Post-training Performance Research Articles

Eight-Week Battle Rope Training Improves Multiple Physical Fitness Dimensions and Shooting Accuracy in Collegiate Basketball Players.

Chen, WH, Wu, HJ, Lo, SL, Chen, H, Yang, WW, Huang, CF, and Liu, C. Eight-week battle rope training improves multiple physical fitness dimensions and shooting accuracy in collegiate basketball players. J Strength Cond Res 32(10): 2715-2724, 2018-Basketball players must possess optimally developed physical fitness in multiple dimensions and shooting accuracy. This study investigated whether battle rope (BR) training enhances multiple physical fitness dimensions, including aerobic capacity (AC), upper-body anaerobic power (AnP), upper-body and lower-body power, agility, and core muscle endurance, and shooting accuracy in basketball players and compared its effects with those of regular training (shuttle run [SR]). Thirty male collegiate basketball players were randomly assigned to the BR or SR groups (n = 15 per group). Both groups received 8-week interval training for 3 sessions per week; the protocol consisted of the same number of sets, exercise time, and rest interval time. The BR group exhibited significant improvements in AC (Progressive Aerobic Cardiovascular Endurance Run laps: 17.6%), upper-body AnP (mean power: 7.3%), upper-body power (basketball chest pass speed: 4.8%), lower-body power (jump height: 2.6%), core muscle endurance (flexion: 37.0%, extension: 22.8%, and right side bridge: 23.0%), and shooting accuracy (free throw: 14.0% and dynamic shooting: 36.2%). However, the SR group exhibited improvements in only AC (12.0%) and upper-body power (3.8%) (p < 0.05). The BR group demonstrated larger pre-post improvements in upper-body AnP (fatigue index) and dynamic shooting accuracy than the SR group did (p < 0.05). The BR group showed higher post-training performance in upper-body AnP (mean power and fatigue index) than the SR group did (p < 0.05). Thus, BR training effectively improves multiple physical fitness dimensions and shooting accuracy in collegiate basketball players.

Motor Sequence Learning Is Associated With Hippocampal Subfield Volume in Humans With Medial Temporal Lobe Epilepsy.

Objectives: Medial temporal lobe epilepsy (mTLE) is characterized by decreased hippocampal volume, which results in motor memory consolidation impairments. However, the extent to which motor memory acquisition are affected in humans with mTLE remains poorly understood. We therefore examined the extent to which learning of a motor tapping sequence task is affected by mTLE.Methods: MRI volumetric analysis was performed using a T1-weighted three-dimensional gradient echo sequence in 15 patients with right mTLE and 15 control subjects. Subjects trained on a motor sequence tapping task with the left hand in right mTLE and non-dominant hand in neurologically-intact controls.Results: The number of correct sequences performed by the mTLE patient group increased after training, albeit to a lesser extent than the control group. Although hippocampal subfield volume was reduced in mTLE relative to controls, no differences were observed in the volumes of other brain areas including thalamus, caudate, putamen and amygdala. Correlations between hippocampal subfield volumes and the change in pre- to post-training performance indicated that the volume of hippocampal subfield CA2–3 was associated with motor sequence learning in patients with mTLE.Significance: These results provide evidence that individuals with mTLE exhibit learning on a motor sequence task. Learning is linked to the volume of hippocampal subfield CA2–3, supporting a role of the hippocampus in motor memory acquisition.Highlights -Humans with mTLE exhibit learning on a motor tapping sequence task but not to the same extent as neurologically-intact controls.-Hippocampal subfield volumes are significantly reduced after mTLE. Surrounding brain area volumes do not show abnormalities.-Hippocampal subfield CA2–3 volume is associated with motor sequence learning in humans with mTLE.

Effects of Training on Lateralization for Simulations of Cochlear Implants and Single-Sided Deafness.

While cochlear implantation has benefitted many patients with single-sided deafness (SSD), there is great variability in cochlear implant (CI) outcomes and binaural performance remains poorer than that of normal-hearing (NH) listeners. Differences in sound quality across ears—temporal fine structure (TFS) information with acoustic hearing vs. coarse spectro-temporal envelope information with electric hearing—may limit integration of acoustic and electric patterns. Binaural performance may also be limited by inter-aural mismatch between the acoustic input frequency and the place of stimulation in the cochlea. SSD CI patients must learn to accommodate these differences between acoustic and electric stimulation to maximize binaural performance. It is possible that training may increase and/or accelerate accommodation and further improve binaural performance. In this study, we evaluated lateralization training in NH subjects listening to broad simulations of SSD CI signal processing. A 16-channel vocoder was used to simulate the coarse spectro-temporal cues available with electric hearing; the degree of inter-aural mismatch was varied by adjusting the simulated insertion depth (SID) to be 25 mm (SID25), 22 mm (SID22) and 19 mm (SID19) from the base of the cochlea. Lateralization was measured using headphones and head-related transfer functions (HRTFs). Baseline lateralization was measured for unprocessed speech (UN) delivered to the left ear to simulate SSD and for binaural performance with the acoustic ear combined with the 16-channel vocoders (UN+SID25, UN+SID22 and UN+SID19). After completing baseline measurements, subjects completed six lateralization training exercises with the UN+SID22 condition, after which performance was re-measured for all baseline conditions. Post-training performance was significantly better than baseline for all conditions (p < 0.05 in all cases), with no significant difference in training benefits among conditions. Given that there was no significant difference between the SSD and the SSD CI conditions before or after training, the results suggest that NH listeners were unable to integrate TFS and coarse spectro-temporal cues across ears for lateralization, and that inter-aural mismatch played a secondary role at best. While lateralization training may benefit SSD CI patients, the training may largely improve spectral analysis with the acoustic ear alone, rather than improve integration of acoustic and electric hearing.

Improvement of Communication Skills after Traumatic Brain Injury: The Efficacy of the Cognitive Pragmatic Treatment Program using the Communicative Activities of Daily Living.

The pragmatic impairment often characterizing individuals after a traumatic brain injury (TBI) significantly limits their independence, preventing social participation. Rehabilitation programs aim to improve the impaired capacities to help participants communicate effectively, increasing their self-perceived life quality. The aim of this study was to verify the effectiveness of the Cognitive Pragmatic Treatment (CPT) in improving communication abilities after TBI, thus enabling better management of communication activities in daily living. Nineteen individuals with TBI in a post-acute phase completed the CPT, a group-based training program designed to improve pragmatic abilities. Pre- and post-training, participants were administered the Communication Activities of Daily Living (CADL-2), and the equivalent forms of the Assessment Battery for Communication (ABaCo). Comparison of pre- and post-training performance showed an overall improvement in pragmatic abilities. Post-training, participants scored higher in communication skills on both the CADL-2 and ABaCo, with such scores remaining constant at a 3-month follow-up assessment. This study showed that the CPT was effective in improving the participants' communicative abilities. The possibility that the benefits of the CPT may generalize to everyday communicative interactions is discussed.

Training children aged 5–10 years in manual compliance control to improve drawing and handwriting

A large proportion of school-aged children exhibit poor drawing and handwriting. This prevalence limits the availability of therapy. We developed an automated method for training improved manual compliance control and relatedly, prospective control of a stylus. The approach included a difficult training task, while providing parametrically modifiable support that enables the children to perform successfully while developing good compliance control. The task was to use a stylus to push a bead along a 3D wire path. Support was provided by making the wire magnetically attractive to the stylus. Support was progressively reduced as 3D tracing performance improved. We report studies that (1) compared performance of Typically Developing (TD) children and children with Developmental Coordination Disorder (DCD), (2) tested training with active versus passive movement, (3) tested progressively reduced versus constant or no support during training, (4) tested children of different ages, (5) tested the transfer of training to a drawing task, (6) tested the specificity of training in respect to the size, shape and dimensionality of figures, and (7) investigated the relevance of the training task to the Beery VMI, an inventory used to diagnose DCD. The findings were as follows. (1) Pre-training performance of TD and DCD children was the same and good with high support but distinct and poor with low support. Support yielded good self-efficacy that motivated training. Post training performance with no support was improved and the same for TD and DCD children. (2) Actively controlled movements were required for improved performance. (3) Progressively reduced support was required for good performance during and after training. (4) Age differences in performance during pre-training were eliminated post-training. (5) Improvements transferred to drawing. (6) There was no evidence of specificity of training in transfer. (7) Disparate Beery scores were reflected in pre-training but not post-training performance. We conclude that the method improves manual compliance control, and more generally, prospective control of movements used in drawing performance.

Effectiveness of the Multilayered Caries Model and Visuo-tactile Virtual Reality Simulator for Minimally Invasive Caries Removal: A Randomized Controlled Trial.

This work presents the multilayered caries model with a visuo-tactile virtual reality simulator and a randomized controlled trial protocol to determine the effectiveness of the simulator in training for minimally invasive caries removal. A three-dimensional, multilayered caries model was reconstructed from 10 micro-computed tomography (CT) images of deeply carious extracted human teeth before and after caries removal. The full grey scale 0-255 yielded a median grey scale value of 0-9, 10-18, 19-25, 26-52, and 53-80 regarding dental pulp, infected carious dentin, affected carious dentin, normal dentin, and normal enamel, respectively. The simulator was connected to two haptic devices for a handpiece and mouth mirror. The visuo-tactile feedback during the operation varied depending on the grey scale. Sixth-year dental students underwent a pretraining assessment of caries removal on extracted teeth. The students were then randomly assigned to train on either the simulator (n=16) or conventional extracted teeth (n=16) for 3 days, after which the assessment was repeated. The posttraining performance of caries removal improved compared with pretraining in both groups (Wilcoxon, p<0.05). The equivalence test for proportional differences (two 1-sided t-tests) with a 0.2 margin confirmed that the participants in both groups had identical posttraining performance scores (95% CI=0.92, 1; p=0.00). In conclusion, training on the micro-CT multilayered caries model with the visuo-tactile virtual reality simulator and conventional extracted tooth had equivalent effects on improving performance of minimally invasive caries removal.

The rhinological simulator: the upgrade and validation study with the evaluation of the effectiveness of its application

The objective of the present study was to upgrade the rhinological simulator employed as a tool for the teaching of the basic technical skills in endoscopic sinus surgery (ESS). The new ESS simulator providing a model of the nasal cavity consists of the replaceable cylinders and the adaptable table stand. It includes a set of 3D printed nasal models. Each of them is the elliptical tube of a specific size. The participants of the study performed different tasks depending on the structural properties of the tubes. A wide variety of surgical instruments and esndoscopes could be fitted to the simulator. 16 otorhinolaryngologists having no previous experience with ESS were recruited into the study to evaluate the effectiveness of the training procedures. After a brief tutorial, the participants practiced an one hour-long exercise per day during 5 days. The pre-training and post-training performances were videotaped. The task-performance time and the number of technical errors made by the operators were estimated immediately before and after the training session. To assess the subjective attitudes of the operators toward the new technology, the participants of the study were asked to complete the model questionnaire soon after the termination of the training course. The questionnaire contained 34 items. The correctness of the answers was assessed based on the 5-point Likert scale, with score 1 meaning 'totally disagree' and score 5 - 'totally agree'. The statistically significant reduction of the performance time and the number of technical mistakes was documented within the first 5 hours after the onset of teaching (p<0.05) which suggests the effectiveness of the training procedures. The questionnaire study has demonstrated the positive attitude of the trainees toward the proposed technology. The average score based on the Likert scale was higher than 3 for all kinds of questions. It is concluded that the results of this study give evidence of the positive assessment of the upgraded rhinological simulator as an effective tool for the teaching of the basic skills necessary to operate various surgical instruments and endoscopes by the novice surgeons in the field of endoscopic sinus surgery .

Perceptual training to improve hip fracture identification in conventional radiographs.

Diagnosing certain fractures in conventional radiographs can be a difficult task, usually taking years to master. Typically, students are trained ad-hoc, in a primarily-rule based fashion. Our study investigated whether students can more rapidly learn to diagnose proximal neck of femur fractures via perceptual training, without having to learn an explicit set of rules. One hundred and thirty-nine students with no prior medical or radiology training were shown a sequence of plain film X-ray images of the right hip and for each image were asked to indicate whether a fracture was present. Students were told if they were correct and the location of any fracture, if present. No other feedback was given. The more able students achieved the same level of accuracy as board certified radiologists at identifying hip fractures in less than an hour of training. Surprisingly, perceptual learning was reduced when the training set was constructed to over-represent the types of images participants found more difficult to categorise. Conversely, repeating training images did not reduce post-training performance relative to showing an equivalent number of unique images. Perceptual training is an effective way of helping novices learn to identify hip fractures in X-ray images and should supplement the current education programme for students.

Are training and transfer effects of working memory updating training modulated by achievement motivation?

Previous studies examining effects of working memory (WM) updating training revealed mixed results. One factor that might modulate training gains, and possibly also transfer of those gains to non-trained cognitive tasks, is achievement motivation. In the present Studies 1 and 2, students with either a high (HAM) or low (LAM) achievement motivation completed a 14-day visuospatial WM updating training program. In Study 2, the students also performed a set of tasks measuring other executive functions and fluid intelligence prior to and after training. In both studies, the HAM students displayed a larger training gain than the LAM students. Study 2 revealed that after training, both groups showed better performance on the near-transfer but not far-transfer tasks. Importantly, the differential training gain was not associated with better post-training performance for the HAM compared to the LAM students on any of the transfer tasks. These results are taken to support a modulatory role of achievement motivation on WM training benefits, but not on transfer of those benefits to other tasks. Possible reasons for the general improvement on the near-transfer tasks and the absence of a modulatory role of achievement motivation on transfer-task performance are discussed.

Abstract 12173: A Randomized Controlled Trial Comparing Self-instruction and Traditional Instruction in Training of Bystander Cardiopulmonary Resuscitation

Introduction: Self-instruction of learning cardiopulmonary resuscitation (CPR) saves manpower and may be applied in large-scale public training, but its effect comparing to traditional instruction remains unclear. Hypothesis: In bystander CPR training, self-instruction compared to traditional instruction, has different post-training performances. Methods: In this randomized controlled study, administrative clerks and other non-health care providers were randomly allocated into 2 groups: self-instruction group and traditional instruction group. Both groups watched a 27-minute standardized teaching video. Participants in the self-instruction group then performed a 30-minute hands-on practice on Resusci Anne® QCPR (Laerdal company, Norway) with automated feedback, while participants in the traditional instruction group performed the same duration of practice on manikins with feedback by the instructors aside. Both groups had to receive skill tests before and after practice. Blinded evaluators used checklists to decide whether participants passed the tests by reviewing the videos of the skill tests. Data of skill performance was also collected using SkillReporter® software. The primary outcome was the pass rate. The secondary outcomes were items of individual skill performances. Results: Totally sixty-four participants were randomly allocated. All participants completed the protocol. The baseline characteristics of 2 groups were no different. In the primary outcome, the pass rates were the same between 2 groups (94% vs 94%, p=1.00). In the secondary outcomes, the self-instruction group performed better in mean compression depth (48.4 vs 42.0 mm, p=0.002), mean percentage of full chest recoils (77.7% vs 56.4%, p=0.014) and mean percentage of correct ventilation volume (96.5% vs 75.1%, p=0.013), but performed worse in confirming environmental safety (47% vs 78%, p=0.010) and checking normal breathing (26% vs 97%, p&lt;0.001). Conclusions: Bystander CPR training using self-instruction was no different from traditional instruction in pass rate, and even better in some skill performances, but confirmation of environmental safety and check of normal breathing before starting CPR should be emphasized in self-instruction training.

Practice makes imperfect: Working memory training can harm recognition memory performance

There is a great deal of debate concerning the benefits of working memory (WM) training and whether that training can transfer to other tasks. Although a consistent finding is that WM training programs elicit a short-term near-transfer effect (i.e., improvement in WM skills), results are inconsistent when considering persistence of such improvement and far transfer effects. In this study, we compared three groups of participants: a group that received WM training, a group that received training on how to use a mental imagery memory strategy, and a control group that received no training. Although the WM training group improved on the trained task, their posttraining performance on nontrained WM tasks did not differ from that of the other two groups. In addition, although the imagery training group's performance on a recognition memory task increased after training, the WM training group's performance on the task decreased after training. Participants' descriptions of the strategies they used to remember the studied items indicated that WM training may lead people to adopt memory strategies that are less effective for other types of memory tasks. These results indicate that WM training may have unintended consequences for other types of memory performance.

Training compliance control yields improved drawing in 5–11 year old children with motor difficulties

There are a large number of children with motor difficulties including those that have difficulty producing movements qualitatively well enough to improve in perceptuo-motor learning without intervention. We have developed a training method that supports active movement generation to allow improvement in a 3D tracing task requiring good compliance control. Previously, we tested a limited age range of children and found that training improved performance on the 3D tracing task and that the training transferred to a 2D drawing test. In the present study, school children (5–11years old) with motor difficulties were trained in the 3D tracing task and transfer to a 2D drawing task was tested. We used a cross-over design where half of the children received training on the 3D tracing task during the first training period and the other half of the children received training during the second training period. Given previous results, we predicted that younger children would initially show reduced performance relative to the older children, and that performance at all ages would improve with training. We also predicted that training would transfer to the 2D drawing task. However, the pre-training performance of both younger and older children was equally poor. Nevertheless, post-training performance on the 3D task was dramatically improved for both age groups and the training transferred to the 2D drawing task. Overall, this work contributes to a growing body of literature that demonstrates relatively preserved motor learning in children with motor difficulties and further demonstrates the importance of games in therapeutic interventions.

When simulated environments make the difference: the effectiveness of different types of training of car service procedures

An empirical analysis was performed to compare the effectiveness of different approaches to training a set of procedural skills to a sample of novice trainees. Sixty-five participants were randomly assigned to one of the following three training groups: (1) learning-by-doing in a 3D desktop virtual environment, (2) learning-by-observing a video (show-and-tell) explanation of the procedures, and (3) trial-and-error. In each group, participants were trained on two car service procedures. Participants were recalled to perform a procedure either 2 or 4 weeks after the training. The results showed that: (1) participants trained through the virtual approach of learning-by-doing performed both procedures significantly better (i.e. p < .05 in terms of errors and time) than people of non-virtual groups, (2) the virtual training group, after a period of non-use, were more effective than non-virtual training (i.e. p < .05) in their ability to recover their skills, (3) after a (simulated) long period from the training--i.e. up to 12 weeks--people who experienced 3D environments consistently performed better than people who received other kinds of training. The results also suggested that independently from the training group, trainees' visuospatial abilities were a predictor of performance, at least for the complex service procedure, adj R2 = .460, and that post-training performances of people trained through virtual learning-by-doing are not affected by learning styles. Finally, a strong relationship (p < .001, R2 = .441) was identified between usability and trust in the use of the virtual training tool--i.e. the more the system was perceived as usable, the more it was perceived as trustable to acquire the competences.

Effectiveness of a multidevice 3D virtual environment application to train car service maintenance procedures

This paper reports a study which demonstrates the advantages of using virtual-reality-based systems for training automotive assembly tasks. Sixty participants were randomly assigned to one of the following three training experiences to learn a car service procedure: (1) observational training through video instruction; (2) an experiential virtual training and trial in a CAVE; and (3) an experiential virtual training and trial through a portable 3D interactive table. Results show that virtual trained participants, after the training, can remember significantly better (p < .05) the correct execution of the steps compared to video-trained trainees. No significant differences were identified between the experiential groups neither in terms of post-training performances nor in terms of proficiency, despite differences in the interaction devices. The relevance of the outcomes for the automotive fields and for the designers of virtual training applications are discussed in light of the outcomes, particularly that virtual training experienced through a portable device such as the interactive table can be effective, as can training performed in a CAVE. This suggests the possibility for automotive industries to invest in advanced portable hardware to deliver effectively long-distance programs of training for car service operators placed all over the world.

Development and Validation of a Model for Training Equine Phlebotomy and Intramuscular Injection Skills.

Simulation in veterinary education offers a solution for bridging the gap between observation and performance of clinical skills. An equine neck model was created that allows repetitive practice of jugular phlebotomy, intramuscular (IM) injection, and intravenous catheterization. The aim of this study was to validate the model for jugular phlebotomy and IM injection. We surveyed experienced veterinarians on the model's realism and the comprehensiveness of its features. In a randomized experimental study, we compared the learning outcomes of first-year veterinary students trained on the model (n=48) and students trained on equine head-neck cadavers (n=45). There was no difference in post-training performance of phlebotomy on the live horse between cadaver-trained students and model-trained students when assessed by a checklist (cadaver 6.87±0.33; model 6.89±0.77; p=.99) or a global rating scale (cadaver 5.23±0.87; model 5.32±0.77; p=.78). No difference was found between post-training scores for IM injection when assessed by checklist (cadaver 6.87±0.34; model 6.89±0.31; p=.76) or global rating scale (cadaver 5.23±0.87; model 5.32±0.77; p=.75). Veterinarians (n=7) found this low-fidelity model acceptable and supported its use as a training tool for veterinary students. Students reported in a post-lab survey that they felt models were as helpful as cadavers for learning the procedures. These results support the use of the model as a component of first-year veterinary student curriculum.

Progressive reduction versus fixed level of support during training: When less is less

Previous empirical and theoretical work suggests that effective skill acquisition requires movements to be generated actively and that learning new skills supports the acquisition of prospective control. However, there are many ways in which practice can be structured, that may affect the acquisition and use of prospective control after training. Here, we tested whether the progressive modulation and reduction of support during training was required to yield good performance after training without support. The task was to use a stylus to push a bead over a complex 3D wire path. The support “magnetically” attracted and held the stylus onto the wire. Three groups of adult participants each experienced one of three training regimes: gradual reduction of magnetic attraction, only a medium level of attraction, or low magnetic attraction. The results showed that use of a single (medium) level of support was significantly less effective in yielding good performance with low support after training. Training with low support yielded post-training performance that was equally good as that yielded by training with progressive reduction of support; however, performance during training was significantly poorer in the former. Thus, less support during training yields effective learning but more difficult training sessions. The results are discussed in the context of application to training with special populations.

Effect of Cyber-Golfing on Balance Amongst the Elderly in Hong Kong: A Pilot Randomised Trial

Background/Objective Recent evidence showed that golf can develop balance amongst the elderly. This study aimed at evaluating if exergaming, in particular cyber-golfing, can be a feasible and inexpensive alternative to this valuable exercise. Methods Twenty healthy community-dwelling elderly were recruited, and they were randomly assigned to either the experimental group (n = 10) or the control group (n = 10). Daily cyber-golfing training for 2 weeks was assigned to the participants of the experimental group, where regular table games with equal lengths and durations were arranged for the control group. Results The results revealed that the participants in the experimental group showed significantly better post-training performances in the functional-reach test, F(2,17) = 5.16, p = .04, and single-leg-stance test, F(2,17) = 5.32, p = .03, than those in the control group. Conclusion The results of this study suggest that cyber-golfing might be an alternative to golfing, which is capable of enhancing balance ability amongst community-dwelling elderly. The potential of exergaming as a clinical tool for geriatric rehabilitation was discussed.

The impact of goal setting and goal orientation on performance during a clerkship surgical skills training program

BackgroundThe purpose of this study was to integrate relevant goal-setting theory and to identify if trainees' goal orientations have an impact on the assigned goals-performance relationship. MethodsTrainees attended 1 of the 3 goal-training activities (do your best, performance, or learning goals) for knot tying (KT) and camera navigation (CN) during the 3rd-year clerkship rotation. Questionnaires and pretests and/or post-tests were completed. ResultsOne twenty-seven 3rd-year medical students (age: 25 ± 2.6; 54% women) participated in the training program. Pretraining to post-training performance changes were significant for all groups on both tasks (P < .01), but the increase was significantly greater (P < .01) for the learning goals group (do your best: KTΔ = 2.14, CNΔ = 1.69; performance: KTΔ = 2.49, CNΔ = 2.24; learning: KTΔ = 3.04 CNΔ = 2.76). Correlations between goal orientations and improvement were examined, revealing a unique role of goal orientation for performance improvement. ConclusionsThese data indicate that consideration of goal type and trainee goal orientation must be considered during curriculum development to maximize educational value.

The Influence of Mirror-Visual Feedback on Training-Induced Motor Performance Gains in the Untrained Hand.

The well-documented observation of bilateral performance gains following unilateral motor training, a phenomenon known as cross-limb transfer, has important implications for rehabilitation. It has recently been shown that provision of a mirror image of the active hand during unilateral motor training has the capacity to enhance the efficacy of this phenomenon when compared to training without augmented visual feedback (i.e., watching the passive hand), possibly via action observation effects [1]. The current experiment was designed to confirm whether mirror-visual feedback (MVF) during motor training can indeed elicit greater performance gains in the untrained hand compared to more standard visual feedback (i.e., watching the active hand). Furthermore, discussing the mechanisms underlying any such MVF-induced behavioural effects, we suggest that action observation and the cross-activation hypothesis may both play important roles in eliciting cross-limb transfer. Eighty participants practiced a fast-as-possible two-ball rotation task with their dominant hand. During training, three different groups were provided with concurrent visual feedback of the active hand, inactive hand or a mirror image of the active hand with a fourth control group receiving no training. Pre- and post-training performance was measured in both hands. MVF did not increase the extent of training-induced performance changes in the untrained hand following unilateral training above and beyond those observed for other types of feedback. The data are consistent with the notion that cross-limb transfer, when combined with MVF, is mediated by cross-activation with action observation playing a less unique role than previously suggested. Further research is needed to replicate the current and previous studies to determine the clinical relevance and potential benefits of MVF for cases that, due to the severity of impairment, rely on unilateral training programmes of the unaffected limb to drive changes in the contralateral affected limb.

Results from a National Central Auditory Processing Disorder Service: A Real-World Assessment of Diagnostic Practices and Remediation for Central Auditory Processing Disorder.

This article describes the development and evaluation of a national service to diagnose and remediate central auditory processing disorder (CAPD). Data were gathered from 38 participating Australian Hearing centers over an 18-month period from 666 individuals age 6, 0 (years, months) to 24, 8 (median 9, 0). A total of 408 clients were diagnosed with either a spatial processing disorder (n = 130), a verbal memory deficit (n = 174), or a binaural integration deficit (n = 104). A hierarchical test protocol was used so not all children were assessed on all tests in the battery. One hundred fifty clients decided to proceed with deficit-specific training (LiSN & Learn or Memory Booster) and/or be fitted with a frequency modulation system. Families were provided with communication strategies targeted to a child's specific listening difficulties and goals. Outcomes were measured using repeat assessment of the relevant diagnostic test, as well as the Client Oriented Scale of Improvement measure and Listening Inventories for Education teacher questionnaire. Group analyses revealed significant improvements postremediation for all training/management options. Individual posttraining performance and results of outcome measures also are discussed.