Locomotor-cognitive dual-tasking in children with developmental coordination disorder.

Introduction: Children with Developmental Coordination Disorder (DCD) demonstrate deficits in predictive motor control and aspects of cognitive control compared with their typically developing (TD) peers. Adjustment to dynamic environments depends on both aspects of control and the deficits for children with DCD may constrain their ability to perform daily actions that involve dual-tasking. Under the assumption that motor-cognitive integration is compromised in children with DCD, we examined proportional dual-task costs using a novel locomotor-cognitive dual-task paradigm that enlisted augmented reality. We expect proportional dual-task performance costs to be greater for children with DCD compared to their TD peers. Methods: Participants were 34 children aged 6-12 years (16 TD, 18 DCD) who walked along a straight 12 m path under single- and dual-task conditions, the cognitive task being visual discrimination under simple or complex stimulus conditions presented via augmented reality. Dual-task performance was measured in two ways: first, proportional dual-task costs (pDTC) were computed for cognitive and gait outcomes and, second, within-trial costs (p-WTC) were measured as the difference on gait outcomes between pre- and post-stimulus presentation. Results: On measures of pDTC, TD children increased their double-limb support time when walking in response to a dual-task, while the children with DCD increased their locomotor velocity. On p-WTC, both groups increased their gait variability (step length and step width) when walking in response to a dual-task, of which the TD group had a larger proportional change than the DCD group. Greater pDTCs on motor rather than cognitive outcomes were consistent across groups and method of dual-task performance measurement. Discussion: Contrary to predictions, our results failed to support dramatic differences in locomotor-cognitive dual-task performance between children with DCD and TD, with both groups tending to priorities the cognitive over the motor task. Inclusion of a within-trial calculation of dual-task interference revealed an expectancy effect for both groups in relation to an impending visual stimulus. It is recommended that dual-task paradigms in the future continue to use augmented reality to present the cognitive task and consider motor tasks of sufficient complexity to probe the limits of performance in children with DCD.

The validity of raw custom-processed global navigation satellite systems data during straight-line sprinting across multiple days.

OBJECTIVES: (1) Determine the validity of instantaneous speed and acceleration and (2) the variation in validity over time (multiple sessions) for global navigation satellite systems (GNSS) devices. DESIGN: Repeated measures. METHODS: 10-Hz GNSS devices from Statsports (n = 2, Apex Pro) and Catapult (n = 2, Vector S7) were examined, whilst a speed laser manufactured by MuscleLab (n = 1, LaserSpeed) was the criterion measure, sampling at 2.56 kHz, with data exported at 1000 Hz. Ten participants completed 40 m sprinting and changes of pace on three separate days. Root mean square error (RMSE) was used to assess the magnitude and direction of the difference between GNSS and criterion measures (instantaneous speed, instantaneous acceleration). Linear mixed models were built to assess the difference in validity across days. RESULTS: RMSE ranged from 0.14 to 0.21 m·s-1 and 0.22 to 0.47 m·s-2 for speed and acceleration, respectively showing strong agreement. There were small variations in the agreement to criterion between days for both devices for speed (Catapult RMSE = 0.12 to 21 m·s-1; Statsports RMSE = 0.14 to 0.17 m·s-1) and for acceleration (Catapult RMSE = 0.26 to 0.47 m·s-2; Statsports RMSE = 0.22 to 0.43 m·s-2) across all movements. There was a negative linear relationship between speed and acceleration error as speed increased. CONCLUSIONS: Wearable microtechnology devices from Catapult (Vector S7) and Statsports (Apex Pro) have suitable validity when measuring instantaneous speed and acceleration across multiple days. There may be small variations during different sessions and over the speed spectrum.

The efficacy of dance interventions for the activity and participation of individuals with cerebral palsy - a systematic review and meta-analysis.

PURPOSE: The aim of this review was to examine the efficacy of dance interventions for individuals with cerebral palsy (CP), measured at any level of the International Classification of Functioning, Disability and Health (ICF). METHODS: A systematic review and meta-analysis was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive search of peer-reviewed articles was performed using six electronic databases. RESULTS: Fourteen studies were included in this review, nine of which were also included in the meta-analysis. The meta-analyses yielded a large overall effect for cognitive, motor, and social-emotional function outcomes, with a high degree of heterogeneity between outcome effects, attributable to differences in study design. CONCLUSION: Although recent studies provide support for the acceptance and efficacy of dance interventions for people with CP, the systematic review revealed significant limitations in study design (only 2 randomised control trials). High-quality research that measures outcomes across all dimensions of the ICF, and particularly at the level of participation, are needed to improve the level of empirical support for dance-based interventions.

Movement- and step-based dance practice for cerebral palsy have a positive impact on walking/gait, balance/postural control, and range of motion.Dance programs should move beyond a traditional focus on body structure and function, placing participation at the forefront of the program.Rehabilitation professionals should consider forming partnerships with stakeholders, addressing their goals, experiences, and challenges, with dance as a feasible and important option for participation-based practice.

Validity and Reliability of Thoracic-Mounted Inertial Measurement Units to Derive Gait Characteristics During Running.

ABSTRACT: Horsley, BJ, Tofari, PJ, Halson, SL, Kemp, JG, Chalkley, D, Cole, MH, Johnston, RD, and Cormack, SJ. Validity and reliability of thoracic-mounted inertial measurement units to derive gait characteristics during running. J Strength Cond Res 38(2): 274-282, 2024-Inertial measurement units (IMUs) attached to the tibia or lumbar spine can be used to analyze running gait but, with team-sports, are often contained in global navigation satellite system (GNSS) units worn on the thoracic spine. We assessed the validity and reliability of thoracic-mounted IMUs to derive gait characteristics, including peak vertical ground reaction force (vGRF peak ) and vertical stiffness (K vert ). Sixteen recreationally active subjects performed 40 m run throughs at 3-4, 5-6, and 7-8 m·s -1 . Inertial measurement units were attached to the tibia, lumbar, and thoracic spine, whereas 2 GNSS units were also worn on the thoracic spine. Initial contact (IC) from a validated algorithm was evaluated with F1 score and agreement (mean difference ± SD ) of gait data with the tibia and lumbar spine using nonparametric limits of agreement (LoA). Test-retest error {coefficient of variation, CV (95% confidence interval [CI])} established reliability. Thoracic IMUs detected a nearly perfect proportion (F1 ≥ 0.95) of IC events compared with tibia and lumbar sites. Step length had the strongest agreement (0 ± 0.04 m) at 3-4 m·s -1 , whereas contact time improved from 3 to 4 (-0.028 ± 0.018 second) to 7-8 m·s -1 (-0.004 ± 0.013 second). All values for K vert fell within the LoA at 7-8 m·s -1 . Test-retest error was ≤12.8% for all gait characteristics obtained from GNSS units, where K vert was most reliable at 3-4 m·s -1 (6.8% [5.2, 9.6]) and vGRF peak at 7-8 m·s -1 (3.7% [2.5, 5.2]). The thoracic-spine site is suitable to derive gait characteristics, including K vert , from IMUs within GNSS units, eliminating the need for additional sensors to analyze running gait.

Validity and Reliability of Methods to Assess Movement Deficiencies Following Concussion: A COSMIN Systematic Review.

BACKGROUND: There is an increased risk of subsequent concussion and musculoskeletal injury upon return to play following a sports-related concussion. Whilst there are numerous assessments available for clinicians for diagnosis and during return to play following concussion, many may lack the ability to detect these subclinical changes in function. Currently, there is no consensus or collated sources on the reliability, validity and feasibility of these assessments, which makes it difficult for clinicians and practitioners to select the most appropriate assessment for their needs. OBJECTIVES: This systematic review aims to (1) consolidate the reliability and validity of motor function assessments across the time course of concussion management and (2) summarise their feasibility for clinicians and other end-users. METHODS: A systematic search of five databases was conducted. Eligible studies were: (1) original research; (2) full-text English language; (3) peer-reviewed with level III evidence or higher; (4) assessed the validity of lower-limb motor assessments used to diagnose or determine readiness for athletes or military personnel who had sustained a concussion or; (5) assessed the test-retest reliability of lower-limb motor assessments used for concussion management amongst healthy athletes. Acceptable lower-limb motor assessments were dichotomised into instrumented and non-instrumented and then classified into static (stable around a fixed point), dynamic (movement around a fixed point), gait, and other categories. Each study was assessed using the COSMIN checklist to establish methodological and measurement quality. RESULTS: A total of 1270 records were identified, with 637 duplicates removed. Titles and abstracts of 633 records were analysed, with 158 being retained for full-text review. A total of 67 records were included in this review; 37 records assessed reliability, and 35 records assessed the validity of lower-limb motor assessments. There were 42 different assessments included in the review, with 43% being non-instrumented, subjective assessments. Consistent evidence supported the use of instrumented assessments over non-instrumented, with gait-based assessments demonstrating sufficient reliability and validity compared to static or dynamic assessments. CONCLUSION: These findings suggest that instrumented, gait-based assessments should be prioritised over static or dynamic balance assessments. The use of laboratory equipment (i.e. 3D motion capture, pressure sensitive walkways) on average exhibited sufficient reliability and validity, yet demonstrate poor feasibility. Further high-quality studies evaluating the reliability and validity of more readily available devices (i.e. inertial measurement units) are needed to fill the gap in current concussion management protocols. Practitioners can use this resource to understand the accuracy and precision of the assessments they have at their disposal to make informed decisions regarding the management of concussion. TRAIL REGISTRATION: This systematic review was registered on PROSPERO (reg no. CRD42021256298).

How Reliable and Valid are Dual-Task Cost Metrics? A Meta-analysis of Locomotor-Cognitive Dual-Task Paradigms.

OBJECTIVE: To assess the retest reliability, predictive validity, and concurrent validity of locomotor and cognitive dual-task cost (DTC) metrics derived from locomotor-cognitive dual-task paradigms. DATA SOURCES: A literature search of electronic databases (PubMed, PsycINFO, MEDLINE, CINAHL, and Scopus) was conducted on May 29th, 2021, without time restriction. STUDY SELECTION: For 1559 search results, titles and abstracts were screened by a single reviewer and full text of potentially eligible papers was considered by 2 independent reviewers. 25 studies that evaluated retest reliability, predictive validity, and concurrent validity of locomotor-cognitive DTC in healthy and clinical groups met inclusion criteria. DATA EXTRACTION: Study quality was assessed using the Consensus-Based Standards for the Selection of Health Measurement Instrument checklist. Data relating to the retest reliability, predictive validity, and concurrent validity of DTC were extracted. DATA SYNTHESIS: Meta-analysis showed that locomotor DTC metrics (intraclass correlation coefficient [ICC]=0.61, 95% confidence interval [CI; 0.53.0.70]) had better retest reliability than cognitive DTC metrics (ICC=0.27, 95% CI [0.17.0.36]). Larger retest reliability estimates were found for temporal gait outcomes (ICC=0.67-0.72) compared with spatial (ICC=0.34-0.53). Motor DTC metrics showed weak predictive validity for the incidence of future falls (r=0.14, 95% CI [-0.03.0.31]). Motor DTC metrics had weak concurrent validity with other clinical and performance assessments (r=0.11, 95% CI [0.07.0.16]), as did cognitive DTC metrics (r=0.19, 95% CI [0.08.0.30]). CONCLUSIONS: Gait-related temporal DTC metrics achieve adequate retest reliability, while predictive and concurrent validity of DTC needs to be improved before being used widely in clinical practice and other applied settings. Future research should ensure the reliability and validity of DTC outcomes before being used to assess dual-task interference.

Gait biofeedback training in people with Parkinson's disease: a pilot study.

BACKGROUND: People with Parkinson's disease (PD) are at a high risk of falls, with ~ 60% experiencing a fall each year. Greater mediolateral head and pelvis motion during gait are known to increase the risk of falling in PD, however the ability to modify these aspects of gait has not been examined. Thus, this study aimed to examine whether mediolateral trunk, head and pelvis motion during walking could be successfully decreased in people with PD using real-time biofeedback. METHODS: Participants were provided with real-time biofeedback regarding their mediolateral trunk lean via a visual projection whilst walking along an 8-m indoor walkway. Using the feedback provided, they were asked to reduce the magnitude of their mediolateral trunk lean. Gait was recorded for four conditions (i) Baseline, (ii) Intervention, (iii) immediately Post-Intervention, and (iv) 1-week Follow-Up. Biomechanical variables associated with falls risk were compared between conditions, including normalised mediolateral motion, gait velocity and stride length. RESULTS: A reduction in mediolateral trunk lean, step length and gait velocity from Baseline to the Intervention and Post-intervention conditions was observed. Contrary to this, increased normalised ML pelvis and trunk motion was observed between the Baseline and Intervention conditions, but returned to Baseline levels in the Post-Intervention condition. CONCLUSIONS: Results from the current study suggest that real-time visual biofeedback may be effective at modifying specific gait characteristics that are associated with falls in PD. Further research is required to better understand the influence of this intervention approach on falls incidence. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12620000994987. Registered 10 June 2020 - Retrospectively registered, https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380324.

Muscle Force Contributions to Anterior Cruciate Ligament Loading.

Anterior cruciate ligament (ACL) injuries are one of the most common knee pathologies sustained during athletic participation and are characterised by long convalescence periods and associated financial burden. Muscles have the ability to increase or decrease the mechanical loads on the ACL, and thus are viable targets for preventative interventions. However, the relationship between muscle forces and ACL loading has been investigated by many different studies, often with differing methods and conclusions. Subsequently, this review aimed to summarise the evidence of the relationship between muscle force and ACL loading. A range of studies were found that investigated muscle and ACL loading during controlled knee flexion, as well as a range of weightbearing tasks such as walking, lunging, sidestep cutting, landing and jumping. The quadriceps and the gastrocnemius were found to increase load on the ACL by inducing anterior shear forces at the tibia, particularly when the knee is extended. The hamstrings and soleus appeared to unload the ACL by generating posterior tibial shear force; however, for the hamstrings, this effect was contingent on the knee being flexed greater than ~ 20° to 30°. The gluteus medius was consistently shown to oppose the knee valgus moment (thus unloading the ACL) to a magnitude greater than any other muscle. Very little evidence was found for other muscle groups with respect to their contribution to the loading or unloading of the ACL. It is recommended that interventions aiming to reduce the risk of ACL injury consider specifically targeting the function of the hamstrings, soleus and gluteus medius.

Behavioral and Neuroimaging Research on Developmental Coordination Disorder (DCD): A Combined Systematic Review and Meta-Analysis of Recent Findings.

AIM: The neurocognitive basis of Developmental Coordination Disorder (DCD; or motor clumsiness) remains an issue of continued debate. This combined systematic review and meta-analysis provides a synthesis of recent experimental studies on the motor control, cognitive, and neural underpinnings of DCD. METHODS: The review included all published work conducted since September 2016 and up to April 2021. One-hundred papers with a DCD-Control comparison were included, with 1,374 effect sizes entered into a multi-level meta-analysis. RESULTS: The most profound deficits were shown in: voluntary gaze control during movement; cognitive-motor integration; practice-/context-dependent motor learning; internal modeling; more variable movement kinematics/kinetics; larger safety margins when locomoting, and atypical neural structure and function across sensori-motor and prefrontal regions. INTERPRETATION: Taken together, these results on DCD suggest fundamental deficits in visual-motor mapping and cognitive-motor integration, and abnormal maturation of motor networks, but also areas of pragmatic compensation for motor control deficits. Implications for current theory, future research, and evidence-based practice are discussed. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, identifier: CRD42020185444.

Acute effect of traditional and adaptive metronomes on gait variability in older individuals with a history of falls.

BACKGROUND: Metronome cueing has been shown to reduce gait variability and thereby potentially reduce falls risk in individuals with Parkinson's disease. It is unclear however, if metronome cueing has a similar effect in healthy older adults with a history of falls. AIM: To investigate whether a traditional and/or an adaptive metronome, based on an individual's gait pattern, were effective in reducing gait variability in older adults with a history of falls. METHODS: Twenty older adults (15 women, 71 ± 4.9 years) with a history of falls were included in this cross-over study. Participants received two types of cueing (adaptive and traditional metronome) 1 week apart. The variability of the participants' stride time, stride length, walking speed and duration of double leg support were recorded during three walking conditions (baseline, during feedback and post-feedback gait). Repeated-measures ANOVA was used to assess the possible effects of the two cueing strategies on gait variables. RESULTS: Compared with the baseline condition, participants had significantly increased stride time variability during feedback (F (2) = 9.83, p < 0.001) and decreased double leg support time variability post-feedback (F (2) 3.69, p = 0.034). Increased stride time variability was observed with the adaptive metronome in comparison to the traditional metronome. CONCLUSION: Metronome cueing strategies may reduce double leg support variability in older adults with a history of falls but seem to increase stride time variability. Further studies are needed to investigate if metronome cueing is more beneficial for individuals with greater baseline gait variability than those included in the current study.

The inter-device reliability of global navigation satellite systems during team sport movement across multiple days.

OBJECTIVES: (1) Determine the inter-device and inter-manufacturer reliability; and (2) investigate the variation in reliability over time for common global navigation satellite systems. DESIGN: Repeated measures. METHODS: A total of twenty 10-Hz devices manufactured by StatSports (n = 10, Apex Pro; StatSports, Newry, Ireland) and Catapult Sports (n = 10, Vector S7; Catapult Sports, Melbourne, Australia) were towed on a sprint sled during 8 × 40-minute team sport movement protocol over a 4-week period. The coefficient of variations for distance, velocity and acceleration/deceleration metrics were calculated to show dispersion of the data relative to the mean or median for each manufacturer and interpreted as good, ≤5%; moderate, <10%; and poor, coefficient of variation ≥10%. The coefficient of variation range described the variation in reliability and was interpreted as small, ≤5%; moderate, <10% and large, ≥10%. Inter-manufacturer agreement was represented as a Cohen d (±95% confidence interval) standardised effect size. RESULTS: Inter-device reliability for distance, peak velocity and average acceleration was good (coefficient of variation = 0.1 to 3.9%) for both manufacturers, with small variation across sessions. For most threshold-based acceleration and deceleration counts, StatSports devices showed good to moderate reliability, with moderate variation across sessions; Catapult showed good to poor reliability, with large variation across sessions. Inter-manufacturer agreement demonstrated moderate to very large effect sizes reported for most metrics. CONCLUSIONS: Reliability was suitable and consistent for measures of distance, velocity, and average acceleration. StatSports devices generally possessed suitable reliability and consistency for threshold-based accelerations and decelerations, though Catapult devices did not. Most metrics should not be compared between manufacturers.

Low-frequency STN-DBS provides acute gait improvements in Parkinson's disease: a double-blinded randomised cross-over feasibility trial.

BACKGROUND: Some people with Parkinson's disease (PD) report poorer dynamic postural stability following high-frequency deep brain stimulation of the subthalamic nucleus (STN-DBS), which may contribute to an increased falls risk. However, some studies have shown low-frequency (60 Hz) STN-DBS improves clinical measures of postural stability, potentially providing support for this treatment. This double-blind randomised crossover study aimed to investigate the effects of low-frequency STN-DBS compared to high-frequency stimulation on objective measures of gait rhythmicity in people with PD. METHODS: During high- and low-frequency STN-DBS and while off-medication, participants completed assessments of symptom severity and walking (e.g., Timed Up-and-Go). During comfortable walking, the harmonic ratio, an objective measures of gait rhythmicity, was derived from head- and trunk-mounted accelerometers to provide insight in dynamic postural stability. Lower harmonic ratios represent less rhythmic walking and have discriminated people with PD who experience falls. Linear mixed model analyses were performed on fourteen participants. RESULTS: Low-frequency STN-DBS significantly improved medial-lateral and vertical trunk rhythmicity compared to high-frequency. Improvements were independent of electrode location and total electrical energy delivered. No differences were noted between stimulation conditions for temporal gait measures, clinical mobility measures, motor symptom severity or the presence of gait retropulsion. CONCLUSIONS: This study provides evidence for the acute benefits of low-frequency stimulation for gait outcomes in STN-DBS PD patients, independent of electrode location. However, the perceived benefits of this therapy may be diminished for people who experienced significant tremor pre-operatively, as lower frequencies may cause these symptoms to re-emerge. TRIAL REGISTRATION: This study was prospectively registered with the Australian and New Zealand Clinical Trials Registry on 5 June 2018 (ACTRN12618000944235).

The Validity and Reliability of Commercially Available Resistance Training Monitoring Devices: A Systematic Review.

BACKGROUND: Monitoring resistance training has a range of unique difficulties due to differences in physical characteristics and capacity between athletes, and the indoor environment in which it often occurs. Traditionally, methods such as volume load have been used, but these have inherent flaws. In recent times, numerous portable and affordable devices have been made available that purport to accurately and reliably measure kinetic and kinematic outputs, potentially offering practitioners a means of measuring resistance training loads with confidence. However, a thorough and systematic review of the literature describing the reliability and validity of these devices has yet to be undertaken, which may lead to uncertainty from practitioners on the utility of these devices. OBJECTIVE: A systematic review of studies that investigate the validity and/or reliability of commercially available devices that quantify kinetic and kinematic outputs during resistance training. METHODS: Following PRISMA guidelines, a systematic search of SPORTDiscus, Web of Science, and Medline was performed; studies included were (1) original research investigations; (2) full-text articles written in English; (3) published in a peer-reviewed academic journal; and (4) assessed the validity and/or reliability of commercially available portable devices that quantify resistance training exercises. RESULTS: A total of 129 studies were retrieved, of which 47 were duplicates. The titles and abstracts of 82 studies were screened and the full text of 40 manuscripts were assessed. A total of 31 studies met the inclusion criteria. Additional 13 studies, identified via reference list assessment, were included. Therefore, a total of 44 studies were included in this review. CONCLUSION: Most of the studies within this review did not utilise a gold-standard criterion measure when assessing validity. This has likely led to under or overreporting of error for certain devices. Furthermore, studies that have quantified intra-device reliability have often failed to distinguish between technological and biological variability which has likely altered the true precision of each device. However, it appears linear transducers which have greater accuracy and reliability compared to other forms of device. Future research should endeavour to utilise gold-standard criterion measures across a broader range of exercises (including weightlifting movements) and relative loads.

The Validity and Reliability of Wearable Microtechnology for Intermittent Team Sports: A Systematic Review.

BACKGROUND: Technology has long been used to track player movements in team sports, with initial tracking via manual coding of video footage. Since then, wearable microtechnology in the form of global and local positioning systems has provided a less labour-intensive way of monitoring movements. As such, there has been a proliferation in research pertaining to these devices. OBJECTIVE: A systematic review of studies that investigate the validity and/or reliability of wearable microtechnology to quantify movement and specific actions common to intermittent team sports. METHODS: A systematic search of CINAHL, MEDLINE, and SPORTDiscus was performed; studies included must have been (1) original research investigations; (2) full-text articles written in English; (3) published in a peer-reviewed academic journal; and (4) assessed the validity and/or reliability of wearable microtechnology to quantify movements or specific actions common to intermittent team sports. RESULTS: A total of 384 studies were retrieved and 187 were duplicates. The titles and abstracts of 197 studies were screened and the full texts of 88 manuscripts were assessed. A total of 62 studies met the inclusion criteria. Additional 10 studies, identified via reference list assessment, were included. Therefore, a total of 72 studies were included in this review. CONCLUSION: There are many studies investigating the validity and reliability of wearable microtechnology to track movement and detect sport-specific actions. It is evident that for the majority of metrics, validity and reliability are multi-factorial, in that it is dependent upon a wide variety of factors including wearable technology brand and model, sampling rate, type of movement performed (e.g., straight line, change of direction) and intensity of movement (e.g., walk, sprint). Practitioners should be mindful of the accuracy and repeatability of the devices they are using when making decisions on player training loads.

Constraints on visual exploration of youth football players during 11v11 match-play: The influence of playing role, pitch position and phase of play.

Visual exploratory action, in which football players turn their head to perceive their environment, improves prospective performance with the ball during match-play. This scanning action, however, is relevant for players throughout the entire match, as the information perceived through visual exploration is needed to guide movement around the pitch during both offensive and defensive play. This study aimed to understand how a player's on-pitch position, playing role and phase of play influenced the visual exploratory head movements of players during 11v11 match-play. Twenty-two competitive-elite youth footballers (M = 16.25 years) played a total of 1,623 minutes (M = 73.8). Inertial measurement units, global positioning system units and notational analysis were used to quantify relevant variables. Analyses revealed that players explored more extensively when they were in possession of the ball, and less extensively during transition phases, as compared to team ball-possession and opposition ball-possession phases of play. Players explored most extensively when in the back third of the pitch, and least when they were in the middle third of the pitch. Playing role, pitch position and phase of play should be considered as constraints on visual exploratory actions when developing training situations aimed at improving the scanning actions of players.

Principles of the Guidance of Exploration for Orientation and Specification of Action.

To control movement of any type, the neural system requires perceptual information to distinguish what actions are possible in any given environment. The behavior aimed at collecting this information, termed "exploration", is vital for successful movement control. Currently, the main function of exploration is understood in the context of specifying the requirements of the task at hand. To accommodate for agency and action-selection, we propose that this understanding needs to be supplemented with a function of exploration that logically precedes the specification of action requirements with the purpose of discovery of possibilities for action-action orientation. This study aimed to provide evidence for the delineation of exploration for action orientation and exploration for action specification using the principles from "General Tau Theory." Sixteen male participants volunteered and performed a laboratory-based exploration task. The visual scenes of different task-specific situations were projected on five monitors surrounding the participant. At a predetermined time, the participant received a simulated ball and was asked to respond by indicating where they would next play the ball. Head movements were recorded using inertial sensors as a measure of exploratory activity. It was shown that movement guidance characteristics varied between different head turns as participants moved from exploration for orientation to exploration for action specification. The first head turn in the trial, used for action-orientation, showed later peaks in the velocity profile and harder closure of the movement gap (gap between the start and end of the head-movement) in comparison to the later head turns. However, no differences were found between the first and the final head turn, which we hypothesized are used mainly for action orientation and specification respectively. These results are in support of differences in the function and control of head movement for discovery of opportunities for action (orientation) vs. head movement for specification of task requirements. Both are important for natural movement, yet in experimental settings,orientation is often neglected. Including both orientation and action specification in an experimental design should maximize generalizability of an experiment to natural behavior. Future studies are required to study the neural bases of movement guidance in order to better understand exploration in anticipation of movement.

The CuePed Trial: How Does Environmental Complexity Impact Cue Effectiveness? A Comparison of Tonic and Phasic Visual Cueing in Simple and Complex Environments in a Parkinson's Disease Population with Freezing of Gait.

BACKGROUND: The optimal prescription of cueing for the treatment of freezing of gait (FoG) in Parkinson's disease (PD) is currently a difficult problem for clinicians due to the heterogeneity of cueing modalities, devices, and the limited comparative trial evidence. There has been a rise in the development of motion-sensitive, wearable cueing devices for the treatment of FoG in PD. These devices generally produce cues after signature gait or electroencephalographic antecedents of FoG episodes are detected (phasic cues). It is not known whether these devices offer benefit over simple (tonic) cueing devices. METHODS: We assembled 20 participants with PD and FoG and familiarized them with a belt-worn, laser-light cueing device (Agilitas™). The device was designed with 2 cueing modalities-gait-dependent or "phasic" cueing and gait-independent or "tonic" cueing. Participants used the device sequentially in the off, phasic, or tonic modes, across 2 tasks-a 2-minute walk and an obstacle course. RESULTS: A significant improvement in mean distance walked during the 2-minute walk test was observed for the tonic mode (127.3 m) compared with the off (111.4 m) and phasic (116.1 m) conditions. In contrast, there was a nonsignificant trend toward improvement in FoG frequency, duration, and course time when the device was switched from off to tonic and to phasic modes for the obstacle course. CONCLUSIONS: Parkinson's disease patients with FoG demonstrated an improvement in distance walked during the two-minute walk test when a cueing device was switched from off to phasic and to tonic modes of operation. However, this benefit was lost when patients negotiated an obstacle course.

Using Microtechnology to Quantify Torso Angle During Match-Play in Field Hockey.

Warman, GE, Cole, MH, Johnston, RD, Chalkley, D, and Pepping, GJ. Using microtechnology to quantify torso angle during match-play in field hockey. J Strength Cond Res 33(10): 2648-2654, 2019-Field hockey is played in a dynamic environment placing specific postural demands on athletes. Little research has been devoted to understanding the nature of a player's torso postures in field hockey match-play and its relationship with the perceptuomotor demands of the sport. We used commercially available microtechnology worn by 16 athletes during a 6-match national tournament to quantify torso flexion/extension angles. Orientation was derived using the inertial and magnetic sensors housed within global positioning system devices, assessing torso angle in the sagittal plane from 91 individual match files. The main independent variable was playing position, whereas the dependent variable was torso flexion/extension, presented as a percentage of playing time spent in 15 × 10° torso postural bands ranging from ≥40° extension to ≥90° flexion. It was shown that athletes spent 89.26% of their playing time in various torso postures, ranging from 20 to 90° of flexion. Defenders spent more time than midfielders (p = 0.004, effect size [ES] = 0.43) and strikers (p = 0.004; ES = 0.44) in the posture band of 10-20° torso flexion, whereas midfielders spent more time between 20 and 30° of torso flexion (p = 0.05; ES = 0.32) than strikers. Conversely, strikers spent more time between 30 and 40° of flexion than defenders (p < 0.001; ES = 0.74). These results reflect the sport-specific and role-specific torso angles adopted by field hockey athletes during match-play. Coaching staff can use these data to gain insight into the postural demands of their sport and inform the preparation of athletes for the perception-action demands of competition.

Trunk Exercises Improve Balance in Parkinson Disease: A Phase II Randomized Controlled Trial.

BACKGROUND AND PURPOSE: Trunk control is important for maintaining balance; hence, deficient trunk control may contribute to balance problems in people with Parkinson disease (PD). Unfortunately, this deficit is poorly managed with pharmacological therapies, emphasizing the need for alternative therapies for these patients. This randomized controlled trial sought to examine the effects of a 12-week trunk-specific exercise-based intervention on balance in people with PD. METHODS: Twenty-four people with PD and with a history of falls completed assessments of motor symptom severity, balance confidence, mobility, quality of life, and quiet-standing balance. Participants were then randomized to receive either 12 weeks of exercise or education and reassessed after 12 and 24 weeks. RESULTS: Linear mixed-models analyses showed no significant changes in clinical outcomes following the intervention. However, during quiet standing, sway area on a foam surface without vision was reduced for the exercise group at 12 (-6.9 ± 3.1 cm; 95% confidence interval [CI] = -13.1 to -0.7; P = 0.029; d = 0.66) and 24 weeks (-7.9 ± 3.1 cm; 95% CI = -14.1 to -1.7; P = 0.013; d = 0.76). Furthermore, the exercise group demonstrated reduced sway variability at 12 (-0.2 ± 0.1 cm; 95% CI = -0.4 to 0.0; P = 0.042; d = 0.62) and 24 weeks in the medial-lateral direction (-0.2 ± 0.1 cm; 95% CI = -0.4 to 0.0; P = 0.043; d = 0.62). No changes in quiet standing balance were recorded for the education group. DISCUSSION AND CONCLUSIONS: The results of this study suggest that exercise-based interventions targeting trunk strength, endurance, and mobility may be effective for improving quiet-standing balance in people with PD. However, additional research is needed to determine whether these improvements are sufficient to reduce falls risk.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A254).

Influence of age and falls incidence on tau guidance of centre of pressure movement during gait initiation.

BACKGROUND: Prospective balance control can be assessed in terms of the characteristics of a tau-guidance function that summarizes the velocity profile of Centre of Pressure (CoP) movement during gait initiation. This allows the nature of CoP movement to be assessed on a continuum between controlled 'soft'- and unstable 'hard' CoP-motion gap-closure. Previous research has shown less stable movement patterns with harder closures with increasing age, which makes movements more prone to overshooting and could possibly explain the increasing falls risk with age. RESEARCH QUESTIONS: The primary research question was 'what is the relationship between falls incidence and tau-guidance in the mediolateral centre of pressure movements during gait initiation?' The secondary research question was 'what are the influences of age and task demands on the variability of tau-guidance characteristics?'. METHODS: Sixteen young adults and 76 older adults performed 33 gait initiations from a force platform, stepping onto stepping-targets imposing differing task demands. Older participants completed a one-year follow-up screening for falls. An analysis was performed investigating linear relationships between a tau-guidance function and the time-to-closure (tau) of the mediolateral centre of pressure motion-gap with coupling constant K (dependent variable). RESULTS: Gait-related falls during the 12-month follow-up period were associated with higher tau-K values. Furthermore, longer movement preparation time was associated with lower K values, particularly in fallers. Previously-reported age-related increases of the tau-coupling constant values which were found in studies of unconstrained gait initiation were not present in our results. SIGNIFICANCE: The presence of the targeting task provided a more prescriptive environment compared to unconstrained gait initiation and could explain the absence of age-related changes to the produced K values. Falls incidence was found to be associated with higher values of K, indicating less stable movement. Future studies should investigate the practical implications of these findings for falls prevention.