex representations. During fMRI scanning, reduced performance was observed in the combined motor and mental training group, possibly indicating interference between the two training methods. We concluded that motor and motor imagery training in older individuals is associated with different functional brain responses. Furthermore, adding mental training to motor training did not result in additional performance gains compared to motor-only training and combining training methods may result in interference between representations, reducing performance.

Functional Magnetic Resonance Imaging Neurofeedback-guided Motor Imagery Training and Motor Training for Parkinson's Disease: Randomized Trial.

Objective: Real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback (NF) uses feedback of the patient’s own brain activity to self-regulate brain networks which in turn could lead to a change in behavior and clinical symptoms. The objective was to determine the effect of NF and motor training (MOT) alone on motor and non-motor functions in Parkinson’s Disease (PD) in a 10-week small Phase I randomized controlled trial.Methods: Thirty patients with Parkinson’s disease (PD; Hoehn and Yahr I-III) and no significant comorbidity took part in the trial with random allocation to two groups. Group 1 (NF: 15 patients) received rt-fMRI-NF with MOT. Group 2 (MOT: 15 patients) received MOT alone. The primary outcome measure was the Movement Disorder Society—Unified PD Rating Scale-Motor scale (MDS-UPDRS-MS), administered pre- and post-intervention “off-medication”. The secondary outcome measures were the “on-medication” MDS-UPDRS, the PD Questionnaire-39, and quantitative motor assessments after 4 and 10 weeks.Results: Patients in the NF group were able to upregulate activity in the supplementary motor area (SMA) by using motor imagery. They improved by an average of 4.5 points on the MDS-UPDRS-MS in the “off-medication” state (95% confidence interval: −2.5 to −6.6), whereas the MOT group improved only by 1.9 points (95% confidence interval +3.2 to −6.8). The improvement in the intervention group meets the minimal clinically important difference which is also on par with other non-invasive therapies such as repetitive Transcranial Magnetic Stimulation (rTMS). However, the improvement did not differ significantly between the groups. No adverse events were reported in either group.Interpretation: This Phase I study suggests that NF combined with MOT is safe and improves motor symptoms immediately after treatment, but larger trials are needed to explore its superiority over active control conditions.

Developing a sensory-enhanced robot-aided motor training programme

The present study aimed at developing a novel sensory enhancement handle used in robot–aided motor training. The handle provided vibro–tactile stimulation through pins connected to small servomotors inside the handle. When the pressure on the handle indicated an active movement of the subject, the corresponding servomotor(s) was activated to generate vibration on the hand of the subject to enhance the cutaneous sensation during motor training. In a feasibility study, nine chronic stroke survivors were randomly assigned to either a sensory–enhanced robot–aided motor training group (SERMT) or robot–aided motor training (RMT) only group. After 6–week motor training, the total motor status (MS) scores showed significant improvement in both groups. However, when dividing MS scores into two sub–scores for the shoulder/elbow and wrist/hand, significant increases in both sub–scores were shown only in the SERMT group (p < 0.05). Enhanced sensation might increase the gain of robot–aided motor training in stroke survivors.

Nonvisual Motor Learning Improves Visual Motion Perception: Evidence From Violating the Two-Thirds Power Law

Few studies have reported direct effects of motor learning on visual perception, especially when using novel movements for the motor system. Atypical motor behaviors that violate movement constraints provide an excellent opportunity to study action-to-perception transfer. In our study, we passively trained blindfolded participants on movements violating the 2/3 power law. Before and after motor training, participants performed a visual discrimination task in which they decided whether two consecutive movements were same or different. For motor training, we randomly assigned the participants to two motor training groups or a control group. The motor training group experienced either a weak or a strong elliptic velocity profile on a circular trajectory that matched one of the visual test stimuli. The control group was presented with linear trajectories unrelated to the viewed movements. After each training session, participants actively reproduced the movement to assess motor learning. The group trained on the strong elliptic velocity profile reproduced movements with increasing elliptic velocity profiles while circular geometry remained constant. Furthermore, both training groups improved in visual discrimination ability for the learned movement as well as for highly similar movements. Participants in the control group, however, did not show any improvements in the visual discrimination task nor did participants who did not acquire the trained movement. The present results provide evidence for a transfer from action to perception which generalizes to highly related movements and depends on the success of motor learning. Moreover, under specific conditions, it seems to be possible to acquire movements deviating from the 2/3 power law.

Effects of a Community-Based Intensive Motor Training Program Combined With Early Supported Discharge After Treatment in a Comprehensive Stroke Unit

Increased amount of therapy seems to be beneficial for motor recovery after stroke. The primary aim of the present study was to evaluate the effect of a 4-week community-based intensive motor training program combined with early supported discharge after initial treatment in a comprehensive stroke unit on balance. Secondary aims were to evaluate the effect on other functional outcome measures. This was a single-blind, randomized, controlled trial with a 26-week follow-up. Sixty-two patients were recruited within 14 days after stroke and were randomly allocated to a standard treatment group (n=32) or to an intensive motor training group (n=30) receiving 3 sessions of physical therapy and a structured home exercise program in addition to standard treatment every week for the first 4 weeks after discharge from hospital. Primary outcome measure was Berg Balance Scale. Secondary measures were Barthel Index, Motor Assessment Scale, Step Test, 5-meter Walk Test, and Stroke Impact Scale. The mean (SD) minutes of physical therapy per week was 171.0 (65.8) in the intensive motor training group vs 85.6(69.9) in the standard treatment group. There were no statistical significant differences between the groups on any measure at end of follow-up except for a trend toward higher Motor Assessment Scale score (P=0.059) and gait speed (P=0.095) in the intensive motor training group. In this randomized, controlled trial, a community-based intensive motor training program, doubling the amount of physical therapy during the first 4 weeks after discharge, did not show significant improvement of balance or any other functional outcomes.

Combination of NEP 1-40 Treatment and Motor Training Enhances Behavioral Recovery After a Focal Cortical Infarct in Rats

Although myelin-associated neurite outgrowth disinhibitors have shown promise in restoring motor function after stroke, their interactive effects with motor training have rarely been investigated. The present study examined whether a combinatorial treatment (NEP 1-40+motor rehabilitation) is more effective than either treatment alone in promoting motor recovery after focal ischemic injury. Adult rats were assigned to one of 3 treatment groups (infarct/NEP 1-40+motor training, infarct/NEP 1-40 only, infarct/motor training only) and 2 control groups (infarct/no treatment, intact/no treatment). A focal ischemic infarct was induced by microinjecting endothelin-1 into the motor cortex. Therapeutic treatments were initiated 1 week postinfarct and included intraventricular infusion of the pharmacological agent NEP 1-40 and motor training (skilled reach task). Behavioral assessments on skilled reach, foot fault, and cylinder tests were conducted before the infarct and for 5 weeks postinfarct. Rats demonstrated significant forelimb impairment on skilled reach and foot fault tests after the infarct. Although all infarct groups improved over time, motor training alone and NEP 1-40 alone facilitated recovery on the skilled reach task at the end of treatment Weeks 2 and 4, respectively. However, only NEP 1-40 paired with motor training facilitated recovery after 1 week of treatment in addition to treatment at Weeks 2 and 4. Finally, only the NEP 1-40+motor training group maintained a performance level equivalent to that of the intact group over the entire period of posttreatment assessment. This study suggests that behavioral training interacts with the effects of the axonal growth promoter, NEP 1-40, and may accelerate behavioral recovery after focal cortical ischemia.

Neuromuscular Adaptation Induced by Motor Imagery Training in the Serial Reaction Time Task

[Purpose] This study examined whether motor imagery leads to a decrease in the temporal process in terms of the onset of muscle activation and reaction time according to acquisition of motor skills in a serial reaction time (SRT) task. [Subjects] Forty one healthy, right-handed subjects with no history of neurological, orthopedic, or psychiatric disorders were enrolled in this study. The subjects were assigned randomly to the motor training group (n=13), motor imagery group (n=14), and control group (n=11). [Methods] After six visual stimuli, the subjects were instructed to move or press a moveable arm/button according to the corresponding stimuli. However, the motor imagery group performed the task without actual movement in the same task paradigm. The kinetic parameters (i.e. muscle activation and movement initiation) were analyzed before and after the training/controlled session over three consecutive days with two repetitions per day for each group. [Results] After motor skill acquisition, the motor training group and motor imagery group showed a significant decrease in processing times between the visual stimuli and two predetermined onsets, which consisted of the onset of muscular activation and reaction time. However, there were no significant changes in the control group. [Conclusion] The decrease in processing time through motor imagery can be attributed to the rapid onset of muscle activation and movement initiation, which might be induced by neuromuscular adaptation in the motor performance phase. Furthermore, we assumed that imagining the performance of a motor task could contributes to improving the motor performance in motor sequential learning.

Overlapping areas of neuronal activation after motor and mental imagery training

Overlapping areas of neuronal activation after motor and mental imagery training

Motor learning affects visual movement perception

In the present study we investigated whether imitation of artificial movement trajectories of meaningless objects has an effect on how these trajectories are later perceptually processed within the human brain. During observation of a sequence of artificial object movements 10 participants (experimental group) actively imitated the trajectories during motor training and 10 participants (control group) solved a working memory task without motor training. The haemodynamic responses were recorded before and after the intervention while participants observed the movements and either had to detect colour changes of one of the objects (colour task, motor-irrelevant) or had to judge whether the movement pattern could be imitated with the hands (simulation judgement task, motor-relevant). The between-group comparison of the post-intervention haemodynamic responses revealed stronger activity for the motor training than for the control group during the simulation judgement task. This activity appeared in motor-related areas (supplementary motor area and inferior parietal lobe) and in the occipito-temporal area. During the colour task, the motor training group showed stronger activity in the occipital lobe. The control group did not reveal any stronger activity than the motor training group for either task. The results suggest that motor training has task-specific effects on neural processes that are involved in perception of movements. Furthermore, they indicate that motor-related areas are triggered by observed artificial object movements, but only if a motor-relevant task is pursued.

Learning by doing and learning by thinking: An fMRI study of combining motor and mental training

The current study investigated behavioral and neural effects of motor, mental, and combined motor and mental training on a finger tapping task. The motor or mental training groups trained on a finger-sequence for a total of 72 min over 6 weeks. The motor and mental training group received 72 min motor training and in addition 72 min mental training. Results showed that all groups increased their tapping performance significantly on the trained sequence. After training functional magnetic resonance imaging (fMRI) data was collected and indicated training specific increases in ventral pre-motor cortex following motor training, and in fusiform gyrus following mental training. Combined motor and mental training activated both the motor and the visual regions. In addition, motor and mental training showed a significant increase in tapping performance on an untrained sequence (transfer). fMRI scanning indicated that the transfer effect involved the cerebellum. Conclusions were that combined motor and mental training recruited both motor and visual systems, and that combined motor and mental training improves motor flexibility via connections from both motor and cognitive systems to the cerebellum.

Can Observational Training Substitute Motor Training in Preventing Backward Balance Loss After an Unexpected Slip During Walking?

A person's awareness of potential slippery walking conditions induces a cautious gait pattern. The purposes of this study were to determine whether neuromechanical changes associated with such cognitive conditioning are sufficient to alter the outcome of a slip and whether the effects of such conditioning are comparable to those of motor training. Prior to their own first slip exposure, 18 young subjects watched videos and slides demonstrating where and how the slip would occur and how people adapted to repeated-slip exposure (observe). The outcomes of the first slip exposure experienced by another 16 subjects who did not receive any such information were used as controls (naïve). The latter subjects subsequently experienced an additional 23 slips and thus served in a dual-role as the motor training group (motor). Gait stability as measured against backward loss of balance (BLOB) was obtained for pre- and postslip instances. A protective step landing posterior to the slipping-limb identified each BLOB outcome. The observe group had a greater postslip stability and lower slip displacement and velocity than the naïve group. However, such effects were insufficient to prevent balance loss (100% BLOB). The motor group showed significantly better performance on the last training slip (0% BLOB) than did the observe group. The results indicated that updating the cognitive centers of the CNS with awareness and perceptual knowledge through observational training can yield tangible benefits. Nonetheless observation could not replace the task-specific motor training that adaptively updated the internal representations of stability limits for prevention of BLOB.