Comparison of cardiac autonomic modulation of athletes and non-athletes individuals with spinal cord injury at rest and during a non-immersive virtual reality task.

STUDY DESIGN: Cross-sectional study. OBJECTIVES: To compare cardiac autonomic modulation of individuals with spinal cord injury (SCI) that practice different amounts of moderate to vigorous physical activity (PA) and able-bodied controls at rest and during a non-immersive Virtual Reality task. SETTING: Athletes with SCI of wheelchair basketball, wheelchair tennis, wheelchair handball, WCMX (wheelchair motocross), and para-swimming were assessed at the Faca na Cadeira Institute, ICEL and Clube Espéria in São Paulo, Brazil; non-athletes with SCI and able-bodied controls were assessed at the Acreditando Centro de Recuperação Neuromotora, São Paulo, Brazil. METHODS: One-hundred forty-five individuals were assessed: 36 athletes with traumatic SCI (41.1 ± 16.8 years old), 52 non-athletes with traumatic SCI (40.2 ± 14.1 years old), and 57 able-bodied individuals (39.4 ± 12.5 years old). Cardiac autonomic modulation was assessed through heart rate variability (HRV) measured in the sitting position at rest and during a VR game activity. RESULTS: We found significantly more favourable HRV for athletes with SCI when compared to non-athletes with SCI, but no differences between athletes with SCI and able-bodied controls. In addition, athletes and able-bodied controls showed adequate autonomic nervous system (ANS) adaptation (rest versus physical activity in VR), i.e., they experienced parasympathetic withdrawal during VR physical activity, which was not found in non-athletes with SCI. CONCLUSION: The practice of moderate to vigorous physical activity is associated with healthier cardiac autonomic modulation in adults with SCI, which may lead to more favourable health outcomes. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04618003, retrospectively registered.

Motor learning and transfer between real and virtual environments in young people with autism spectrum disorder: A prospective randomized cross over controlled trial.

Autism spectrum disorder (ASD) is associated with persistent deficits in social communication and social interaction, including impaired multisensory integration, which might negatively impact cognitive and motor skill performance, and hence negatively affect learning of tasks. Considering that tasks in virtual environment may provide an engaging tool as adjuncts to conventional therapies, we set out to compare motor performance between young people with ASD and a typically developing (TD) control group that underwent coincident timing tasks based on Kinect (no physical contact) and on Keyboard (with physical contact) environments. Using a randomized repeated cross-over controlled trial design, 50 young people with ASD and 50 with TD, matched by age and sex were divided into subgroups of 25 people that performed the two first phases of the study (acquisition and retention) on the same device-real or virtual-and then switched to the other device to repeat acquisition and retention phases and finally switched on to a touch screen (transfer phase). Results showed that practice in the virtual task was more difficult (producing more errors), but led to a better performance in the subsequent practice in the real task, with more pronounced improvement in the ASD as compared to the TD group. It can be concluded that the ASD group managed to transfer the practice from a virtual to a real environment, indicating that virtual methods may enhance learning of motor and cognitive skills. A need for further exploration of its effect across a number of tasks and activities is warranted. Autism Res 2020, 13: 307-319. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Individuals with autism spectrum disorder are known to have difficulties with learning motor tasks. Considering that performing motor tasks in virtual environment may be an engaging tool as adjuncts to conventional therapies, we aimed to estimate performance in tasks regardless of physical touch. Results showed that participants had more difficulty using the non-touch task; however, virtual training improved performance on the physical (real) task. This result indicates that virtual methods could be a promising therapeutic approach for the ASD population.

Motor learning characterization in people with autism spectrum disorder: A systematic review.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder primarily characterized by deficits in social interaction, communication and implicit skill learning. OBJECTIVE: To analyse the results of research on "motor learning" and the means used for measuring "autistic disorder". METHODS: A systematic literature search was done using Medline/PubMed, Web of Science, BVS (virtual health library), and PsycINFO. We included articles that contained the keywords "autism" and "motor learning". The variables considered were the methodological aspects; results presented, and the methodological quality of the studies. RESULTS: A total of 42 studies were identified; 33 articles were excluded because they did not meet the inclusion criteria. Data were extracted from nine eligible studies and summarized. CONCLUSION: We concluded that although individuals with ASD showed performance difficulties in different memory and motor learning tasks, acquisition of skills still takes place in this population; however, this skill acquisition is related to heterogeneous events, occurring without the awareness of the individual.

O Transtorno do Espectro Autista (TEA) é uma desordem do desenvolvimento neurológico caracterizada principalmente por déficits na interação social, comunicação e aprendizagem de habilidades implícitas. OBJETIVO: Analisar os resultados da pesquisa sobre "aprendizagem motora" e suas formas de mensurar na "desordem autista". MÉTODOS: Uma pesquisa bibliográfica sistemática foi feita usando Medline/PubMed, Web of Science, BVS (biblioteca virtual de saúde) e PsycINFO. Incluímos artigos que mostraram as palavras-chave "autismo" e "aprendizagem motora". As variáveis consideradas foram os aspectos metodológicos; os resultados apresentados e a qualidade metodológica dos estudos. RESULTADOS: Um total de 42 artigos foram identificados; foram excluídos 33 artigos porque não atendiam aos critérios de inclusão. Os dados foram extraídos de nove estudos elegíveis e resumidos. CONCLUSÃO: Concluímos que, embora as pessoas com TEA tenham demonstrado dificuldades de desempenho em diferentes tarefas de aprendizagem motora de memória, a aquisição de habilidades ocorre nessa população; No entanto, essa aquisição de habilidades está relacionada a eventos heterogêneos, ocorrendo sem a consciência dos indivíduos.

Improvements in motor tasks through the use of smartphone technology for individuals with Duchenne muscular dystrophy.

BACKGROUND: In individuals severely affected with Duchenne muscular dystrophy (DMD), virtual reality has recently been used as a tool to enhance community interaction. Smartphones offer the exciting potential to improve communication, access, and participation, and present the unique opportunity to directly deliver functionality to people with disabilities. OBJECTIVE: To verify whether individuals with DMD improve their motor performance when undertaking a visual motor task using a smartphone game. PATIENTS AND METHODS: Fifty individuals with DMD and 50 healthy, typically developing (TD) controls, aged 10-34 years participated in the study. The functional characterization of the sample was determined through Vignos, Egen Klassifikation, and the Motor Function Measure scales. To complete the task, individuals moved a virtual ball around a virtual maze and the time in seconds was measured after every attempt in order to analyze improvement of performance after the practice trials. Motor performance (time to finish each maze) was measured in phases of acquisition, short-term retention, and transfer. RESULTS: Use of the smartphone maze game promoted improvement in performance during acquisition in both groups, which remained in the retention phase. At the transfer phases, with alternative maze tasks, the performance in DMD group was similar to the performance of TD group, with the exception of the transfer to the contralateral hand (nondominant). However, the group with DMD demonstrated longer movement time at all stages of learning, compared with the TD group. CONCLUSION: The practice of a visual motor task delivered via smartphone game promoted an improvement in performance with similar patterns of learning in both groups. Performance can be influenced by task difficulty, and for people with DMD, motor deficits are responsible for the lower speed of execution. This study indicates that individuals with DMD showed improved performance in a short-term motor learning protocol using a smartphone. We advocate that this technology could be used to promote function in this population.