Standardized Psychomotor Research Articles

Psychomotor semiology in depression: a standardized clinical psychomotor approach

BackgroundAlthough psychomotor symptoms are associated with the clinical symptomatology of depression, they are rarely assessed and standardized clinical evaluation tools are lacking. Psychomotor retardation is sometimes assessed through direct patient observations by clinicians or through a clinical observation grid, in the absence of a standardized psychomotor assessment. In this pilot study, we evaluated the feasibility of standardized psychomotor examination of patients with major depressive disorder (MDD) and detailed a psychomotor semiology in these patients.MethodsWe used a standardized psychomotor assessment to examine 25 patients with MDD and 25 age- and sex-matched healthy controls (HC) and compared their psychomotor profiles. Using standardized tests, we assessed muscle tone and posture, gross motor skills, perceptual-motor skills, and body image/organization. Clinical assessments of depressive symptoms (levels of psychomotor retardation, anxiety, and self-esteem) comprised this detailed psychomotor examination.ResultsAll participants were examined using the standardized psychomotor assessment. The main results of the psychomotor examination highlighted low body image of MDD participants (p < 0.001). Significant differences between groups were found in passive muscle tone, posture, emotional control, jumping, manual dexterity, walking, and praxis. Among these psychomotor variables, body image, passivity, jumping and rhythm scores predicted an MDD diagnosis.ConclusionsBeyond the psychomotor retardation known to be present in MDD patients, this examination revealed an entire psychomotor symptomatology characterized by elevated muscle tone, poor body image associated with poor self-esteem, slowness in global motor skills and manual praxis, and poor rhythmic adaptation.In light of these results, we encourage clinicians to consider using a standardized tool to conduct detailed psychomotor examination of patients with depressive disorders.Trial registrationClinicalTrials.gov identifier: NCT04031937, 24/07/2019.

Biometric validation of a virtual reality-based psychomotor test for motor skill training

ABSTRACTPsychomotor tests have been applied in clinical therapy and laboratory research as tools for evaluating motor and cognitive skills. Some studies have developed computerized versions of such tests using virtual reality (VR) systems with haptic interface controls. These systems allow for increased flexibility in test delivery and accuracy in performance assessment. In this study, a VR-based computer simulation of the block design (BD) test (a standardized psychomotor task as part of an adult IQ test) was developed and compared with the physical version of the test. Performance was evaluated based on four types of muscle activation collected using electromyography (EMG), time spent in completing the task, and subjective ratings of workload. Results verified the VR-based task as physically comparable to the conventional BD test. The validated computerized psychomotor task may be applied for both experimental and clinical use in future studies.

Evaluation of an Augmented Virtual Reality and Haptic Control Interface for Psychomotor Training

This study investigated the design of a virtual reality (VR) simulation integrating a haptic control interface for motor skill training. Twenty-four healthy participants were tested and trained in standardized psychomotor control tasks using native and VR forms with their nondominant hands in order to identify VR design features that might serve to accelerate motor learning. The study was also intended to make preliminary observations on the degree of specific motor skill development that can be achieved with a VR-based haptic simulation. Results revealed significant improvements in test performance following training for the VR with augmented haptic features with insignificant findings for the native task and VR with basic haptic features. Although performance during training was consistently better with the native task, a correspondence between the VR training and test task interfaces led to greater improvement in test performance as reported by a difference between baseline and post-test scores. These findings support use of VR-based haptic simulations of standardized psychomotor tests for motor skill training, including visual and haptic enhancements for effective pattern recognition and discrete movement of objects. The results may serve as an applicable guide for design of future haptic VR features.

Factors that influence the selection of sterile glove brand: a randomized controlled trial evaluating the performance and cost of gloves

To determine whether glove use modifies tactile and psychomotor performance of health care providers when compared with no glove use and to evaluate factors that influence the selection of sterile glove brand. Forty-two anesthesia providers (nine anesthesiologists, seven nurse anesthetists, 20 residents, six student nurse anesthetists) enrolled in and completed this cross-over randomized trial from May 2010 until August 2011. Participants underwent standardized psychomotor testing while wearing five different types of protective gloves. Assessments of psychomotor performance included tactile, fine motor/dexterity, and hand-eye coordination tests. Subjective ratings of glove comfort and performance were reported at the completion of each glove trial. The manufacturer's suggested retail price was collected for each glove tested. There were statistically significant differences in touch sensitivity for all nerve distributions, with all glove types resulting in less sensitivity than a bare hand. When compared with the non-sterile glove, only the thickest glove tested (Ansell Perry Orthopaedic) was found to have less touch sensitivity. Fine motor dexterity testing revealed no statistically significant differences in time to completion amongst glove types or bare handed performance. In hand-eye coordination testing across treatment conditions, the thickest glove tested (Ansell Perry(®) Orthopaedic) was the only glove to show a statistically significant difference from a bare hand. There were statistically significant differences in glove comfort ratings across glove types, with latex-free, powder-free (Cardinal Esteem(®)), and latex powder-free (Mölnlycke-Biogel(®)) rated highest; however, there were no statistically significant differences in subjective performance ratings across glove types. Given the observed similarities in touch sensitivity and psychomotor performance associated with five different glove types, our results suggest that subjective provider preferences, such as glove comfort, should be balanced against material costs.

Correlation of psychomotor findings and the ability to partially weight bear

BackgroundPartial weight bearing is thought to avoid excessive loading that may interfere with the healing process after surgery of the pelvis or the lower extremity. The object of this study was to investigate the relationship between the ability to partially weight bear and the patient's psychomotor skills and an additional evaluation of the possibility to predict this ability with a standardized psychomotor test.Methods50 patients with a prescribed partial weight bearing at a target load of 15 kg following surgery were verbally instructed by a physical therapist. After the instruction and sufficient training with the physical therapist vertical ground reaction forces using matrix insoles were measured while walking with forearm crutches. Additionally, psychomotor skills were tested with the Motorische Leistungsserie (MLS). To test for correlations Spearman's Rank correlation was used. For further comparison of the two groups a Mann-Withney test was performed using Bonferroni correction.ResultsThe patient's age and body weight significantly correlated with the ability to partially weight bear at a 15 kg target load. There were significant correlations between several subtests of the MLS and ground reaction forces measured while walking with crutches. Patients that were able to correctly perform partial weight bearing showed significant better psychomotor skills especially for those subtests where both hands had to be coordinated simultaneously.ConclusionsThe ability to partially weight bear is associated with psychomotor skills. The MLS seems to be a tool that helps predicting the ability to keep within the prescribed load limits.

Effect of prenatal supplementation with docosahexanoic acid on infant development: a randomized placebo‐controlled trial in Mexico.

The omega‐3 fatty acid docosahexanoic acid (DHA) is deposited in the brain early in life and plays an important role in neural and visual function. Little is known however about the benefits of ingesting DHA supplements during pregnancy for infant development. We conducted a randomized double‐blind placebo‐controlled trial of 400 mg/day algal DHA (Martek) from week 20 of gestation through delivery (n=1094 pregnant women) and followed the offspring (n=973 live births). Child development was measured in 730 children (75% of birth cohort) using the Spanish version of the Bayley Scales of Infant Development (BSID)‐II at 18 mo of age; we calculated standardized psychomotor development (PDI) and mental development indices (MDI). PDI and MDI scores (mean ± S.D.) were 94.3 ± 10.7 and 93.0 ± 8.9 in the DHA group (n=365) and 95.2 ± 9.3 and 93.3 ± 9.8 in the placebo group (n=365), respectively. Intent to treat differences in PDI and MDI scores at 18 mo were 0.90 (95% CI: −0.55, 2.35; p=0.23) and 0.26 (95% CI: −1.10, 1.63; p=0.70), respectively. Prenatal supplementation with 400 mg algal DHA did not result in improved global development scores at 18 mo of age in a study population (Mexico) with low intakes of DHA. Follow‐up of the cohort is ongoing. Funding: NIH (HD043099) and March of Dimes Foundation.

Infant Overweight Is Associated with Delayed Motor Development

To examine how infant overweight and high subcutaneous fat relate to infant motor development. Participants were from the Infant Care, Feeding, and Risk of Obesity Project, a prospective, longitudinal study of low-income African-American mother-infant dyads assessed from 3 to 18 months of age (836 observations on 217 infants). Exposures were overweight (weight-for-length z-score>or=90th percentile of 2000 Centers for Disease Control/National Center for Health Statistics growth reference) and high subcutaneous fat (sum of 3 skinfold measurements>90th percentile of our sample). Motor development was assessed by using the Bayley Scales of Infant Development-II. Developmental delay was characterized as a standardized Psychomotor Development Index score<85. Longitudinal models estimated developmental outcomes as functions of time-varying overweight and subcutaneous fat, controlling for age and sex. Alternate models tested concurrent and lagged relationships (earlier weight or subcutaneous fat predicting current motor development). Motor delay was 1.80 times as likely in overweight infants compared with non-overweight infants (95% CI,1.09-2.97) and 2.32 times as likely in infants with high subcutaneous fat compared with infants with lower subcutaneous fat (95% CI, 1.26-4.29). High subcutaneous fat was also associated with delay in subsequent motor development (odds ratio, 2.27; 95% CI, 1.08-4.76). Pediatric overweight and high subcutaneous fat are associated with delayed infant motor development.

How to select aspirant laparoscopic surgical trainees: Establishing concurrent validity comparing Xitact LS500 index performance scores with standardized psychomotor Aptitude Test Battery scores

Background Although a controversial topic in medical education, the selection of aspirant surgical trainees is a subject that needs to be addressed. In the view of preventing surgical trainee drop-outs and of appropriate allocation of limited resources, it is an issue critical to the profession. Traditional methods of selection are often subjective, and do not seem to correlate with skill needed for surgery. Standardized neuropsychometric test batteries may be useful in helping to select aspirant laparoscopic surgeons. Our study attempts to link surgical novices’ psychometric ability test battery data with actual performance outcome on an objective, validated, and reproducible surgical laparoscopic task using virtual-reality simulation. Materials and methods Thirty-three novices with no laparoscopic surgical experience participated. Each participant performed the Xitact LS500 Virtual Reality cholecystectomy clip-and-cut module 30 times. Individual learning curves were computed and patterns were assessed. Participants were examined using the aptitude test battery including the Abstract Reasoning test, the Space Relations test, the Gibson Spiral Maze test, and the Crawford Small Parts Dexterity tester. Results Over 900 virtual-reality simulation tasks were generated and assessed. Of the participants, 93.3% were able to complete the virtual-reality simulation 30 times and all elements of our aptitude test battery. The abstract reasoning test is the only test correlating significantly to Xitact test outcome. This test is highly correlated to the space relations test. Both tests have discriminative power, comparing groups of performers. Conclusions The present study addresses the concurrent validity in aptitude testing, comparing scores of surgical novices on the Xitact LS500 laparoscopic cholecystectomy virtual-reality simulation with performance scores on a battery of standardized psychometric aptitude tests. The abstract reasoning and the space-relation test have predictive and selective value, identifying individuals who have good laparoscopic surgical virtual-reality performance. Aspiring laparoscopic surgeons who score below 25 on either test, that is, an expected 36%, would have to be further assessed using Xitact surgical task performance. The group of participants scoring above 35 on the Abstract Reasoning test and above 45 on the Space Relations test, that is, an expected 18% of the population, is unlikely to mal-perform on Xitact. The other 46% could very well benefit from Xitact simulation and assessment when the opportunity is present.

Preference for ethanol and diazepam in light and moderate social drinkers: a within-subjects study

Preference for ethanol (versus placebo) and diazepam (versus placebo) was assessed in light and moderate social drinkers. The study was designed to investigate the relationship of habitual alcohol use to the subjective and behavioral effects of the two drugs. A secondary purpose of the study was to investigate relationships within subjects in their responses to ethanol and diazepam. Light drinkers (n = 13) who consumed one to five drinks per week and moderate drinkers (n = 14) who consumed seven or more drinks per week participated in two seven-session choice experiments, one assessing preference for 0.5 g/kg ethanol versus placebo and the other assessing preference for 20 mg diazepam versus placebo. Drugs were administered double-blind and double-dummy, and the order of participation in the two experiments was counterbalanced. Sessions were conducted during the evenings in a comfortable laboratory environment. The primary dependent measure was the number of times each subject chose the drug (i.e., ethanol or diazepam) over placebo. Subjective and objective measures of the drugs' effects were obtained using standardized self-report questionnaires and psychomotor tests. Whereas both groups preferred the ethanol over placebo (i.e., 63% and 83% ethanol choice for light and moderate drinkers, respectively), only the moderate drinkers preferred the diazepam over placebo (i.e., 40% and 73% diazepam choice for light and moderate drinkers, respectively). Subjective responses to the drugs were generally similar across the groups, although on some measures the light drinkers reported more marked drug effects. The number of times each subject chose ethanol was positively correlated with the number of times he or she chose diazepam (r = 0.57), and on subjective measures, responses to ethanol and diazepam were positively correlated. Thus, subjective and behavioral responses to diazepam and ethanol were related to habitual alcohol consumption, and most notably, moderate drinkers were more likely than light drinkers to prefer diazepam over a placebo.

Experimental human exposures to fluorocarbon 12 (dichlorodifluoromethane).

The acute toxicity of fluorocarbon 12 was studied as it relates to establishing safe hygienic standards for single, brief exposures. Two human volunteers were exposed to concentrations of 1000 and 10,000 ppm of fluorocarbon 12 for 2.5 hours. They were exposed twice to both concentrations, and on six occasions they were exposed to air. Clinical observations, laboratory tests, subjective impressions, continuous electrocardiogram monitoring, and tests of psychomotor performance did not reveal any adverse effects resulting from exposure to 1000 ppm of fluorocarbon 12. Exposures to 10,000 ppm resulted only in a 7% reduction in the standardized psychomotor test score. These findings suggest that exposure to 10,000 ppm of fluorocarbon 12 for 2.5 hours will not pose a serious threat to an individual's health. Measurement of the subjects’ end-tidal air for fluorocarbon 12 made immediately postexposure and periodically thereafter showed that the compound is rapidly eliminated from the lungs.