The influence of proximal motor strategies on pianists' upper-limb movement variability

Repetitive movements are considered a risk factor for developing practice-related musculoskeletal disorders. Intra-participant kinematic variability might help musicians reduce the risk of injury during repetitive tasks. No research has studied the effects of proximal motion (i.e., trunk and shoulder movement) on upper-limb movement variability in pianists. The first objective was to determine the effect of proximal movement strategies and performance tempo on both intra-participant joint angle variability of upper-limb joints and endpoint variability. The second objective was to compare joint angle variability between pianist's upper-limb joints. As secondary objectives, we assessed the relationship between intra-participant joint angle variability and task range of motion (ROM) and documented inter-participant joint angle variability. The upper body kinematics of 9 expert pianists were recorded using an optoelectronic system. Participants continuously performed two right-hand chords (lateral leap motions) while changing movements based on trunk motion (with and without) and shoulder motion (counter-clockwise, back-and-forth, and clockwise) at two tempi (slow and fast). Trunk and shoulder movement strategies collectively influenced variability at the shoulder, elbow and, to a lesser extent, the wrist. Slow tempi led to greater variability at wrist and elbow flexion/extension compared to fast tempi. Endpoint variability was influenced only along the anteroposterior axis. When the trunk was static, the shoulder had the lowest joint angle variability. When trunk motion was used, elbow and shoulder variability increased, and became comparable to wrist variability. ROM was correlated with intra-participant joint angle variability, suggesting that increased task ROM might result in increased movement variability during practice. Inter-participant variability was approximately six times greater than intra-participant variability. Pianists should consider incorporating trunk motion and a variety of shoulder movements as performance strategies while performing leap motions at the piano, as they might reduce exposure to risks of injury.     

Dimensions of movement specific reinvestment in practice of a golf putting task

ObjectivesThis study aimed to investigate the role of the two dimensions of movement specific reinvestment (conscious motor processing and movement self-consciousness) in performance of a complex task early and later in practice. Furthermore, the study also examined the underlying kinematic mechanisms by which conscious motor processing and movement self-consciousness influence performance in practice.MethodsTrait measures of conscious motor processing and movement self-consciousness were obtained from participants using the Movement Specific Reinvestment Scale. Participants (n = 30) with no prior golf putting experience practiced 300 golf putts over the course of two days. Putting proficiency (number of putts holed) and variability of movement kinematics (SD impact velocity and SD putter face angle at impact) were assessed early and later in practice.ResultsMovement self-consciousness positively influenced putting proficiency early and later in practice by reducing variability of impact velocity and putter face angle at impact. Conscious motor processing positively influenced putting proficiency early in practice by reducing variability of impact velocity and putter face angle at impact. Later in practice, conscious motor processing was not associated with putting proficiency.ConclusionThe findings suggest that higher propensity for movement self-consciousness potentially influences performance early and later in practice by reducing variability of impact velocity and putter face angle at impact. A higher propensity for conscious motor processing benefits performance in a similar manner as movement self-consciousness early in practice but it does not seem to influence performance later in practice. The findings of the current study suggest that movement self-consciousness and conscious motor processing differentially influence performance at different stages in practice of a complex motor skill, suggesting that they might depict different types of conscious processing.     

Interplay of biomechanical constraints and kinematic strategies in selecting arm postures

In this study, the authors examined the interplay between biomechanics and control strategies in the resolution of excess degrees of freedom at the joint level. Seven participants made aimed arm movements from 30 starting points and several starting postures to targets. Final arm postures for movements to a target exhibited substantial joint angle variation. Through regression modeling and by comparing observed final arm postures with biomechanically plausible postures, the authors identified 3 kinematic strategies: (a) Maintain deviations from the average angle at the starting point to the joint's final posture; (b) make torso rotations that are a fixed proportion of shoulder rotations; and (c) adopt a characteristic combination of 4 wrist-positioning approaches. The results demonstrated that kinematic strategies can account for substantial variance in final arm postures, if one takes into account 2 types of individual differences-those that arise inevitably from biomechanical constraints and those that reflect choices in movement strategy.     

Interplay of Biomechanical Constraints and Kinematic Strategies in Selecting Arm Postures

In this study, the authors examined the interplay between biomechanics and control strategies in the resolution of excess degrees of freedom at the joint level. Seven participants made aimed arm movements from 30 starting points and several starting postures to targets. Final arm postures for movements to a target exhibited substantial joint angle variation. Through regression modeling and by comparing observed final arm postures with biomechanically plausible postures, the authors identified 3 kinematic strategies: (a) Maintain deviations from the average angle at the starting point to the joint's final posture; (b) make torso rotations that are a fixed proportion of shoulder rotations; and (c) adopt a characteristic combination of 4 wrist-positioning approaches. The results demonstrated that kinematic strategies can account for substantial variance in final arm postures, if one takes into account 2 types of individual differences—those that arise inevitably from biomechanical constraints and those that reflect choices in movement strategy.     

Test-retest repeatability reveals a temporal kinematic signature for an upper limb precision grasping task in adults

Hand-eye coordination skills, such as reaching and grasping, are fundamentally important for the performance of most daily activities. Upper limb kinematics recorded by motion tracking systems provide detailed insight into the central nervous system control of movement planning and execution. For example, kinematic metrics can reveal deficits in control, and compensatory neuromotor strategies in individuals with neuropathologies. However, the clinical utility of kinematic metrics is currently limited because their psychometric properties, such as test-retest repeatability, have not been well characterized. Therefore, the purpose of this study was to examine the degree of repeatability of spatiotemporal kinematic metrics and determine which, if any, measures form a kinematic signature for a precision grasping task. Healthy adults (n = 40) were tested on two occasions separated by 5–10 days on a bead threading task consisting of reaching and precision grasping. Results showed good test-retest repeatability for reach peak velocity, reach and grasp durations, whereas poor to moderate reliability was observed for measures of spatial precision and maximum grip aperture. In addition, analysis showed that reliable estimates of kinematic metrics can be obtained using 10 trials. Overall, our results indicate that reach peak velocity and temporal metrics form a stable characteristic, or a kinematic signature, of individual performance on a standardized bead threading task. These findings suggest potential utility in applying kinematic metrics for clinical assessment of upper limb reaching tasks.     

Response timing variability: coherence of kinematic and EMG parameters

A detailed kinematic and electromyographic (EMG) analysis of single degree of freedom timing responses is reported to (a) determine the coherence of kinematic and EMG variability to the reduced timing error variability exhibited with amplitude increments within a given criterion movement time and (b) understand the temporal organization of various movement parameters in simple responses. The data reveal that the variability of kinematic (time to peak acceleration, duration of acceleration phase, time to peak deceleration) and EMG (duration of agonist burst, duration of antagonist burst, time to antagonist burst) timing parameters decreased with increments of average velocity in a manner consistent with the variable timing error. In addition, the coefficient of variation for peak acceleration, peak deceleration, and integrated EMG of the agonist burst followed the same trend. Increasing average movement velocity also led to decreases in premotor and motor reaction times. Overall, the findings suggest a strong coherence between the variability of response outcome, kinematic, and EMG parameters.     

Response Timing Variability

A detailed kinematic and electromyographic (EMG) analysis of single degree of freedom timing responses is reported to (a) determine the coherence of kinematic and EMG variability to the reduced timing error variability exhibited with amplitude increments within a given criterion movement time and (b) understand the temporal organization of various movement parameters in simple responses. The data reveal that the variability of kinematic (time to peak acceleration, duration of acceleration phase, time to peak deceleration) and EMG (duration of agonist burst, duration of antagonist burst, time to antagonist burst) timing parameters decreased with increments of average velocity in a manner consistent with the variable timing error. In addition, the coefficient of variation for peak acceleration, peak deceleration, and integrated EMG of the agonist burst followed the same trend. Increasing average movement velocity also led to decreases in premotor and motor reaction times. Overall, the findings suggest a strong coherence between the variability of response outcome, kinematic, and EMG parameters.     

Effects of concurrent physical and cognitive demands on arm movement kinematics in a repetitive upper-extremity precision task

The effect of concurrent physical and cognitive demands on arm motor control is poorly understood. This exploratory study compared movement kinematics in a repetitive high-precision pipetting task with and without additional concurrent cognitive demands in the form of instructions necessary to locate the correct target tube. Thirty-five healthy female subjects performed a standardized pipetting task, transferring liquid repeatedly from one pick-up tube to different target tubes. In the reference condition, lights indicated the target tube in each movement cycle, while the target tube had to be deciphered from a row and column number on a computer screen in the condition with additional cognitive demands. Kinematics of the dominant arm was assessed using the central tendency and variability of the pipette-tip end-point trajectory and joint kinematics properties of the shoulder and elbow. Movements slowed down (lower velocities and higher area under the movement curves) and trajectory variability increased in the condition with additional cognitive demands, but there were no changes in the kinematics properties such as joint range of motion, times of acceleration and deceleration (as indicated by the time to peak velocity), average angles, or phase relationships between angle and angular velocity of shoulder or elbow movements between the two conditions. Further, there were also no differences in the size or structure of variability of the shoulder and elbow joint angles, suggesting that subjects could maintain the motor repertoire unaltered in the presence of these specific additional cognitive demands. Further studies should address motor control at other levels of concurrent cognitive demands, and with motor tasks that are less automated than the pipetting task used in the present study, so as to gain an increased understanding of the effect of concurrent cognitive demands for other activities of relevance to daily life.     

Investigating how children produce rotation and pointing movements when they learn to write letters

How do children learn to write letters? During writing acquisition, some letters may be more difficult to produce than others because certain movement sequences require more precise motor control (e.g., the rotation that produces curved lines like in letter O or the pointing movement to trace the horizontal bar of a T). Children of ages 6–10 (N = 108) wrote sequences of upper-case letters on a digitizer. They varied in the number of pointing and rotation movements. The data revealed that these movements required compensatory strategies in specific kinematic variables. For pointing movements there was a duration decrease that was compensated by an increase in in-air movement time. Rotation movements were produced with low maximal velocity but high minimal velocity. At all ages there was a global tendency to keep stability in the tempo of writing: pointing movements exhibited a duration trade-off whereas rotation movements required a trade-off on maximal and minimal velocity. The acquisition of letter writing took place between ages 6 and 7. At age 8 the children shifted focus to improving movement control. Writing automation was achieved around age 10 when the children controlled movement duration and fluency. This led to a significant increase in writing speed.     

Quantifying the three-dimensional joint position sense of the shoulder

Joint position sense is important for performing activities of daily living and recreational activities. The objective of this study was to develop new insights into the proprioceptive capabilities of the shoulder using a novel virtual reality paradigm where participants actively recreated shoulder positions in all three dimensions. This allows for better identification of changes in joint position sense across different shoulder postures. Ten males and ten female healthy adults matched a cursor controlled by shoulder rotations calculated from motion capture tracking, to a target shoulder position presented in a virtual environment with the use of a virtual reality headset. Four elevation angles, three plane of elevation angles, and three rotation angles were investigated, totaling thirty-six angles that encompassed the range of motion of the shoulder. Joint position sense was enhanced as the elevation angle was increased, and further enhanced when the arm was more externally rotated and elevated. As elevation angle increased to 90°, joint position sense significantly increased. There was also a significant interaction of external rotation on elevation angle. As elevation angle increased, participants were more accurate when the arm was externally, but exhibited greater variability. These improvements in joint position sense are likely produced by increased tension in muscles and capsuloligamentous mechanoreceptors within the shoulder. As many sports and activities of daily living require joint position sense to complete a task, the ability to elevate and externally rotate is important for adequate shoulder proprioception and control.     

Inter- and intra-individual variability in the kinematics of the back squat

The purpose of this study was to explore the level of inter- and intra-individual variability in the kinematic profiles of the back squat movement among skilled weightlifters. Ten competitive weightlifters volunteered for participation in this study. Barbell velocity (V_Barbell) and angular velocity of the ankle (ω_Ankle), knee (ω_Knee) and hip joint (ω_Hip) were obtained by kinematic recording of six trials at 90% of 1RM in the back squat. Inter-individual variability was assessed by analysing inter-individual differences in the velocity curves through the statistical parametric mapping method. Intra-individual variability was assessed through a correlation analysis between the barbell velocity curves of each trial for each participant. Partial least squares regression analysis, was performed to relate changes in intra-individual variability to movement and anthropometric characteristics. Significant inter- and intra-individual differences were identified in V_Barbell, ω_Ankle, ω_Knee, and ω_Hip (p ≤ 0.05). Having a short trunk and thigh, and a long shin in combination with greater anterior-posterior displacement of the barbell and slower velocities during the acceleration phase increased intra-individual movement consistency over movement variability. The results of the present study clearly demonstrate that skilled weightlifters display both significant inter- and intra-individual variability in the successful execution of the back squat.     

The Relationship of Impulse to Response Timing Error

This paper examines the relationship between response impulse and timing error in 200 msec discrete timing responses over a range of movement velocities and system masses. The results from two experiments showed that variable timing error decreased as both movement velocity and the mass of the system to be moved increased. The variability of force proportional to force (measured either as impulse or peak force) decreased curvilinearly as force output increased. The correlations between each of these parameters and variable timing errors, calculated on a group mean basis, ranged between .91 and .95. The ability to predict the movement time outcome of each individual trial from impulse-related parameters was considerably reduced, although the relationship between the various kinematic and kinetic parameters did strengthen as the movement velocity approached maximum. Collectively, the findings show that size of impulse is related to movement timing error, although it is premature to argue that impulse variability is a causal agent of timing error.     

Temporal modulations of agonist and antagonist muscle activities accompanying improved performance of ballistic movements

Although many studies have examined performance improvements of ballistic movement through practice, it is still unclear how performance advances while maintaining maximum velocity, and how the accompanying triphasic electromyographic (EMG) activity is modified. The present study focused on the changes in triphasic EMG activity, i.e., the first agonist burst (AG1), the second agonist burst (AG2), and the antagonist burst (ANT), that accompanied decreases in movement time and error. Twelve healthy volunteers performed 100 ballistic wrist flexion movements in ten 10-trial sessions under the instruction to "maintain maximum velocity throughout the experiment and to stop the limb at the target as fast and accurately as possible". Kinematic parameters (position and velocity) and triphasic EMG activities from the agonist (flexor carpi radialis) and antagonist (extensor carpi radialis) muscles were recorded. Comparison of the results obtained from the first and the last 10 trials, revealed that movement time, movement error, and variability of amplitudes reduced with practice, and that maximum velocity and time to maximum velocity remained constant. EMG activities showed that AG1 and AG2 durations were reduced, whereas ANT duration did not change. Additionally, ANT and AG2 latencies were reduced. Integrated EMG of AG1 was significantly reduced as well. Analysis of the alpha angle (an index of the rate of recruitment of the motoneurons) showed that there was no change in either AG1 or AG2. Correlation analysis of alpha angles between these two bursts further revealed that the close relationship of AG1 and AG2 was kept constant through practice. These findings led to the conclusion that performance improvement in ballistic movement is mainly due to the temporal modulations of agonist and antagonist muscle activities when maximum velocity is kept constant. Presumably, a specific strategy is consistently applied during practice.     

Timing and the Control of Rhythmic Upper-Limb Movements

Accurate timing of limb displacement is crucial for effective motor control. The authors examined the effects of movement velocity, duration, direction, added mass, and auditory cueing on timing, spatial, and trajectory variability of single- and multijoint rhythmic movements. During single-joint movements, increased velocity decreased timing and spatial variability, whereas increased movement duration increased timing variability but decreased spatial variability. For multijoint movements, regardless of condition, increasing velocity decreased joint timing, spatial, and trajectory variability, but all hand variabilities were unaffected by velocity, duration, load, or direction. Timing, spatial, and trajectory variability was greater at the shoulder compared with the elbow and minimal at the hand, supporting the notion that reaching movements are planned in hand space as opposed to joint space.     

Learning a pointing task with a kinematically redundant limb: Emerging synergies and patterns of final position variability

The study tested a hypothesis that practice of arm pointing movement can lead to a reorganization of the joint coordination reflected in the emergence of several synergies based on the same set of joints. In particular, involvement of the wrist may represent a choice by the central nervous system and not be driven by the typical “freezing-to-freeing” sequence. The effects of practice on the kinematic patterns and variability of a “fast and accurate” pointing movement using a pointer were studied. An obstacle was placed between the initial position and the target to encourage a curvilinear trajectory and larger wrist involvement. Practice led to a decrease in variability indices accompanied by an increase in movement speed of the endpoint and of the elbow and the shoulder, but not of the wrist joint. Five out of six subjects decreased the peak-to-peak amplitude of wrist motion. Before practice, the variability along the line connecting the endpoint to the shoulder (extent) was similar to that in the direction orthogonal to this line. After practice, variability was reduced along the extent, but not along the orthogonal direction perpendicular to this line. Prior to practice, indices of variability of the endpoint were lower than those of the marker placed over the wrist; after practice, the endpoint showed higher variability indices than the wrist. We interpret the data as consequences of the emergence of two synergies: (a) Pointing with a non-redundant set of the elbow and shoulder joints; and (b) keeping wrist position constant. The former synergy is based on a structural unit involving the elbow and the shoulder, while the latter is based on a structural unit that includes all the major arm joints.     

Kinematic descriptions of upper limb function using simulated tasks in activities of daily living after stroke

Assessment of upper limb function poststroke is critical for clinical management and determining the efficacy of interventions. We designed a unilateral upper limb task to simulate activities of daily living to examine how chronic stroke survivors manage reaching, grasping and handling skills simultaneously to perform the functional task using kinematic analysis. The aim of the study was to compare the motor strategies for performing a functional task between paretic and nonparetic arms. Sixteen chronic stroke survivors were instructed to control an ergonomic spoon to transfer liquid from a large bowl to a small bowl using paretic or nonparetic arm. Kinematic data were recorded using a Vicon motion capture system. Outcome measures included movement duration, relative timing, path length, joint excursions, and trial-to-trial variability. Results showed that movement duration, spoon path length, and trunk path length increased significantly when participants used paretic arm to perform the task. Participants tended to reduce shoulder and elbow excursions, and increase trunk excursions to perform the task with paretic arm and altered the relative timing of the task. Although participants used different motor strategies to perform the task with their paretic arms, we did not find the significant differences in trial-to trial variability of joint excursions between paretic and nonparetic arms. The results revealed differences in temporal and spatial aspects of motor strategies between paretic and nonparetic arms. Clinicians should explore the underlying causes of pathological movement patterns and facilitate preferred movement patterns of paretic arm.     

Speed and Rhythm Affect Temporal Structure of Variability in Reaching Poststroke: A Pilot Study

Temporal structure reveals the potential adaptive strategies employed during upper extremity movements. The authors compared the temporal structure of upper extremity joints under 3 different reaching conditions: preferred speed, fast speed, and reaching with rhythmic auditory cues in 10 individuals poststroke. They also investigated the temporal structure of these 3 reaching conditions in 8 healthy controls to aid in the interpretation of the observed patterns in the poststroke cohort. Approximate entropy (ApEn) was used to measure the temporal structure of the upper extremity joints. ApEn was similar between conditions in controls. After stroke, ApEn was significantly higher for shoulder, elbow, and wrist both at fast speed and with rhythmic cues compared with preferred speed. ApEn at index finger was significantly higher only with rhythmic cues compared with preferred speed. The authors propose that practice reaching at faster speed and with rhythmic cues as a component of rehabilitation interventions may enhance adaptability after stroke.     

Two-year follow-up of an interdisciplinary cognitive-behavioral intervention program for obese adults

Intervention programs for treating adiposity which focus on dietary change and physical exercise often do not lead to the desired long-term reduction in weight. This article reports on the effectiveness of M.O.B.I.L.I.S., a standardized theory-driven intervention program. Participants are taught cognitive-behavioral strategies of goal setting, action planning, barrier management, and self-monitoring. Persons with obesity (N=316) responded to a public advertisement to participate in the intervention program (IG) or comparison group (CG; quasi-experimental design). Assessments were conducted at four time points, with the last assessment being conducted two years after baseline. At the 24-month follow-up, the IG showed weight loss of 5.57%, whereas the CG lost 1.12% of their weight (t1-t4, p < .01). The results yielded significant interaction terms (group x time), indicating that the intervention had a substantial effect on food choice and level of physical exercise (p < .01). The IG showed significantly enhanced self-efficacy, stronger goal intentions, and more detailed implementation intentions than the CG at follow-ups. The intervention program has the potential to evoke enduring changes in the cognitions we hypothesized to be responsible for inducing obese adults to begin and continue regular exercise and healthy eating behavior, resulting in substantial weight loss.     

Joint control strategies and hand trajectories in multijoint pointing movements

The role of timing in the control of multijoint pointing movements was evaluated. Eight subjects performed rapid pointing movements to a variety of target locations. The subject's right arm was strapped to a 2 degrees of freedom manupilandum that permitted shoulder and elbow motion in the horizontal plane. Initial and final position of the hand and magnitude of displacement was varied to determine effects on timing characteristics. Kinematics and kinetics of the shoulder, elbow, and hand were analyzed. The hand paths and velocity profiles observed were consistent with prior reports. Multiple regression analysis of kinematic variables disclosed that timing of joint movement onset was independent of initial and final positions of the hand, but was linearly related to joint displacement: the joint that moved farther started moving first. Using computer simulations to create joint movement onset, times that were different from the observed ones always resulted in hand paths with increased curvatures and loss of the smooth velocity profiles. Secondly, a very stable, linear relationship was observed between peak velocity and displacement at both the elbow and shoulder joints. This relationship was not affected by variations in movement space. We suggest that space-time transformation based on difference in joint displacement is used to regulated timing of joint movement onset. The simulations indicate that this transformation is set to produce smooth velocity profiles. The relationships between timing of movement onset and displacement and between peak velocity and displacement complement each other: by maintaining a linear relationship between velocity and displacement, a linear space time transformation can be used to control timing. Furthermore, these relationships are probably used to simplify coordination between the moving joints.     

Reorganised anticipatory postural adjustments due to experimental lower extremity muscle pain

Automated movements adjusting postural control may be hampered during musculoskeletal pain leaving a risk of incomplete control of balance. This study investigated the effect of experimental muscle pain on anticipatory postural adjustments by reaction task movements. While standing, nine healthy males performed two reaction time tasks (shoulder flexion of dominant side and bilateral heel lift) before, during and after experimental muscle pain. On two different days experimental pain was induced in the m. vastus medialis (VM) or the m. tibialis anterior (TA) of the dominant side by injections of hypertonic saline (1 ml, 5.8%). Isotonic saline (1 ml, 0.9%) was used as control injection. Electromyography (EMG) was recorded from 13 muscles. EMG onset, EMG amplitude, and kinematic parameters (shoulder and ankle joint) were extracted. During shoulder flexion and VM pain the onset of the ipsilateral biceps femoris was significantly faster than baseline and post injection sessions. During heels lift in the VM and TA pain conditions the onset of the contralateral TA was significantly faster than baseline and post injection sessions in bilateral side. VM pain significantly reduced m. quadriceps femoris activity and TA pain significantly reduced ipsilateral VM activity and TA activity during bilateral heel lift. The EMG reaction time was delayed in bilateral soleus muscles during heels lift with VM and TA pain. The faster onset of postural muscle activity during anticipatory postural adjustments may suggest a compensatory function to maintain postural control whereas the reduced postural muscle activity during APAs may indicate a pain adaptation strategy to avoid secondary damage.