A slow limit: Extensive motor training can not overcome a limit on the production of slow and smooth motion.

Previous research from several paradigms indicated that people have difficulty in producing slow and smooth movements (SSM). It is not clear whether these difficulties are due to biomechanical constraints, planning constraints, or lack of experience with moving slowly. Here, we investigated the latter possibility: we empirically tested whether short-term practice and long-term expertise with moving slowly would result in an increased ability to perform SSM. In Study 1, novice participants completed 10 training sessions in which they moved a stylus on a digitizing tablet as they traced an ellipse that moved at different frequency/peak velocity combinations, with frequencies ranging from 0.25 Hz to 0.875 Hz. In Study 2, experts in slow movement (tai chi performers) and fast movement (karate performers) completed the same task in one session. The results indicated that all participants had difficulties in producing SSM, as evidenced by an increase in submovement rate with decreasing frequency. Participants in Study 1 did show a marked improvement in their ability to produce fewer submovements while reducing mean squared jerk (MSJ). These short-term improvements were not evident in long-term slow motor expertise (i.e., tai chi). Taken together, our results suggest that SSM are likely difficult to produce due to a combination of several factors: lack of experience, planning, biomechanical, and neural constraints.

Quantifying Changes in Dexterity as a Result of Piano Training in People with Parkinson's Disease.

People with Parkinson's disease often show deficits in dexterity, which, in turn, can lead to limitations in performing activities of daily life. Previous studies have suggested that training in playing the piano may improve or prevent a decline in dexterity in this population. In this pilot study, we tested three participants on a six-week, custom, piano-based training protocol, and quantified dexterity before and after the intervention using a sensor-enabled version of the nine-hole peg test, the box and block test, a test of finger synergies using unidimensional force sensors, and the Quantitative Digitography test using a digital piano, as well as selected relevant items from the motor parts of the MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and the Parkinson's Disease Questionnaire (PDQ-39) quality of life questionnaire. The participants showed improved dexterity following the training program in several of the measures used. This pilot study proposes measures that can track changes in dexterity as a result of practice in people with Parkinson's disease and describes a potential protocol that needs to be tested in a larger cohort.

The effect of high-definition transcranial direct current stimulation intensity on motor performance in healthy adults: a randomized controlled trial.

BACKGROUND: The results of transcranial direct current stimulation (tDCS) studies that seek to improve motor performance for people with neurological disorders, by targeting the primary motor cortex, have been inconsistent. One possible reason, among others, for this inconsistency, is that very little is known about the optimal protocols for enhancing motor performance in healthy individuals. The best way to optimize stimulation protocols for enhancing tDCS effects on motor performance by means of current intensity modulation has not yet been determined. We aimed to determine the effect of current intensity on motor performance using-for the first time-a montage optimized for maximal focal stimulation via anodal high-definition tDCS (HD-tDCS) on the right primary motor cortex in healthy subjects. METHODS: Sixty participants randomly received 20-min HD-tDCS at 1.5, 2 mA, or sham stimulation. Participants' reaching performance with the left hand on a tablet was tested before, during, and immediately following stimulation, and retested after 24 h. RESULTS: In the current montage of HD-tDCS, movement time did not differ between groups in each timepoint. However, only after HD-tDCS at 1.5 mA did movement time improve at posttest as compared to pretest. This reduction in movement time from pretest to posttest was significantly greater compared to HD-tDCS 2 mA. Following HD-tDCS at 1.5 mA and sham HD-tDCS, but not 2 mA, movement time improved at retest compared to pretest, and at posttest and retest compared to the movement time during stimulation. In HD-tDCS at 2 mA, the negligible reduction in movement time from the course of stimulation to posttest was significantly lower compared to sham HD-tDCS. Across all groups, reaction time improved in retest compared to pretest and to the reaction time during stimulation, and did not differ between groups in each timepoint. CONCLUSIONS: It appears that 2 mA in this particular experimental setup inhibited the learning effects. These results suggest that excitatory effects induced by anodal stimulation do not hold for every stimulation intensity, information that should be taken into consideration when translating tDCS use from the realm of research into more optimal neurorehabilitation. TRIAL REGISTRATION: Clinical Trials Gov, NCT04577768. Registered 6 October 2019 -Retrospectively registered, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000A9B3&selectaction=Edit&uid=U0005AKF&ts=8&cx=buucf0 .

Proximal and distal movement patterns during a graphomotor task in typically developing children and children with handwriting problems.

BACKGROUND: Therapists specializing in handwriting difficulties in children often address motor problems including both proximal and distal movements in the upper extremity. Kinematic measures can be used to investigate various aspects of handwriting. This study examined differences in movement patterns in proximal and distal joints of the upper extremity during graphomotor tasks between typically developing children with and without handwriting problems. Additionally, it explored relationships between movement patterns, speed, and legibility of writing. METHODS: Forty-one children, aged 7-11 years, were assessed with the Aleph Aleph Ktav Yad Hebrew Handwriting assessment and the Beery Test of Visual Motor Integration and, based on their scores, were divided into a research group (with handwriting difficulties) and a control group (without handwriting difficulties). Upper extremity joint movement patterns were analyzed with a motion capture system. Differences in the quality of shapes traced and copied on a graphics tablet positioned horizontally and vertically were compared. Between-group differences and relationships with speed and legibility were analyzed. RESULTS: In both groups, there was greater movement in the distal compared to the proximal joints, greater movement when performing the task in a horizontal compared to a vertical plane, and greater movement when tracing than copying. Joint movements in the arm executed scaled-down versions of the shapes being drawn. While the amount of joint displacement was similar between groups, children in the research group showed greater dissimilarity between the drawn shape and the shape produced by the proximal joints. Finally, the drawing measure on the tablet was a significant predictor of legibility, speed of writing, visual motor integration and motor coordination, whereas the dissimilarity measure of joint movement was a significant predictor of speed of writing and motor coordination. CONCLUSIONS: This study provides support for the role of the distal upper extremity joints in the writing process and some guidance to assist clinicians in devising treatment strategies for movement-related handwriting problems. While we observed differences in proximal joint movements between the children with and without handwriting difficulties, the extent to which they are responsible for the differences in drawing quality remains to be determined. Further studies should use a similar methodology to examine additional tasks such as drawing shapes of varying sizes.

Home exercise in the dart-throwing motion plane after distal radius fractures: A pilot randomized controlled trial.

INTRODUCTION: During daily functions, our wrist moves through an oblique plane, named the dart-throwing motion (DTM) plane. This plane is considered a more stable plane because the proximal carpal row remains relatively immobile. However, rehabilitation programs that incorporate exercising in the DTM plane have yet to be explored. PURPOSE OF THE STUDY: The purpose of this study was to evaluate the rehabilitation outcomes after treatment in the DTM plane compared with outcomes after treatment in the sagittal plane after distal radius fracture. STUDY DESIGN: This is a pilot randomized controlled trial. METHODS: Subjects after open reduction internal fixation were assigned into a research group (N = 12; ages 48.7 ± 7.3) and a control group (N = 12; ages 50.8 ± 15). The control group activated the wrist in the sagittal plane, whereas the research group activated the wrist in the DTM plane. Range of motion, pain levels, functional hand motor skills tests, and satisfaction from self-training exercise were measured before and after a 12-session intervention. RESULTS: The outcome measures were similar between the treatment groups. The research group reported significantly higher satisfaction rates than the control group on topics such as general satisfaction (research group: 3.4 ± 0.7, control group: 2. 5 ± 1.2, P = .030), motivation to exert oneself (research group: 2.8 ± 1.0, control group: 2.3 ± 1.2, P = .009), progressed function (research group: 3.4 ± 0.7, control group: 2.4 ± 1.1, P = .012), and self-training contribution to the daily function (research group: 3.4 ± 0.7, control group: 2.5 ± 1.2, P = .030). DISCUSSION AND CONCLUSION: Pilot results do not favor one treatment method over the other. However, exercising in the DTM plane may contribute to the satisfaction of the client and increase self-training motivation.

Reaching trajectories unravel modality-dependent temporal dynamics of the automatic process in the Simon task: a model-based approach.

The Simon effect represents a phenomenon in which the location of the stimuli affects the speed and accuracy of the response, despite being irrelevant for the task demands. This is believed to be due to an automatic activation of a response corresponding to the location of the stimuli, which conflicts with the controlled decision process based on relevant stimuli features. Previously, differences in the nature of the Simon effect (i.e., the pattern of change of the effect across the distribution of response times) between visual and somatosensory stimuli were reported. We hypothesize that the temporal dynamics of visual and somatosensory automatic and controlled processes vary, thus driving the reported behavioral differences. While most studies have used response times to study the underlying mechanisms involved, in this study we had participants reach out to touch the targets and recorded their arm movements using a motion capture system. Importantly, the participants started their movements before a final decision was made. In this way, we could analyze the movements to gain insights into the competition between the automatic and controlled processes. We used this technique to describe the results in terms of a model assuming automatic activation due to location-based evidence, followed by inhibition. We found that for the somatosensory Simon effect, the decay of the automatic process is significantly slower than for the visual Simon effect, suggesting quantitative differences in this automatic process between the visual and somatosensory modalities.

DataSpoon: Validation of an Instrumented Spoon for Assessment of Self-Feeding.

Clinically feasible assessment of self-feeding is important for adults and children with motor impairments such as stroke or cerebral palsy. However, no validated assessment tool for self-feeding kinematics exists. This work presents an initial validation of an instrumented spoon (DataSpoon) developed as an evaluation tool for self-feeding kinematics. Ten young, healthy adults (three male; age 27.2 ± 6.6 years) used DataSpoon at three movement speeds (slow, comfortable, fast) and with three different grips: "natural", power and rotated power grip. Movement kinematics were recorded concurrently using DataSpoon and a magnetic motion capture system (trakSTAR). Eating events were automatically identified for both systems and kinematic measures were extracted from yaw, pitch and roll (YPR) data as well as from acceleration and tangential velocity profiles. Two-way, mixed model Intraclass correlation coefficients (ICC) and 95% limits of agreement (LOA) were computed to determine agreement between the systems for each kinematic variable. Most variables demonstrated fair to excellent agreement. Agreement for measures of duration, pitch and roll exceeded 0.8 (excellent agreement) for >80% of speed and grip conditions, whereas lower agreement (ICC < 0.46) was measured for tangential velocity and acceleration. A bias of 0.01-0.07 s (95% LOA [-0.54, 0.53] to [-0.63, 0.48]) was calculated for measures of duration. DataSpoon enables automatic detection of self-feeding using simple, affordable movement sensors. Using movement kinematics, variables associated with self-feeding can be identified and aid clinical reasoning for adults and children with motor impairments.

Referent control of anticipatory grip force during reaching in stroke: an experimental and modeling study.

To evaluate normal and impaired control of anticipatory grip force (GF) modulation, we compared GF production during horizontal arm movements in healthy and post-stroke subjects, and, based on a physiologically feasible dynamic model, determined referent control variables underlying the GF-arm motion coordination in each group. 63% of 13 healthy and 48% of 13 stroke subjects produced low sustained initial force (< 10 N) and increased GF prior to arm movement. Movement-related GF increases were higher during fast compared to self-paced arm extension movements only in the healthy group. Differences in the patterns of anticipatory GF increases before the arm movement onset between groups occurred during fast extension arm movement only. In the stroke group, longer delays between the onset of GF change and elbow motion were related to clinical upper limb deficits. Simulations showed that GFs could emerge from the difference between the actual and the referent hand aperture (Ra) specified by the CNS. Similarly, arm movement could result from changes in the referent elbow position (Re) and could be affected by the co-activation (C) command. A subgroup of stroke subjects, who increased GF before arm movement, could specify different patterns of the referent variables while reproducing the healthy typical pattern of GF-arm coordination. Stroke subjects, who increased GF after arm movement onset, also used different referent strategies than controls. Thus, altered anticipatory GF behavior in stroke subjects may be explained by deficits in referent control.

Myoelectric Prosthesis Users Improve Performance Time and Accuracy Using Vibrotactile Feedback When Visual Feedback Is Disturbed.

OBJECTIVE: To evaluate the effects of adding vibrotactile feedback (VTF) in myoelectric prosthesis users during performance of a functional task when visual feedback is disturbed. DESIGN: A repeated-measures design with a counter-balanced order of 3 conditions. SETTING: Laboratory setting. PARTICIPANTS: Transradial amputees using a myoelectric prosthesis with normal or corrected eyesight (N=12, median age 65±13y). Exclusion criteria were orthopedic or neurologic problems. INTERVENTIONS: All participants performed the modified Box and Blocks Test, grasping and manipulating 16 blocks over a partition using their myoelectric prosthesis. This was performed 3 times: in full light, in a dark room without VTF, and in a dark room with VTF. MAIN OUTCOME MEASURES: Performance time, that is, the time needed to transfer 1 block, and accuracy during performance, measured by number of empty grips, empty transitions with no block and block drops from the hand. RESULTS: Significant differences were found in all outcome measures when VTF was added, with improved performance time (4.2 vs 5.3s) and a reduced number of grasping errors (3.0 vs 6.5 empty grips, 1.5 vs 4 empty transitions, 2.0 vs 4.5 block drops). CONCLUSIONS: Adding VTF to myoelectric prosthesis users has positive effects on performance time and accuracy when visual feedback is disturbed.

Evaluation of the effects of adding vibrotactile feedback to myoelectric prosthesis users on performance and visual attention in a dual-task paradigm.

OBJECTIVE: To evaluate the effects of adding vibrotactile feedback to myoelectric prosthesis users on the performance time and visual attention in a dual-task paradigm. DESIGN: A repeated-measures design with a counterbalanced order of two conditions. SETTING: Laboratory setting. SUBJECTS: Transradial amputees using a myoelectric prosthesis with normal or corrected eyesight ( N = 12, median age = 65 ± 13 years). Exclusion criteria were orthopedic or neurologic problems. INTERVENTIONS: Subjects performed grasping tasks with their prosthesis, while controlling a virtual car on a road with their intact hand. The dual task was performed twice: with and without vibrotactile feedback. MAIN MEASURES: Performance time of each of the grasping tasks and gaze behavior, measured by the number of times the subjects shifted their gaze toward their hand, the relative time they applied their attention to the screen, and percentage of error in the secondary task. RESULTS: The mean performance time was significantly shorter ( P = 0.024) when using vibrotactile feedback (93.2 ± 9.6 seconds) compared with the performance time measured when vibrotactile feedback was not available (107.8 ± 20.3 seconds). No significant differences were found between the two conditions in the number of times the gaze shifted from the screen to the hand, in the time the subjects applied their attention to the screen, and in the time the virtual car was off-road, as a percentage of the total game time (51.4 ± 15.7 and 50.2 ± 19.5, respectively). CONCLUSION: Adding vibrotactile feedback improved performance time during grasping in a dual-task paradigm. Prosthesis users may use vibrotactile feedback to perform better during daily tasks, when multiple cognitive demands are present.

Wrist Plane of Motion and Range During Daily Activities.

OBJECTIVE: The dart-throwing motion (DTM) is a multiplane wrist motion that is needed for many daily occupations. Mobilization along the DTM plane may be essential for rehabilitation after wrist injury, but DTM angles are reported for the dominant hand alone, so their relevance to injury in the nondominant hand cannot be surmised. The aim of this study was to quantify the DTM plane angles for both hands during different activities of daily living (ADLs). METHOD: Forty-three healthy participants wore a twin-axis electrogoniometer during ADLs. RESULTS: No significant differences were found between the DTM plane angles of the dominant (20°-45°) and nondominant (15°-40°) hands. These angles varied by task and across participants. CONCLUSION: The DTM plane is a functional motion used by both hands during ADLs. Because the DTM plane angle differs among hands, tasks, and individual clients, wrist rehabilitation involving the DTM plane should not be limited to a singular DTM plane angle.

Graphical Product Quality and Muscle Activity in Children With Mild Disabilities Drawing on a Horizontally or Vertically Oriented Tablet.

OBJECTIVE: We compared performance level and muscle activity patterns during shape copying and tracing in two positions, while sitting at a desk and while standing in front of a wall, between typically developing (TD) preschool children and children with mild disabilities (MD). METHOD: Twenty-two TD children (8 boys, 14 girls; mean [M] age = 5.2 yr, standard deviation [SD] = 0.1) and 13 children with MD (9 boys, 4 girls; M age = 4.9 yr, SD = 0.5) participated in this study. RESULTS: The children performed faster and smoother movements when copying shapes on the vertical surface, with no reduction of accuracy, than on the horizontal surface. Children with MD exerted their upper trapezius while performing the short tasks on the vertical surface compared with their muscle activity on the horizontal surface. CONCLUSION: Incorporating short copying or drawing tasks on a vertical surface may increase the control of proximal muscles and ease graphomotor performance in children with MD.

Development of finger force coordination in children.

Coordination is often observed as body parts moving together. However, when producing force with multiple fingers, the optimal coordination is not to produce similar forces with each finger, but rather for each finger to correct mistakes of other fingers. In this study, we aim to determine whether and how this skill develops in children aged 4-12 years. We measured this sort of coordination using the uncontrolled manifold hypothesis (UCM). We recorded finger forces produced by 60 typically developing children aged between 4 and 12 years in a finger-pressing task. The children controlled the height of an object on a screen by the total amount of force they produced on force sensors. We found that the synergy index, a measure of the relationship between "good" and "bad" variance, increased linearly as a function of age. This improvement was achieved by a selective reduction in "bad" variance rather than an increase in "good" variance. We did not observe differences between males and females, and the synergy index was not able to predict outcomes of upper limb behavioral tests after controlling for age. As children develop between the ages of 4 and 12 years, their ability to produce negative covariation between their finger forces improves, likely related to their improved ability to perform dexterous tasks.

Corrective jitter motion shows similar individual frequencies for the arm and the finger.

A characteristic of visuomotor tracking of non-regular oscillating stimuli are high-frequency jittery corrective motions, oscillating around the tracked stimuli. However, the properties of these corrective jitter responses are not well understood. For example, does the jitter response show an idiosyncratic signature? What is the relationship between stimuli properties and jitter properties? Is the jitter response similar across effectors with different inertial properties? To answer these questions, we measured participants' jitter frequencies in two tracking tasks in the arm and the finger. Thirty participants tracked the same set of eleven non-regular oscillating stimuli, vertically moving on a screen, once with forward-backward arm movements (holding a tablet stylus) and once with upward-downward index finger movements (with a motion tracker attached). Participants' jitter frequencies and tracking errors varied systematically as a function of stimuli frequency and amplitude. Additionally, there were clear individual differences in average jitter frequencies between participants, ranging from 0.7 to 1.15 Hz, similar to values reported previously. A comparison of individual jitter frequencies in the two tasks showed a strong correlation between participants' jitter frequencies in the finger and the arm, despite the very different inertial properties of the two effectors. This result suggests that the corrective jitter response stems from common neural processes.

The plausibility of visual information for hand ownership modulates multisensory synchrony perception.

We are frequently changing the position of our bodies and body parts within complex environments. How does the brain keep track of one's own body? Current models of body ownership state that visual body ownership cues such as viewed object form and orientation are combined with multisensory information to correctly identify one's own body, estimate its current location and evoke an experience of body ownership. Within this framework, it may be possible that the brain relies on a separate perceptual analysis of body ownership cues (e.g. form, orientation, multisensory synchrony). Alternatively, these cues may interact in earlier stages of perceptual processing-visually derived body form and orientation cues may, for example, directly modulate temporal synchrony perception. The aim of the present study was to distinguish between these two alternatives. We employed a virtual hand set-up and psychophysical methods. In a two-interval force-choice task, participants were asked to detect temporal delays between executed index finger movements and observed movements. We found that body-specifying cues interact in perceptual processing. Specifically, we show that plausible visual information (both form and orientation) for one's own body led to significantly better detection performance for small multisensory asynchronies compared to implausible visual information. We suggest that this perceptual modulation when visual information plausible for one's own body is present is a consequence of body-specific sensory predictions.

Kinematic descriptors of arm reaching movement are sensitive to hemisphere-specific immediate neuromodulatory effects of transcranial direct current stimulation post stroke.

Transcranial direct current stimulation (tDCS) exerts beneficial effects on motor recovery after stroke, presumably by enhancement of adaptive neural plasticity. However, patients with extensive damage may experience null or deleterious effects with the predominant application mode of anodal (excitatory) stimulation of the damaged hemisphere. In such cases, excitatory stimulation of the non-damaged hemisphere might be considered. Here we asked whether tDCS exerts a measurable effect on movement quality of the hemiparetic upper limb, following just a single treatment session. Such effect may inform on the hemisphere that should be excited. Using a single-blinded crossover experimental design, stroke patients and healthy control subjects were assessed before and after anodal, cathodal and sham tDCS, each provided during a single session of reaching training (repeated point-to-point hand movement on an electronic tablet). Group comparisons of endpoint kinematics at baseline-number of peaks in the speed profile (NoP; smoothness), hand-path deviations from the straight line (SLD; accuracy) and movement time (MT; speed)-disclosed greater NoP, larger SLD and longer MT in the stroke group. NoP and MT revealed an advantage for anodal compared to sham stimulation of the lesioned hemisphere. NoP and MT improvements under anodal stimulation of the non-lesioned hemisphere correlated positively with the severity of hemiparesis. Damage to specific cortical regions and white-matter tracts was associated with lower kinematic gains from tDCS. The study shows that simple descriptors of movement kinematics of the hemiparetic upper limb are sensitive enough to demonstrate gain from neuromodulation by tDCS, following just a single session of reaching training. Moreover, the results show that tDCS-related gain is affected by the severity of baseline motor impairment, and by lesion topography.

Using virtual reality-based neurocognitive testing and eye tracking to study naturalistic cognitive-motor performance.

Natural human behavior arises from continuous interactions between the cognitive and motor domains. However, assessments of cognitive abilities are typically conducted using pen and paper tests, i.e., in isolation from "real life" cognitive-motor behavior and in artificial contexts. In the current study, we aimed to assess cognitive-motor task performance in a more naturalistic setting while recording multiple motor and eye tracking signals. Specifically, we aimed to (i) delineate the contribution of cognitive and motor components to overall task performance and (ii) probe for a link between cognitive-motor performance and pupil size. To that end, we used a virtual reality (VR) adaptation of a well-established neurocognitive test for executive functions, the 'Color Trails Test' (CTT). The VR-CTT involves performing 3D reaching movements to follow a trail of numbered targets. To tease apart the cognitive and motor components of task performance, we included two additional conditions: a condition where participants only used their eyes to perform the CTT task (using an eye tracking device), incurring reduced motor demands, and a condition where participants manually tracked visually-cued targets without numbers on them, incurring reduced cognitive demands. Our results from a group of 30 older adults (>65) showed that reducing cognitive demands shortened completion times more extensively than reducing motor demands. Conditions with higher cognitive demands had longer target search time, as well as decreased movement execution velocity and head-hand coordination. We found larger pupil sizes in the more cognitively demanding conditions, and an inverse correlation between pupil size and completion times across individuals in all task conditions. Lastly, we found a possible link between VR-CTT performance measures and clinical signatures of participants (fallers versus non-fallers). In summary, performance and pupil parameters were mainly dependent on task cognitive load, while maintaining systematic interindividual differences. We suggest that this paradigm opens the possibility for more detailed profiling of individual cognitive-motor performance capabilities in older adults and other at-risk populations.

Climate change and its impact on health: a global collaborative learning model.

To address the health effects of climate change, leaders in healthcare have called for action to integrate climate adaptation and mitigation into training programs for health professionals. However, current educators may not possess sufficient climate literacy and the expertise to effectively include such content in their respective healthcare curricula. We, an international and interprofessional partnership, collaborated with experts to develop and deploy curriculum to increase health educators' and graduate health profession students' knowledge and competencies on climate change. In a tri-step process, the first phase included recruiting interested faculty members from two institutions and varying health professions. In phase two, faculty members collaborated to develop a faculty symposium on climate change including educational competencies required of health professions, practice standards, guidelines, and profession-specific content. Symposium outcomes included broader faculty member interest and commitment to create an interprofessional climate change course for healthcare graduate students. In phase three, course development resulted from collaboration between faculty members at the two institutions and faculty members from the Global Consortium on Climate and Health Education (GCCHE), with course objectives informed by GCCHE competencies. Climate experts and faculty members delivered the course content over a 10-week period to 30 faculty members and students representing seven health professions, who were surveyed (n = 13) for feedback. This course can serve as an example for international collaborators interested in developing climate change courses for health profession students. Lessons learned in this process include: climate change novice faculty members can develop impactful climate change courses; students and faculty members can be co-learners; diverse representation in course attendees enriches the learning experience; and collaboration is key.

Learning juggling by gradually increasing difficulty vs. learning the complete skill results in different learning patterns.

Motor learning is central to sports, medicine, and other health professions as it entails learning through practice. To achieve proficiency in a complex motor task, many hours of practice are required. Therefore, finding ways to speed up the learning process is important. This study examines the impact of different training approaches on learning three-ball cascade juggling. Participants were assigned to one of two groups: practicing by gradually increasing difficulty and elements of the juggling movement ("learning in parts") or training on the complete skill from the start ("all-at-once"). Results revealed that although the all-at-once group in the early stages of learning showed greater improvement in performance, the "learning in parts" group managed to catch up, even over a relatively short period of time. The lack of difference in performance between the groups at the end of the training session suggests that the choice of training regime (between all-at-once and learning in parts), at least in the short term, can be selected based on other factors such as the learner's preference, practical considerations, and cognitive style.

The relationship between thoracic posture and ultrasound echo intensity of muscles spanning this region in healthy men and women.

PURPOSE: Skeletal muscle echogenicity intensity (EI) is considered a measure of muscle quality, being associated with old age and pathologies. Whether EI variations can be identified in healthy adults, due to habitual shortened or elongated muscle position is unknown. Thus, this study aimed to assess the relationship between thoracic kyphosis angulation and EI scores of muscles spanning this region ((Lower Trapezius (LT), Rhomboid Major (RM), Erector Spine (ES)) in healthy young people and in addition to examine the relationship between the change in thoracic kyphosis angle from relaxed to upright position (∆°) and the EI of these muscles. METHODS: Thoracic kyphosis in relaxed and erect standing was measured using a digital inclinometer in 29 healthy adults (16 women, 13 men), aged 25-35 years. The thoracic kyphosis angles including the difference between relaxed and erect postures (∆°) were correlated to the EI scores of right and left LT, RM and ES. RESULTS: No significant differences in EI were found between the 3 muscles EI or between sides, hence they were pooled together to a total thoracic EI score (TTEI). Although the TTEI did not correlate with relaxed or erect thoracic kyphosis, it was significantly but negatively correlated with ∆° in the entire group: Pearson's correlation coefficient of r = -0.544; p = .01 and in men; r = -0.732; p = .01, failing to reach significance in women; r = -0.457. CONCLUSION: The negative association between the EI of the explored muscles and ∆° could imply a possible relationship between these muscles range of movement excursions and their composition.