Task-related and person-related variables influence the effect of low back pain on anticipatory postural adjustments

BackgroundPeople with low back pain exhibit altered postural coordination that has been suggested as a target for treatment, but heterogeneous presentation has rendered it difficult to identify appropriate candidates and protocols for such treatments. This study evaluated the associations of task-related and person-related factors with the effect of low back pain on anticipatory postural adjustments.MethodsThirteen subjects with and 13 without low back pain performed seated, rapid arm flexion in self-initiated and cued conditions. Mixed-model ANOVA were used to evaluate group and condition effects on APA onset latencies of trunk muscles, arm-raise velocity, and pre-movement cortical potentials. These measures were evaluated for correlation with pain ratings, Fear Avoidance Beliefs Questionnaire scores, and Modified Oswestry Questionnaire scores.FindingsDelayed postural adjustments of subjects with low back pain were greater in the cued condition than in the self-initiated condition. The group with low back pain exhibited larger-amplitude cortical potentials than the group without pain, but also significantly slower arm-raise velocities. With arm-raise velocity as a covariate, the effect of low back pain remained significant for the latencies of postural adjustments but not for cortical potentials. Latencies of the postural adjustments significantly correlated with Oswestry and Fear Avoidance Beliefs scores.InterpretationDelayed postural adjustments with low back pain appear to be influenced by cueing of movement, pain-related disability and fear of activity. These results highlight the importance of subject characteristics, task condition, and task performance when comparing across studies or when developing treatment of people with low back pain.     

Does mental practice still enhance performance? A 24 Year follow-up and meta-analytic replication and extension

ObjectivesMotor imagery (MI) is a dynamic mental state during which the representation of a given motor movement is rehearsed in working memory without overt motor output. Mental practice (MP; also known as motor imagery practice) is the systematic application of MI for the cognitive rehearsal of a task in the absence of overt physical movements. Although MP is known to enhance skilled performance, debate still exists about the magnitude and moderators of these imagery effects. Against this background, and amid concerns about the “reproducibility crisis” in psychology, it seems timely to revisit, update and extend a key meta-analysis of MP effects published over two decades ago – namely, that of Driskell, Copper, and Moran (1994). To this end, the present paper reports a methodological replication of the Driskell et al’s (1994) meta-analysis of MP effects.Design & methodIncluded are 37 studies on MP effects published between 1995 and 2018. Nine factors were selected to examine the extent to which they moderate the effectiveness of mental practice, providing a window into the conditions under which mental practice is most effectively implemented. Practice Type (Mental or Physical), Expertise, Duration of practice (both program and session), Task Type, and Control Type were retained as factors of interest from the original Driskell et al. (1994) meta-analysis. In order to further explore the nuance of mental practice implementation, we additionally examined the Imagery Type, the Performance Measure used, Activity Type (team versus individual activities) and the Setting of the intervention.ResultsFollowing publication bias analyses, our results confirm that overall, MP has a small but significant positive effect on performance (r = 0.131). Moderators of this beneficial effect were MP duration, type of task and type of imagery used.ConclusionsWe conclude that MP has an enduring positive influence on performance.     

Harnessing the Power of a Novel Program for Dynamic Balance Perturbation with Supported Body Weight

Abstract

Self-initiated postural adjustments commonly occur in daily life. To accessibly measure this type of dynamic balance, we developed a simple computer program to induce virtual perturbations and combined it with a commercially available balance board and portable EMG system to measure resulting self-initiated postural adjustments. When performing perturbed balance tests, safety harness with body weight support (BWS) is often used. However, influences of these harnesses on postural reactions are not well known. This study investigated the sensitivity of our assessment tool under different BWS conditions and muscle responses during postural adjustments following perturbation at different directions. Fifteen neurologically intact participants performed self-initiated postural adjustments under conditions with: (1) no harness; (2) harness with no BWS; and (3) harness with 10% BWS. Postural adjustment time and muscle activities of the lower leg were measured. We observed significant increases in postural adjustment time in the harness with no BWS condition and differneces in lower leg muscles response to virtual perturbation. Our findings suggest that the combination of our customized program with EMG is a sensitive and convenient tool to measure postural adjustments that approximate real-world scenarios. This method can be used with light body weight support to ensure safety without influencing muscle synergies.     

Are postural adjustments during reaching related to walking development in typically developing infants and infants at risk of cerebral palsy?

BackgroundIn typical development, postural adjustments during reaching change in the second half of infancy, including increasing rates of direction-specific adjustments. These changes are absent or different in infants at risk of cerebral palsy (CP). To discover whether these changes are related to acquisition of independent walking, we studied postural adjustments during reaching in infants before and after they learned to walk.MethodsTen typically developing (TD) infants and 11 infants at very high risk (VHR) of CP were assessed before and after they learned to walk. Reaching movements were elicited during supported sitting, while surface electromyography was recorded of arm, neck, and trunk muscles. Percentages of direction-specific adjustments (first level of control), and recruitment patterns and anticipatory activation (second level of control) were calculated.ResultsIn both groups, postural adjustments during reaching were similar before and after acquisition of independent walking. Direction-specificity increased with age in typically developing infants but not in VHR-infants.ConclusionIncreasing age rather than the transition to independent walking is associated with increasing direction-specificity of TD-infants during reaching while sitting, while infants at very high risk of CP show no increase in direction-specificity, suggesting that they gradually grow into a postural deficit.     

Science-Based Neurorehabilitation: Recommendations for Neurorehabilitation From Basic Science

ABSTRACT

Neuroscience has fundamentally changed the understanding of learning and memory within recent years. Here, the authors discuss a number of specific areas where they believe new understanding of the CNS from basic science is having a fundamental impact on neurorehabilitation and is leading to new therapeutic approaches. These areas have constituted a basis for development of some basic principles for neurorehabilitation: Optimal rehabilitation should involve (a) active (patient) participation in the training, (b) training that does not only involve many repetitions, but also continues to challenge the skill of the training person, (c) motivation and reward, (d) intensive training and practice over a long time, (e) careful organization of the training in relation to other activities, and (f) incorporation of other potentially beneficial parameters such as sleep and diet. It should in this relation also be pointed out that albeit neurorehabilitation may be predicted to have the most optimal effect early in life and as soon after injury as possible, there is no reason to believe that beneficial effects of training may not be obtained late in life or several years after injury.     

Sleep dependent consolidation of gross motor sequence learning with motor imagery

Acquisition of gross motor sequence learning with physical and mental training elicits gains in performance. However, the effects of sleep or daytime consolidation after both types of practice remain unclear, especially the effects upon the goal- and movement-based components of a gross motor sequential task. The main purpose of this study was to test the effect of physical practice (PP) and motor imagery practice (MIP) on the acquisition and consolidation processes of gross motor sequence learning.Seventy-six participants were tested before and after PP or MIP on a whole-body sequential paradigm, following either a night of sleep (PP_sleep and MIP_sleep groups) or an equivalent daytime period (PP_day and MIP_day groups). Control groups without training were tested following similar timespans (CTRL_sleep and CTRL_day groups). The number of sequential movements and the centre of mass displacement – corresponding to goal and movement-based components, respectively – were assessed.Results showed that relative to the CTRL groups, the PP and MIP groups improved performance during acquisition. Importantly, only the MIP_sleep group further improved performance after a night of sleep; participants of other groups stabilised their performance after consolidation. Additionally, the number of sequential movements and the centre of mass displacement evolved conjointly without being influenced by the type of training or the nature of the consolidation.To conclude, these results confirm that sleep contributes to the consolidation of gross motor sequence learning acquired with MIP but not PP. The relationship between the goal- and movement-based components of a gross motor sequential task is discussed.     

Intrinsic motivation and individual deliberate practice are reciprocally related: Evidence from a longitudinal study of adolescent team sport athletes

ObjectiveThere is limited understanding of how sport motivation is associated with deliberate practice in youth team sport athletes. Therefore, the aim of this study was to examine prospective associations between intrinsic motivation and individual deliberate practice in specializing team sport athletes.DesignLongitudinal.MethodEstonian adolescent team sport athletes (N = 163; M_age – 13.6 years at the beginning of study) completed the Sport Motivation Scale and training diary across a 12-month period.ResultsBoth individual deliberate practice and intrinsic motivation increased over the 1-year period. Greater baseline intrinsic motivation predicted subsequent individual deliberate practice and greater initial individual deliberate practice predicted greater subsequent intrinsic motivation. The bidirectional relationship between athletes intrinsic motivation and individual deliberate practice were replicated across both time lags.ConclusionThe findings have significant implications for the importance placed on intrinsic motivation as a means of increasing of individual deliberate practice as well being an important outcome variable in specializing team sport athletes.     

The effect of a virtual reality environment on gaze behaviour and motor skill learning

ObjectiveVirtual reality (VR) systems hold significant potential for training skilled behaviours and are currently receiving intense interest in the sporting domain. They offer both practical and pedagogical benefits, but there are concerns about the effect that perceptual deficiencies in VR systems (e.g. reduced haptic information, and stereoscopic display distortions) may have on learning and performance. ‘Specificity of learning’ theories suggest that VR could be ineffective (or even detrimental) if important differences (e.g. perceptual deficiencies) exist between practice and real task performance conditions. Nevertheless, ‘structural learning’ theories suggest VR could be a useful training tool, despite these deficiencies, because a trainee can still learn the underlying structure of the behaviour. We explored these theoretical predictions using golf putting as an exemplar skill.MethodIn Experiment 1 we used a repeated measures design to assess putting accuracy (radial error) and quiet eye duration of expert golfers (n = 18) on real putts before and after 40 VR ‘warm up’ putts. In Experiment 2, novice golfers (n = 40) were assigned to either VR or real-world putting training. Putting accuracy and quiet eye durations were then assessed on a real-world retention test.ResultsBoth visual guidance (quiet eye) and putting accuracy were disrupted temporarily when moving from VR to real putting (Experiment 1). However, real-world and VR practice produced comparable improvements in putting accuracy in novice golfers (Experiment 2).ConclusionOverall, the results suggest that: (i) underlying skill structures can be learned in VR and transferred to the real-world; (ii) perceptual deficiencies will place limits on the use of VR. These findings demonstrate the challenges and opportunities for VR as a training tool, and emphasise the need to empirically test the costs and benefits of specific systems before deploying VR training.     

The influence of attentional focus on the development of skill representation in a complex action

ObjectivesRecent research has indicated that performers' mental representation of a motor skill changes over the course of learning. In the present study, we sought to ascertain whether the type of instructions (instructions that emphasize either an internal or external focus of attention) influences the development of skill representation during motor learning.DesignParticipants without golf experience were recruited to practice a golf putting task over the course of three training days. Participants were randomly assigned to either an internal focus (focus on the swing of the arms; n = 10) or external focus (focus on the speed of the ball roll; n = 10) learning group. Changes in putting performance and mental representation structure were assessed over the course of learning, as well as during a follow-up retention test two days after practice.MethodsMental representation structure was measured employing the structural dimensional analysis of mental representations (SDA-M), which provided psychometric data on the structure of the mental representation in long-term memory. Additionally, the change in putting accuracy and consistency was recorded over the course of learning.ResultsFindings indicated that the external focus group performed with greater accuracy and consistency during training, and revealed a larger degree of development in their mental representation of the putting task.ConclusionsOverall, our findings suggest that facilitating the link between an action and its effect by means of an external focus is crucial for motor performance as well as the development of skill representation.     

Four Weeks of Neuromuscular Training Improve Static and Dynamic Postural Control in Overweight and Obese Children: A Randomized Controlled Trial

Abstract

Thirty-two children with overweight or obesity were randomly divided into a neuromuscular training group (NTG) (n = 16) and a control group (CG) (n = 16). All individuals participated in the measurement of static postural control under two conditions: the double-leg stance with eyes open (EO) and eyes closed (EC). The center of pressure variables was obtained. mSEBT was used for dynamic postural control. Neuromuscular training was performed twice per week and lasted 4 weeks. The results of this study indicate that 4 weeks of neuromuscular training improve static and dynamic postural control in children with excess body weight.     

Mechanisms of postural control in older adults based on surface electromyography data

ObjectivesThe present study aimed to clarify the mechanisms of postural control during standing in older adults and document the mechanisms of age-related motor control based on changes in muscle activities.MethodsA total of 26 healthy male adults (older adult group, ≥65–78 years: n = 16; younger adult group, 20–23 years: n = 10) participated in this study. Ground reaction force and kinematic data of the lower limbs (hip, knee, and ankle), and electromyographic data from 6 postural muscles on the right side were recorded and quantified for each motor phase during rapid voluntary center of pressure (COP) shift.ResultsAlthough hip strategy was more frequently observed in older adults than in young adults (56.3% vs. 20.0%), no muscle activity of hip agonists was observed in some (31.3%) older adults. Furthermore, older adults had a statistically significant delay in the inhibition of postural muscles during anticipatory postural adjustments (p < 0.05). After the onset of COP motion, the co-contraction time between agonists and antagonists was significantly prolonged in the older adults than in the younger adults (p < 0.05), and the reciprocal muscle pattern was unclear in the older adults. Prior to the termination of movement, agonist activity continued longer in the older adult group than in the younger adult group; that is, inhibition was insufficient in the older adult group.ConclusionA series of postural strategies during the voluntary movement task were altered in older adults, and this was significantly related not only with the activation but also the inhibition of postural muscles.     

Effects of A Dual-Task Intervention in Postural Control and Cognitive Performance in Adolescents

Abstract

The aim was to assess dual- versus single-task training for motor performance and cognitive performance in adolescents. Two experiments were performed. In the first, 30 adolescents were randomized to three groups to determine the effect of dual-task difficulty on postural control: α-scaling and root mean square (RMS). In the second, 20 adolescents were randomized to two groups to determine the effect of dual-task practice to improve working memory. RMS in the post-test was lower than the pre-test in both dual-task groups, while α-scaling was lower in post-test than pre-test only in the high-difficulty dual-task group. A practice effect was observed on the percentage of correct answers only in the dual-task group (p?=?0.035). Thus, dual-task training could enhance motor and cognitive performance more than single-task training.     

A scenario for change: reflective practice for post-ordination professional development

The continuing professional development of ordained ministers is an important concept given the ever-changing nature of ministry and society as a whole. Within such a context, professional development needs to cope with continuous change through reflective practice in order to challenge and renew expertise. The proposed scenario for change seeks to embed reflective practice as the central method for the professional development of ordained ministers, thereby extending reflective practice from training and into the mode of lifelong learning. Components of this approach will include: ? Intentional reflective practice as the central methodology.

? Communities of practice as the central location for reflective practice.

? Facilitation as the central mechanism for reflective practice.

     

Combining Action Observation and Motor Imagery Improves Eye–Hand Coordination during Novel Visuomotor Task Performance

Abstract

In this study, we compared the effectiveness of concurrent action observation and motor imagery (AO?+?MI), observing with the intent to imitate (active observation; AO), and passive observation (PO) training interventions for improving eye–hand coordination. Fifty participants were assigned to five groups [AO?+?MI, AO, PO, physical practice (PP); control] and performed a visuomotor rotation task, whilst eye movements were recorded. Each participant then performed 20 task trials in a training intervention before repeating the visuomotor rotation task in a post-test. As expected, PP produced the greatest improvement in task performance and eye–hand coordination. However, in comparison to the control group, AO?+?MI training produced a statistically significant increase in both task performance and eye–hand coordination, but no such improvements were found following AO or PO.     

Learning to Be a Professional: Two Models of Competence and Related Learning Strategies

SUMMARY

Occupations required by the health industry, specifically in aged and palliative care, include nursing, pastoral care, medicine, and social work amongst many others. Professional education for these health disciplines incorporates competence for practice and critical thinking skills. Two different conceptual models of competence, personal and operational, reveal different approaches to learning. Personal competence, currently dominant in the higher eduction (tertiary) sector, privileges theory over practice. Personal competence can exclude non-propositional forms of knowledge, making it difficult for students to explain their practice experiences. The operational model of competence, which is emerging in professional education, has the potential to develop critical approaches to learning and practice, skills required for practice development and quality improvement in today's health environment.     

The Effects of a PETTLEP Imagery Intervention on Learners' Coincident Anticipation Timing Performance

Little research has examined how imagery effects learners' acquisition of motor tasks requiring coincident anticipation timing (CAT). CAT is a fundamental component of hitting, passing, and receiving required in several sports. The purpose of the current study was to examine the effects of a PETTLEP imagery intervention on learners' CAT performance using a Bassin Anticipation Timer. Fifty-six participants (M = 20.61 years, SD = 2.48) were randomly assigned into one of four training groups: physical practice (PP), imagery practice (IP), imagery practice + physical practice (IP +PP), or a control (CON) group. The study consisted of three phases: pretest, intervention, and a posttest. Results revealed that the PP and IP+PP groups had significantly lower absolute timing error compared to the CON group on the posttest. The IP+PP group was the only group to have lower variable error compared to the CON group on the posttest. Results extend prior research by demonstrating that imagery combined with physical practice can benefit the learning of a CAT task and that imagery alone may not assist learners in acquiring tasks requiring CAT. Results are congruent with prior research demonstrating that imagery is most effective when combined with physical practice.     

Fonctionnements et dysfonctionnements des psychothérapies : synthèse de la littérature et présentation de deux méthodologies associées aux meilleurs résultats

IntroductionPsychological difficulties are part of higher stakes health issues. What are the real effects and the difficulties to generate results of psychotherapies?Literature resultsPsychotherapy is efficient for multiple psychological disorders, as well in controlled as in naturalistic studies, and participate in reduction of health expenditure. However, all patients do not get real benefits from care, patients can deteriorate or drop-out treatment, and persistent side effects can occur; clinicians overestimate their efficiency and their performances decline during their career. Two promising methodologies seems to be associated with better outcomes: Routine Outcome Monitoring (ROM) and a specific form of training clinician expertise named “Deliberate Practice”.DiscussionUsing client feedback allows to implement ROM and “Deliberate Practice” in routine care.ConclusionImplementation of Routine Outcome Monitoring should be encouraged in French Speaking countries to produce evidence-informed practice for the delivering, the improvement and the payment for psychotherapy expenditure.     

Aging and automaticity: Evaluation of instance-based and strength-based mechanisms

Abstract

Experiments evaluated instance-based learning as a possible sole mechanism underlying development of automaticity. Age differences in extended practice lexical decision and factors that could effect age-related performance on lexical decision tasks were also examined. the first experiment was conducted to evaluate the role of stimulus-specific and strategic, task-specific learning underlying performance improvement in a trained lexical decision task. the first experiment consisted of a training and a transfer phase. the training phase assessed age-related differences on a lexical decision task where an attention response could, in principle, be developed (Search condition) and where an attention response could not develop (Nonsearch condition). the transfer phase was conducted to evaluate the role of strategic, task-specific factors on performance improvement observed in the training phase. Age-related differences in word-nonword response time differences were eliminated with practice in the nonsearch, but not the search, version of the task. Transfer tests also implicate strategic differences as a partial source of age differences in lexical decision performance. Experiment 2 was a 10-session (two-week) extended practice study which was conducted to provide a strong test of instance-based learning as a sole mechanism for automaticity. Contrary to predictions of instance theory, the Search and Nonsearch conditions converged for the young adults. Consistent with a strength-based theory of automaticity applied to cognitive aging, the conditions did not converge for older adults. the results provide further support for age differences in automaticity-as-attention training. Based on these and other results, the importance of considering varieties of automaticity in theories of cognitive aging is discussed.     

Do students really prefer repeated rereading over testing when studying textbooks? A reexamination

ABSTRACT

Experimental studies have shown that testing promotes better long-term retention than repeated rereading. Regarding implications for educational practice, based on a survey study seemingly showing that students prefer repeated rereading over testing when studying [Karpicke, J. D., Butler, A. C., & Roediger, H. L. (2009). Metacognitive strategies in student learning: Do students practise retrieval when they study on their own? Memory, 17, 471–479. doi:10.1080/09658210802647009], it has been concluded that increasing the number of tests may boost students’ achievement. However, a closer look at the survey study reveals that “repeated rereading” has been operationalised in terms of “restudying” which represents a term that may subsume a variety of study strategies. We reexamined the study behaviour of students in a more fine-grained way by surveying both their hypothetical (Study 1) and real (Study 2) study behaviour when restudying texts. Results showed that rereading is preferred only by few students early in the learning process, with almost all shifting to testing late in the learning process, and that rereading is mainly performed in terms of “rereading not understood parts”, and rarely in terms of “repeated rereading”. These results indicate that the implications of the testing effect for educational practice may have to be reconsidered.     

Motor interference does not impair the memory consolidation of imagined movements

The present study aimed to investigate whether an interference task might impact the sleep-dependent consolidation process of a mentally learned sequence of movements. Thirty-two participants were subjected to a first training session through motor imagery (MI) or physical practice (PP) of a finger sequence learning task. After 2 h, half of the participants were requested to perform a second interfering PP task (reversed finger sequence). All participants were finally re-tested following a night of sleep on the first finger sequence. The main findings revealed delayed performance gains following a night of sleep in the MI group, i.e. the interfering task did not alter the consolidation process, by contrast to the PP group. These results confirm that MI practice might result in less retroactive interference than PP, and further highlight the relevance of the first night of sleep for the consolidation process following MI practice. These data might thus contribute to determine in greater details the practical implications of mental training in motor learning and rehabilitation.