Motor Tasks Research Articles

Oculomotor atypicalities in motor neurone disease: a systematic review

IntroductionCognitive dysfunction is commonplace in Motor Neurone Disease (MND). However, due to the prominent motor symptoms in MND, assessing patients’ cognitive function through traditional cognitive assessments, which oftentimes require motoric responses, may become increasingly challenging as the disease progresses. Oculomotor pathways are apparently resistant to pathological degeneration in MND. As such, abnormalities in oculomotor functions, largely driven by cognitive processes such as saccades and smooth pursuit eye movement, may be reflective of frontotemporal cognitive deficits in MND. Thus, saccadic and smooth pursuit eye movements may prove to be ideal mechanistic markers of cognitive function in MND.MethodsTo ascertain the utility of saccadic and smooth pursuit eye movements as markers of cognitive function in MND, this review summarizes the literature concerning saccadic and smooth pursuit eye movement task performance in people with MND.Results and discussionOf the 22 studies identified, noticeable patterns suggest that people with MND can be differentiated from controls based on antisaccade and smooth pursuit task performance, and thus the antisaccade task and smooth pursuit task may be potential candidates for markers of cognition in MND. However, further studies which ascertain the concordance between eye tracking measures and traditional measures of cognition are required before this assumption is extrapolated, and clinical recommendations are made.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=376620, identifier CRD42023376620.

Corpus Callosum-Mediated Interhemispheric Interactions in Cervical Spondylotic Myelopathy.

The corpus callosum is crucial for interhemispheric interactions in the motor control of limb functions. Human and animal studies suggested spinal cord pathologies may induce cortical reorganization in sensorimotor areas. We investigate participation of the corpus callosum in executions of a simple motor task in patients with cervical spondylotic myelopathy (CSM) using transcranial magnetic stimulation. Twenty patients with CSM with various MRI grades of severity of cord compression were compared with 19 normal controls. Ipsilateral silent period, contralateral silent period, central motor conduction time, and transcallosal conduction time (TCT) were determined. In both upper and lower limbs, TCTs were significantly increased for patients with CSM than normal controls ( p < 0.001 for all), without side-to-side differences. Ipsilateral silent period and contralateral silent period durations were significantly increased bilaterally for upper limbs in comparison to controls ( p < 0.01 for all), without side-to-side differences. There were no significant correlations of TCT with central motor conduction time nor severity of CSM for both upper and lower limbs ( p > 0.05 for all) bilaterally. Previous transcranial magnetic stimulation studies show increased motor cortex excitability in CSM; hence, increased TCTs observed bilaterally may be a compensatory mechanism for effective unidirectional and uniplanar execution of muscle activation in the distal limb muscles. Lack of correlation of TCTs with severity of CSM or central motor conduction time may be in keeping with a preexistent role of the corpus callosum as a predominantly inhibitory pathway for counteracting redundant movements resulting from increased motor cortex excitability occurring after spinal cord lesions.

Reconfigurations of cortical manifold structure during reward-based motor learning

Adaptive motor behavior depends on the coordinated activity of multiple neural systems distributed across the brain. While the role of sensorimotor cortex in motor learning has been well established, how higher-order brain systems interact with sensorimotor cortex to guide learning is less well understood. Using functional MRI, we examined human brain activity during a reward-based motor task where subjects learned to shape their hand trajectories through reinforcement feedback. We projected patterns of cortical and striatal functional connectivity onto a low-dimensional manifold space and examined how regions expanded and contracted along the manifold during learning. During early learning, we found that several sensorimotor areas in the dorsal attention network exhibited increased covariance with areas of the salience/ventral attention network and reduced covariance with areas of the default mode network (DMN). During late learning, these effects reversed, with sensorimotor areas now exhibiting increased covariance with DMN areas. However, areas in posteromedial cortex showed the opposite pattern across learning phases, with its connectivity suggesting a role in coordinating activity across different networks over time. Our results establish the neural changes that support reward-based motor learning and identify distinct transitions in the functional coupling of sensorimotor to transmodal cortex when adapting behavior.

Beta-band power classification of Go/No-go arm reaching responses in the human hippocampus.

Introduction&#xD;Can we decode movement execution and inhibition from hippocampal oscillations during arm-reaching tasks? Traditionally associated with memory encoding, spatial navigation, and motor sequence consolidation, the hippocampus has come under scrutiny for its potential role in movement processing. Stereotactic electroencephalography (SEEG) has provided a unique opportunity to study the neurophysiology of the human hippocampus during motor tasks.&#xD;&#xD;Objective&#xD;In this study, we assess the accuracy of discriminant functions, in combination with principal component analysis (PCA), in classifying between "Go" and "No-go" trials in a Go/No-go arm-reaching task. Our approach centers on capturing the modulation of beta-band (13-30 Hz) power from multiple SEEG contacts in the hippocampus and minimizing the dimensional complexity of channels and frequency bins.&#xD;&#xD;Methods&#xD;This study utilizes SEEG data from the human hippocampus of 10 participants diagnosed with epilepsy. Spectral power was computed during a "center-out" Go/No-go arm-reaching task, where participants reached or withheld their hand based on a colored cue. PCA was used to reduce data dimension and isolate the highest-variance components within the beta band. The Silhouette score was employed to measure the quality of clustering between "Go" and "No-go" trials. The accuracy of five different discriminant functions was evaluated using cross-validation.&#xD;&#xD;Results&#xD;The Diagonal-Quadratic model performed best of the 5 classification models, exhibiting the lowest error rate in all participants (median: 9.91%, average: 14.67%). PCA showed that the first two principal components collectively accounted for 54.83% of the total variance explained on average across all participants, ranging from 36.92% to 81.25% among participants.&#xD;&#xD;Conclusion&#xD;This study shows that PCA paired with a Diagonal-Quadratic model can be an effective method for classifying between Go/No-go trials from beta-band power in the hippocampus during arm-reaching responses. This emphasizes the significance of hippocampal beta-power modulation in motor control, unveiling its potential implications for brain-computer interface (BCI) applications.

A novel method for estimating properties of attentional oscillators reveals an age-related decline in flexibility.

Dynamic attending theory proposes that the ability to track temporal cues in the auditory environment is governed by entrainment, the synchronization between internal oscillations and regularities in external auditory signals. Here, we focused on two key properties of internal oscillators: their preferred rate, the default rate in the absence of any input; and their flexibility, how they adapt to changes in rhythmic context. We developed methods to estimate oscillator properties (Experiment 1) and compared the estimates across tasks and individuals (Experiment 2). Preferred rates, estimated as the stimulus rates with peak performance, showed a harmonic relationship across measurements and were correlated with individuals' spontaneous motor tempo. Estimates from motor tasks were slower than those from the perceptual task, and the degree of slowing was consistent for each individual. Task performance decreased with trial-to-trial changes in stimulus rate, and responses on individual trials were biased toward the preceding trial's stimulus properties. Flexibility, quantified as an individual's ability to adapt to faster-than-previous rates, decreased with age. These findings show domain-specific rate preferences for the assumed oscillatory system underlying rhythm perception and production, and that this system loses its ability to flexibly adapt to changes in the external rhythmic context during aging.

Time synchronization between parietal–frontocentral connectivity with MRCP and gait in post-stroke bipedal tasks

BackgroundIn post-stroke rehabilitation, functional connectivity (FC), motor-related cortical potential (MRCP), and gait activities are common measures related to recovery outcomes. However, the interrelationship between FC, MRCP, gait activities, and bipedal distinguishability have yet to be investigated.MethodsTen participants were equipped with EEG devices and inertial measurement units (IMUs) while performing lower limb motor preparation (MP) and motor execution (ME) tasks. MRCP, FCs, and bipedal distinguishability were extracted from the EEG signals, while the change in knee degree during the ME phase was calculated from the gait data. FCs were analyzed with pairwise Pearson’s correlation, and the brain-wide FC was fed into support vector machine (SVM) for bipedal classification.ResultsParietal–frontocentral connectivity (PFCC) dysconnection and MRCP desynchronization were related to the MP and ME phases, respectively. Hemiplegic limb movement exhibited higher PFCC strength than nonhemiplegic limb movement. Bipedal classification had a short-lived peak of 75.1% in the pre-movement phase. These results contribute to a better understanding of the neurophysiological functions during motor tasks, with respect to localized MRCP and nonlocalized FC activities. The difference in PFCCs between both limbs could be a marker to understand the motor function of the brain of post-stroke patients.ConclusionsIn this study, we discovered that PFCCs are temporally dependent on lower limb gait movement and MRCP. The PFCCs are also related to the lower limb motor performance of post-stroke patients. The detection of motor intentions allows the development of bipedal brain-controlled exoskeletons for lower limb active rehabilitation.

Optimization of robot manipulator configuration calibration by using Zhang neural network for repetitive motion

High precision and low complexity control algorithm plays an important role in the developing of the end-effector instrumentation of different robot manipulators. In order to reduce the kinetic energy and the high-speed drift phenomenon of the repetitive motion tracking task, the robot manipulator needs to calibrate its configuration. In this paper, we formulate the configuration calibration of the robot manipulator for the repetitive motion task as a future quadratic programming optimization problem constrained with equality constraints, which is also regarded as a fundamental problem in artificial intelligence and modern control engineering. Zhang neural network, which is a canonical method, can be adopted to deal with the continuous form of the future optimization problem, named as temporally dependent quadratic programming problem with equality constraints. In order to overcome the issue of temporally dependent inverse computing, a novel Zhang neural network model and its uncertain disturbance tolerant model, which are termed as filtered reciprocal-kind Zhang neural network model and uncertain disturbance tolerant filtered reciprocal-kind Zhang neural network model, respectively, are proposed by integrating the energy-type cost function and Zhang neural network design formula for solving the temporally dependent quadratic programming problem with equality constraints in this paper. Based on the Euler discrete formula and the models, the discrete filtered reciprocal-kind Zhang neural network and the discrete uncertain disturbance tolerant filtered reciprocal-kind Zhang neural network algorithms are proposed for solving the future quadratic programming problem with equality constraints and the robot manipulator configuration calibration problem of repetitive motion. The convergence properties of the reciprocal-kind Zhang neural network model and its corresponding uncertain disturbance tolerant model are obtained by Lyapunov stability theory of nonlinear system and its corresponding perturbed system, while the convergence property of the filtered reciprocal-kind Zhang neural network model is analyzed by the limit thinking. For the repetitive motion task, three experiments for solving the configuration calibration problem of PUMA560, Kinova Jaco2, and Franka Emika Panda robot manipulators are performed to illustrate the effectiveness, robustness and superiority of our proposed discrete filtered reciprocal-kind Zhang neural network algorithms.

Motor imagery of finger movements: Effects on cortical and muscle activities

PurposeThe purpose of the current study was to explore the immediate effect of motor imagery (MI) involving finger movement of a given limb on cortical response and muscle activity in healthy subjects. MethodsTwenty healthy right-handed adults (7 females and 13 males) with a mean + SD age of 22.05 + 6.08 years participated in the study. The beta-band event-related desynchronization (ERD) at the sensorimotor cortex and muscle activity during finger movement tasks using either the index, middle, or thumb digits on the non-dominant left hand were compared before and after an MI training session. Subjects underwent a pre-MI, MI training, and finally a post-MI session where they either performed or imagined performing a button-pushing action 50 times per session with each of the three digits. ResultsThe ERD power in the beta frequency band was lower in pre-MI compared to post-MI and was significantly different between the pre- and post-MI sessions for both the index and middle fingers, but not the thumb. A significant decrease was seen in the mean muscle activity during post-MI compared to pre-MI for all the digits except the thumb. ConclusionsThe results from the current study suggest that complex MI can result in motor learning and improvement in motor performance, thereby requiring less effort during motion.

Balance, Landing Biomechanics, and Functional Movement Screen Characteristics With and Without Knee Exoskeleton in Military Soldiers.

A light-weight pneumatic-powered knee exoskeleton could augment mobility and lifting capabilities for a variety of occupational settings. However, added weight/bulkiness and artificially produced knee extension torque could compromise sensorimotor characteristics. Ten healthy participants conducted 3 visits within 10 days to the biomechanics laboratory. Participants were asked to complete the following tasks on each visit: single-leg balance, single-leg drop-landing, and select functional movement tasks. Balance characteristics (the ground reaction forces variability and center-of-pressure velocity) were derived from force plates while knee flexion angles during drop-landing and functional movement tasks were captured using a motion capture system. Descriptive statistics as well as paired t-tests or Wilcoxon signed-rank tests were used to compare between conditions. Significance was set at P < .05 a priori. During single-leg balance, the ground reaction force variabilities were significantly increased (P = .013-.019) and the center of pressure velocity was decreased (P = .001-.017) when wearing knee exoskeleton. During single-leg drop-landing, the exoskeleton condition showed lower knee flexion angles at the initial contact (P = .004-.021) and peak (P = .006-.010). Additionally, the peak vertical ground reaction force was higher in the exoskeleton condition (P = .007). During functional movement tasks, the exoskeleton condition showed less knee flexion range-of-motion during the overhead squat (P = .007-.033) and hurdle step-over (P = .004-.005). Participants exhibited stiffer landing technique with the exoskeleton. Given that these compromised sensorimotor characteristics have been associated with musculoskeletal injury risk, modifications to exoskeletons to promote softer landing and greater knee flexion range-of-motion during dynamic activities may be warranted.

Development and Validation of a Bedside Scale for Assessing Upper Limb Function Following Stroke: A Methodological Study.

Background Numerous tools are available for evaluation of upper limb (UL) functions among stroke survivors. Despite the excellent psychometric properties, many require considerable amount of time, are resource-intensive, and often impractical for bedside evaluation. Objectives To develop and concurrently validate a simple, resource-efficient, and time-efficient bedside tool for evaluating UL function in stroke survivors. Methods Relevant literature review was carried out to conceptualize and define the theoretical framework of day-to-day UL movement tasks. Subsequently, an item pool of 18 UL movements was developed. A mini-Delphi method was employed to verify content validity. During the iterative rounds, 18-items were revised and refined to a 12-items scale. The final bedside upper limb evaluation tool (BUFET) scale underwent concurrent validation by correlating the scores with Wolf Motor Function Test (WMFT) scores using Spearman’s correlation coefficient. Internal consistency was evaluated through Cronbach’s alpha. Results Concurrent validity and internal consistency of the scale were supported by a high correlation coefficient (r = 0.937; p&lt;0.001) with WMFT and high Cronbach’s alpha (0.948). Conclusions Newly developed BUFET was found to be a valid and reliable bedside tool in the evaluation of upper limb functions and can be administered in a resource and time-efficient manner.

EEG connectivity in functional brain networks supporting visuomotor integration processes in dominant and non-dominant hand movements

Objective. This study explores the changes in the organization of functional brain networks induced by performing a visuomotor integration task, as revealed by noninvasive spontaneous electroencephalographic traces (EEG). Approach. EEG data were acquired during the execution of the Nine Hole Peg Test (NHPT) with the dominant and non-dominant hands in a group of 44 right-handed volunteers. Both spectral analysis and phase-based connectivity analysis were performed in the theta (ϑ), mu ( μ ) and beta (ß) bands. Graph Theoretical Analysis (GTA) was also performed to investigate the topological reorganization induced by motor task execution. Main results. Spectral analysis revealed an increase of frontoparietal ϑ power and a spatially diffused reduction of µ and ß contribution, regardless of the hand used. GTA showed a significant increase in network integration induced by movement performed with the dominant limb compared to baseline in the ϑ band. The µ and ß bands were associated with a reduction in network integration during the NHPT. In the µ rhythm, this result was more evident for the right-hand movement, while in the ß band, results did not show dependence on the laterality. Finally, correlation analysis highlighted an association between frequency-specific topology measures and task performance for both hands. Significance. Our results show that functional brain networks reorganize during visually guided movements in a frequency-dependent manner, differently depending on the hand used (dominant/non dominant).

Formulation of Common Spatial Patterns for Multi-Task Hyperscanning BCI.

This work proposes a new formulation for common spatial patterns (CSP), often used as a powerful feature extraction technique in brain-computer interfacing (BCI) and other neurological studies. In this approach, applied to multiple subjects' data and named as hyperCSP, the individual covariance and mutual correlation matrices between multiple simultaneously recorded subjects' electroencephalograms are exploited in the CSP formulation. This method aims at effectively isolating the common motor task between multiple heads and alleviate the effects of other spurious or undesired tasks inherently or intentionally performed by the subjects. This technique can provide a satisfactory classification performance while using small data size and low computational complexity. By using the proposed hyperCSP followed by support vector machines classifier, we obtained a classification accuracy of 81.82% over 8 trials in the presence of strong undesired tasks. We hope that this method could reduce the training error in multi-task BCI scenarios. The recorded valuable motor-related hyperscanning dataset is available for public use to promote the research in this area.

Tablet-Based Cognitive and Eye Movement Measures as Accessible Tools for Schizophrenia Assessment: Multisite Usability Study.

Schizophrenia is a complex mental disorder characterized by significant cognitive and neurobiological alterations. Impairments in cognitive function and eye movement have been known to be promising biomarkers for schizophrenia. However, cognitive assessment methods require specialized expertise. To date, data on simplified measurement tools for assessing both cognitive function and eye movement in patients with schizophrenia are lacking. This study aims to assess the efficacy of a novel tablet-based platform combining cognitive and eye movement measures for classifying schizophrenia. Forty-four patients with schizophrenia, 67 healthy controls, and 41 patients with other psychiatric diagnoses participated in this study from 10 sites across Japan. A free-viewing eye movement task and 2 cognitive assessment tools (Codebreaker task from the THINC-integrated tool and the CognitiveFunctionTest app) were used for conducting assessments in a 12.9-inch iPad Pro. We performed comparative group and logistic regression analyses for evaluating the diagnostic efficacy of the 3 measures of interest. Cognitive and eye movement measures differed significantly between patients with schizophrenia and healthy controls (all 3 measures; P<.001). The Codebreaker task showed the highest classification effectiveness in distinguishing schizophrenia with an area under the receiver operating characteristic curve of 0.90. Combining cognitive and eye movement measures further improved accuracy with a maximum area under the receiver operating characteristic curve of 0.94. Cognitive measures were more effective in differentiating patients with schizophrenia from healthy controls, whereas eye movement measures better differentiated schizophrenia from other psychiatric conditions. This multisite study demonstrates the feasibility and effectiveness of a tablet-based app for assessing cognitive functioning and eye movements in patients with schizophrenia. Our results suggest the potential of tablet-based assessments of cognitive function and eye movement as simple and accessible evaluation tools, which may be useful for future clinical implementation.

Boosting Prefrontal Brain Responsiveness by Interoceptive Attentiveness during Synchronized Breathing, Motor, and Cognitive Task

Background: this study explored the prefrontal cortex (PFC) hemodynamic variations produced by the association of an Interoceptive Attentiveness (IA) condition with a simple breath, motor, and cognitive synchronization task. Methods: 18 healthy individuals performed different synchronization activities (breath, motor, and cognitive) under both IA and control conditions, while levels of oxygenated (O2Hb) and deoxygenated hemoglobin were measured using functional Near-Infrared Spectroscopy (fNIRS). Results: findings revealed higher O2Hb levels in the prefrontal brain region during the experimental condition (IA) in contrast to the control condition. Notably, this difference was particularly evident during the cognitive task as opposed to the other tasks (breath and motor). In contrast, no significant differences were found for the PFC lateralization effect. Conclusions: This evidence holds potential for rehabilitation professionals suggesting that the combination of deliberate attention to the breath and a cognitive synchronization task (such as a vocal exercise executed simultaneously) could boost PFC responsiveness.

Decision-Making Time Analysis for Assessing Processing Speed in Athletes during Motor Reaction Tasks.

Reaction time (RT) is a widely used measure for testing physical performance in motor tasks. This study focused on assessing the processing speed in athletes. Twenty-five healthy volunteers were assigned to the control (n = 16) or athletes groups (n = 9). They were evaluated during motor reaction tasks based on visual stimuli and three difficulty conditions. Physiological measures were obtained from motion capture and electromyography recordings of several muscles. Two RT phases, decision-making (DMK) and electromechanical delay (EMD), were used to analyze the processing speed. The results show significant RT differences between groups. The athletes were ~30% faster compared to the control group. Despite the fact that all participants were right-handed, RT did not show any differences between hands performances in any group. However, DMK time revealed significant differences between the hands. Controls showed a longer DMK time for the right-hand election, ~20% more than the left, while athletes showed no such disparity. These findings reveal that quantifying the decision-making component of reaction time is crucial to assessing processing speed in sport. This approach could facilitate the monitoring of adaptations in both motor-cognitive and neuromuscular processes. The theoretical implications presented in this study offer perspectives on handedness research.

Excitation of natural spinal reflex loops in the sensory-motor control of hand prostheses.

Sensory feedback for prosthesis control is typically based on encoding sensory information in specific types of sensory stimuli that the users interpret to adjust the control of the prosthesis. However, in physiological conditions, the afferent feedback received from peripheral nerves is not only processed consciously but also modulates spinal reflex loops that contribute to the neural information driving muscles. Spinal pathways are relevant for sensory-motor integration, but they are commonly not leveraged for prosthesis control. We propose an approach to improve sensory-motor integration for prosthesis control based on modulating the excitability of spinal circuits through the vibration of tendons in a closed loop with muscle activity. We measured muscle signals in healthy participants and amputees during different motor tasks, and we closed the loop by applying vibration on tendons connected to the muscles, which modulated the excitability of motor neurons. The control signals to the prosthesis were thus the combination of voluntary control and additional spinal reflex inputs induced by tendon vibration. Results showed that closed-loop tendon vibration was able to modulate the neural drive to the muscles. When closed-loop tendon vibration was used, participants could achieve similar or better control performance in interfaces using muscle activation than without stimulation. Stimulation could even improve prosthetic grasping in amputees. Overall, our results indicate that closed-loop tendon vibration can integrate spinal reflex pathways in the myocontrol system and open the possibility of incorporating natural feedback loops in prosthesis control.

Parkinson's disease patients show delayed hemodynamic changes in primary motor cortex in fine motor tasks and decreased resting-state interhemispheric functional connectivity: a functional near-infrared spectroscopy study.

People with Parkinson's disease (PD) experience changes in fine motor skills, which is viewed as one of the hallmark signs of this disease. Due to its non-invasive nature and portability, functional near-infrared spectroscopy (fNIRS) is a promising tool for assessing changes related to fine motor skills. We aim to compare activation patterns in the primary motor cortex using fNIRS, comparing volunteers with PD and sex- and age-matched control participants during a fine motor task and walking. Moreover, inter and intrahemispheric functional connectivity (FC) was investigated during the resting state. We used fNIRS to measure the hemodynamic changes in the primary motor cortex elicited by a finger-tapping task in 20 PD patients and 20 controls matched for age, sex, education, and body mass index. In addition, a two-minute walking task was carried out. Resting-state FC was also assessed. Patients with PD showed delayed hypoactivation in the motor cortex during the fine motor task with the dominant hand and delayed hyperactivation with the non-dominant hand. The findings also revealed significant correlations among various measures of hemodynamic activity in the motor cortex using fNIRS and different cognitive and clinical variables. There were no significant differences between patients with PD and controls during the walking task. However, there were significant differences in interhemispheric connectivity between PD patients and control participants, with a statistically significant decrease in PD patients compared with control participants. Decreased interhemispheric FC and delayed activity in the primary motor cortex elicited by a fine motor task may one day serve as one of the many potential neuroimaging biomarkers for diagnosing PD.

Effect of low versus high balance training complexity on balance performance in male adolescents

ObjectiveThe current study aimed to determine the effects of low (i.e., balance task only) versus high (i.e., balance task combined with an additional motor task like dribbling a basketball) balance training complexity (6 weeks of training consisting of 2 × 30 min balance exercises per week) on measures of static and dynamic balance in 44 healthy male adolescents (mean age: 13.3 ± 1.6 years).ResultsIrrespective of balance training complexity, significant medium- to large-sized pretest to posttest improvements were detected for static (i.e., One-Legged Stance test, stance time [s], 0.001 < p ≤ 0.008) and dynamic (i.e., 3-m Beam Walking Backward test, steps [n], 0.001 < p ≤ 0.002; Y-Balance-Test-Lower-Quarter, reach distance [cm], 0.001 < p ≤ 0.003) balance performance. Further, in all but one comparison (i.e., stance time with eyes opened on foam ground) no group × test interactions were found. These results imply that balance training is effective to improve static and dynamic measures of balance in healthy male adolescents, but the effectiveness seems unaffected by the applied level of balance training complexity.

Dual-Tasks in Soccer: Effects of Players' Experience and Task Condition on Physical Performance.

In this study, we examined whether experience level and various dual motor and cognitive or single tasks influenced young soccer players' physical performance during small-sided games. Participants were 72 players from U-13 (n = 36) and U-17 (n = 36) groups who participated in 3-to-a-side small-sided games under four experimental conditions: control, a secondary motor task, an additional related secondary cognitive task, and an additional secondary non-specific task. We used GPS devices to measure physical performance in terms of distances covered and accelerations at different thresholds. We found no significant interaction effect between player experience and task condition (p = .540), meaning that dual tasks had comparable effects on players of different experience levels. There were significant main effects of both experience level (p < .001) and condition (p < .001) on most physically related variables. Older players outperformed younger ones, particularly in high-intensity actions. While secondary motor tasks decreased physical performance, secondary cognitive tasks, irrespective of specificity, did not impair players' performances. In conclusion, experience level did not influence the players' physical response to dual tasks, and a secondary motor task was more disruptive to physical performance than either of two types of secondary cognitive tasks. Cognitive tasks can be incorporated into soccer training without compromising physical performance.

RTMS of the Cerebellum Using an Accelerated Stimulation Protocol Improved Gait in Parkinson’s Disease

Background Repetitive transcranial magnetic stimulation (rTMS) is a nonpharmacological and noninvasive brain stimulation technique that has been proven to be effective in Parkinson’s disease (PD). The combination of rTMS and treadmill training improved gait function in PD greater than treadmill training alone. Objective The aim of our study was to evaluate the combination of a novel high-intensity, short intervention rTMS treatment and a multimodal treatment protocol including of physiotherapy, occupational therapy and language therapy, the so-called Parkinson’s Disease Multimodal Complex Treatment (PD-MCT), to improve motor function. Methods In this randomized double-blind sham-controlled trial rTMS with 48 Hz or sham was applied over the cerebellum 3 times a day for 5 consecutive days. Patients were assessed at baseline (V0), after 5 days of treatment (V1), and 4 weeks later (V2). The primary clinical outcome measure was the motor sum-score of the Unified PD Rating Scale (UPDRSIII), secondary clinical outcomes were quantitative motor tasks. Results A total of 36 PD patients were randomly allocated either to rTMS (n = 20) or sham (n = 16), both combined with PD-MCT. rTMS improved the UDPRSIII score comparing baseline and V1 in the treatment group by −8.2 points (P = .004). The 8MW and dynamic posturography remained unchanged in both groups after intervention. Conclusion. Compressing weeks of canonical rTMS protocols into 5 days was effective and well tolerated. rTMS may serve as an add-on therapy for augmenting the multimodal complex treatment of motor symptoms, but seems to be ineffective to treat postural instability.