A Method for Using Neurofeedback to Guide Mental Imagery for Improving Motor Skill.

Mental imagery (MI) is gaining attention as a strategy towards endogenous brain stimulation for improving motor skill. Neurofeedback (NF) is commonly used to guide MI in order to activate the relevant brain networks. The current study investigates an individualized EEG-based method for NF through broad consideration of interactions between different brain networks. We selected the change in brain functional connectivity (FC) as an objective neurophysiological measure of change in motor skill during a longitudinal physical training (PT) program. Digital tracing tasks were developed for skill training and the spatial error in tracing was used to gauge the change in skill. We used partial least squares algorithms to find the most robust contributing networks towards correlation between the resting state FC and the acquired motor skill. We used the network with the largest margin for increasing FC as the candidate for NF training while experimenting with MI during a neurofeedback training program. The participant was informed of the changes in instantaneous FC through real-time audio feedback to help guide the MI. We showed over 20% reduction in tracing error through neurofeedback training alone, without any additional PT. We also showed retention of improvement in skill for several days after the completion of neurofeedback training. Our proposed methodology shows promise for a highly individualized approach towards improvement in motor skill. Given that EEG is an accessible health and wellness technology, such a method could provide a practical complementary option towards personalized therapeutic strategies to improve motor function.

Motor imagery training of goal-directed reaching in relation to imagery of reaching and grasping in healthy people.

The study aimed to determine whether four weeks of motor imagery training (MIT) of goal-directed reaching (reaching to grasp task) would affect the cortical activity during motor imagery of reaching (MIR) and grasping (MIG) in the same way. We examined cortical activity regarding event-related potentials (ERPs) in healthy young participants. Our study also evaluated the subjective vividness of the imagery. Furthermore, we aimed to determine the relationship between the subjective assessment of motor imagery (MI) ability to reach and grasp and the cortical activity during those tasks before and after training to understand the underlying neuroplasticity mechanisms. Twenty-seven volunteers participated in MIT of goal-directed reaching and two measurement sessions before and after MIT. During the sessions 128-channel electroencephalography (EEG) was recorded during MIR and MIG. Also, participants assessed the vividness of the MI tasks using a visual analog scale (VAS). The vividness of imagination improved significantly (P < .05) after MIT. A repeated measures ANOVA showed that the task (MIR/MIG) and the location of electrodes had a significant effect on the ERP's amplitude (P < .05). The interaction between the task, location, and session (before/after MIT) also had a significant effect on the ERP's amplitude (P < .05). Finally, the location of electrodes and the interaction between location and session had a significant effect on the ERP's latency (P < .05). We found that MIT influenced the EEG signal associated with reaching differently than grasping. The effect was more pronounced for MIR than for MIG. Correlation analysis showed that changes in the assessed parameters due to MIT reduced the relationship between the subjective evaluation of imagining and the EEG signal. This finding means that the subjective evaluation of imagining cannot be a simple, functional insight into the bioelectrical activity of the cerebral cortex expressed by the ERPs in mental training. The changes we noted in ERPs after MIT may benefit the use of non-invasive EEG in the brain-computer interface (BCI) context.Trial registration: NCT04048083.

Effects of Chinese Martial Arts on Motor Skills in Children between 5 and 6 Years of Age: A Randomized Controlled Trial.

Children's motor skills can be fully developed only by the appropriate stimulation of physical activities and the environment, and the poor development of motor skills greatly increases the risk of cognitive impairment, obesity, and movement coordination disorder. This study aimed to examine the effects of Chinese martial arts on the motor skills of preschool children aged 5−6 years through a randomized controlled trial. A total of 87 children aged 5−6 years served as participants in a martial arts sensory teaching group (MAST, n = 29), a martial arts traditional teaching group (MATT, n = 29), and a free activity group (FA, n = 29). The interventions were conducted twice weekly for a total of 10 weeks, with each session lasting 30 min. Children's motor skills were assessed before and after the intervention using the Movement Assessment Battery for Children (MABC-2). The results indicated that the balance index scores in the MAST (p < 0.001) and MATT (p = 0.014) groups were significantly higher than those in the FA and that the MAST score was significantly higher than the MATT (p = 0.004). Meanwhile, the MAST was significantly higher in total scores on motor skills when compared to the FA (p = 0.039), and the MAST showed significantly higher scores on manual dexterity when compared to both the MATT (p = 0.021) and FA (p = 0.011). Chinese martial arts can significantly improve the balance ability of preschool children, and the MAST method was found to be better than that of the MATT. Meanwhile, the MAST had good potential for the development of preschool children's manual dexterity and their overall level of motor skills.

Effects of Neuromuscular Electrical Stimulation Combined with Repetitive Transcranial Magnetic Stimulation on Upper Limb Motor Function Rehabilitation in Stroke Patients with Hemiplegia.

OBJECTIVE: To investigate the effect of neuromuscular electrical stimulation (NMES) combined with repetitive transcranial magnetic stimulation (rTMS) on upper limb motor dysfunction in stroke patients with hemiplegia. METHODS: A total of 240 stroke patients with hemiplegia who met the inclusion criteria were selected and randomly divided into 4 groups (60 cases in each group): control group, NMES group, rTMS group, and NMES + rTMS group. Before treatment and 4 weeks after treatment, we evaluated and compared the results including Fugl-Meyer assessment of upper extremity (FMA-UE) motor function, modified Barthel index (MBI), modified Ashworth scale (MAS), and motor nerve electrophysiological results among the 4 groups. RESULTS: Before treatment, there was no significant difference in the scores of FMA-UE, MBI, MAS, and motor nerve electrophysiological indexes among the four groups, with comparability. Compared with those before treatment, the scores of the four groups were significantly increased and improved after treatment. And the score of the NMES + rTMS group was notably higher than those in the other three groups. CONCLUSION: NMES combined with rTMS can conspicuously improve the upper extremity motor function and activities of daily life of stroke patients with hemiplegia, which is worthy of clinical application and promotion.

Effect of Yoga on the Motor Proficiency of Children with Autism Spectrum Disorder and the Feasibility of its Inclusion in Special School Environments.

Yoga as a movement-based intervention is increasingly considered to improve the motor skills of children with autism spectrum disorder (ASD). However, there is little evidence of the effect of yoga on their motor skills. The current study aims to explore the effect of group yoga program on motor proficiency of children with ASD and feasibility of its inclusion in special schools. Forty-three children with ASD from four special schools were randomized into yoga (n = 23) and control (n = 20) group. A structured yoga program of 45 min for 12 weeks was delivered by trained yoga teachers who also tracked their daily responses. The Bruininks-Oseretsky Test of Motor Proficiency. Second Edition was used to assess both the groups pre- and postintervention. In conclusion, the study highlighted that yoga appears to have a positive impact on the gross motor rather than fine motor proficiency of children with ASD and is feasible to be delivered as group intervention in special schools.

Coupling between motor cortex and striatum increases during sleep over long-term skill learning.

The strength of cortical connectivity to the striatum influences the balance between behavioral variability and stability. Learning to consistently produce a skilled action requires plasticity in corticostriatal connectivity associated with repeated training of the action. However, it remains unknown whether such corticostriatal plasticity occurs during training itself or 'offline' during time away from training, such as sleep. Here, we monitor the corticostriatal network throughout long-term skill learning in rats and find that non-rapid-eye-movement (NREM) sleep is a relevant period for corticostriatal plasticity. We first show that the offline activation of striatal NMDA receptors is required for skill learning. We then show that corticostriatal functional connectivity increases offline, coupled to emerging consistent skilled movements, and coupled cross-area neural dynamics. We then identify NREM sleep spindles as uniquely poised to mediate corticostriatal plasticity, through interactions with slow oscillations. Our results provide evidence that sleep shapes cross-area coupling required for skill learning.

Disengagement of Motor Cortex during Long-Term Learning Tracks the Performance Level of Learned Movements.

Not all movements require the motor cortex for execution. Intriguingly, dependence on motor cortex of a given movement is not fixed, but instead can dynamically change over the course of long-term learning. For instance, rodent forelimb movements that initially require motor cortex can become independent of the motor cortex after an extended period of training. However, it remains unclear whether long-term neural changes rendering the motor cortex dispensable are a simple function of the training length. To address this issue, we trained mice (both male and female) to perform two distinct forelimb movements, forward versus downward reaches with a joystick, concomitantly over several weeks, and then compared the involvement of the motor cortex between the two movements. Most mice achieved different levels of motor performance between the two movements after long-term training. Of the two movements, the one that achieved higher trial-to-trial consistency (i.e., consistent-direction movement) was significantly less affected by inactivation of motor cortex than the other (i.e., variable-direction movement). Two-photon calcium imaging of motor cortical neurons revealed that the consistent-direction movement activates fewer neurons, producing weaker and less consistent population activity than the variable-direction movement. Together, the motor cortex was less engaged and less necessary for learned movements that achieved higher levels of consistency. Thus, the long-term reorganization of neural circuits that frees the motor cortex from the learned movement is not a mere function of training length. Rather, this reorganization tracks the level of motor performance that the animal achieves during training.SIGNIFICANCE STATEMENT Long-term training of a movement reshapes motor circuits, disengaging motor cortex potentially for automatized execution of the learned movement. Acquiring new motor skills often involves learning of multiple movements (e.g., forehand and backhand strokes when learning tennis), but different movements do not always improve at the same time nor reach the same level of proficiency. Here we showed that the involvement of motor cortex after long-term training differs between similar yet distinct movements that reached different levels of expertise. Motor cortex was less engaged and less necessary for the more proficient movement. Thus, disengagement of motor cortex is not a simple function of training time, but instead tracks the level of expertise of a learned movement.

Contribution of the brain-derived neurotrophic factor and neurometabolites to the motor performance.

Individual motor performance ability is affected by various factors. Although the key factor has not yet completely been elucidated, the brain-derived neurotrophic factor (BDNF) genotype as well as neurometabolites may become contibuting factors depending on the learning stage. We investigated the effects of the Met allele of the BDNF gene and those of the neurometabolites on visuomotor learning. In total, 43 healthy participants performed a visuomotor learning task consisting of 10 blocks using the right index finger (Val66Val, n = 15; Val66Met, n = 15; and Met66Met, n = 13). Glutamate plus glutamine (Glx) concentrations in the primary motor cortex, primary somatosensory cortex (S1), and cerebellum were evaluated using 3-T magnetic resonance spectroscopy in 19 participants who participated in the visuomotor learning task. For the learning stage, the task error (i.e., learning ability) was significantly smaller in the Met66Met group compared with that observed in the remaining groups, irrespective of the learning stage (all p values < 0.003). A significant difference was observed between the Val66Val and Met66Met groups in the learning slope (i.e., learning speed) in the early learning stage (p = 0.048) but not in the late learning stage (all p values> 0.54). Moreover, positive correlations were detected between the learning slope and Glx concentrations in S1 only in the early learning stage (r = 0.579, p = 0.009). The BDNF genotype and Glx concentrations in S1 partially contribute to interindividual variability on learning speed in the early learning stage.

Technology-based methods for the assessment of fine and gross motor skill in children: A systematic overview of available solutions and future steps for effective in-field use.

The present review aims at providing researchers and practitioners with a holistic overview of technology-based methods for the assessment of fine and gross motor skill in children. We conducted a search of electronic databases using Web of Science, PubMed and Google Scholar, including studies published up to March 2020, that assessed fine and/or gross motor skills, and utilized technological assessment of varying study design. A total of 739 papers were initially retrieved, and after title/abstract screening, removal of duplicates, and full-text screening, 47 were included. Results suggest that motor skills can be quantitatively estimated using objective methods based on a wearable- and/or laboratory-based technology, for typically developing (TD) and non-TD children. Fine motor skill assessment solutions were; force transducers, instrumented tablets and pens, surface electromyography, and optoelectronic systems. Gross motor skill assessment solutions were; inertial measurements units, optoelectronic systems, baropodometric mats, and force platforms. This review provides a guide in identifying and evaluating the plethora of available technological solutions to motor skill assessment. Although promising, there is still a need for large-scale studies to validate these approaches in terms of accuracy, repeatability, and usability, where interdisciplinary collaborations between researchers and practitioners and transparent reporting practices should be advocated.

Childhood ischaemic stroke in the basal ganglia can lead to fine motor and anxiety disorders: a retrospective analysis and follow-up of 109 cases.

BACKGROUND: Stroke in children easily causes long-term dysfunction. Whether the prognoses of motor and anxiety disorders are related to the affected stroke area has not been reported. METHODS: One hundred nine cases of children with ischaemic stroke were reviewed and divided into three groups: lenticular nucleus lesions only (lenticular nucleus group), lenticular nucleus and caudate head lesions (caudate head group), and lenticular nucleus and thalamus lesions (thalamus group). Overall prognosis was evaluated by the mRS score. The SCAS-P was used to evaluate anxiety in children aged ≥6 years. RESULTS: mRS scores were ≤ 2 points (mean: 0.62), no significant difference among groups. 3/21 (14.2%) patients in the caudate head group changed handedness, which is significantly higher than other groups. Patients with lesions in thalamus group had significantly higher SCAS-P scores. CONCLUSIONS: The overall prognosis of children with basal ganglia ischaemic stroke is good. However, hand preference changes and anxiety disorders may develop. Patients in the caudate head groups are more likely to suffer from fine motor disorders and changes in handedness. Patients within the thalamus group are more prone to anxiety than patients in the other groups. Anxiety disorders should be noted in children with basal ganglia stroke.

Acquisition and consolidation processes following motor imagery practice.

It well-known that mental training improves skill performance. Here, we evaluated skill acquisition and consolidation after physical or motor imagery practice, by means of an arm pointing task requiring speed-accuracy trade-off. In the main experiment, we showed a significant enhancement of skill after both practices (72 training trials), with a better acquisition after physical practice. Interestingly, we found a positive impact of the passage of time (+ 6 h post training) on skill consolidation for the motor imagery training only, without any effect of sleep (+ 24 h post training) for none of the interventions. In a control experiment, we matched the gain in skill learning after physical training (new group) with that obtained after motor imagery training (main experiment) to evaluate skill consolidation after the same amount of learning. Skill performance in this control group deteriorated with the passage of time and sleep. In another control experiment, we increased the number of imagined trials (n = 100, new group) to compare the acquisition and consolidation processes of this group with that observed in the motor imagery group of the main experiment. We did not find significant differences between the two groups. These findings suggest that physical and motor imagery practice drive skill learning through different acquisition and consolidation processes.

Children with Auditory Brainstem Implant: How Do They Perform in Motor and Language Skills?

BACKGROUND: Young children are able to explore new objects and practice language through the acquisition of motor skills that lead to their overall development. Congenital hearing loss and total vestibular loss may contribute to the delay in speech and motor skill development. OBJECTIVES: To investigate the relationship between motor development performance, speech perception, and language performance in children with auditory brainstem implant (ABI). METHOD: Ten children, aged 4-17 years (mean age 9.76 ± 4.03), fitted with unilateral ABI for at least 2 years due to the presence of labyrinthine aplasia and rudimentary otocyst at least 1 side were included in the study. Several standardized tests, such as Bruininks-Oseretsky Motor Proficiency Test-2 (BOT-2), Children's Auditory Perception Test Battery, Meaningful Auditory Integration Scale (MAIS), and Test of Early Language Development-3, were performed to evaluate their skills of fine motor control, balance, manual dexterity, language, and auditory perception. RESULTS: A significant correlation was established between the BOT-2 manual dexterity and MAIS scores (r = 0.827, p < 0.05) and between the manual dexterity and language skills (for expressive language, r = 0.762, p < 0.05; for receptive language, r = 0.650, p < 0.05). Some of the BOT-2 balance tasks, such as standing on 1 leg on a line with eyes closed, standing on 1 leg on a balance beam with eyes open, standing heel-to-toe on a balance beam, and walking forward heel-to-toe on a line, showed a strong correlation with their receptive and expressive language performance (p < 0.05). CONCLUSION: The current study has indicated that significantly poor manual and balance performances are associated with poor speech perception and language skills in children with ABI. The authors recommend performing a vestibular assessment before and after ABI surgery and the use of a holistic rehabilitation approach, including auditory and vestibular rehabilitation, to support development of the children with ABI.

Motor imagery as a method of maintaining performance in pianists during forced non-practice: a single case study.

Background: Musicians suffer from upper limb playing-related musculoskeletal disorders that often oblige them to periodic inactivity. Objectives: To assess the effectiveness of motor imagery as a means of practice when the physical piano practice is restricted. Methods: A 17-year-old healthy pianist participated in a single subject case study with a multiple baseline design (ABC design). Performance ability was assessed during a period of the no practice, then a period of performing motor imagery and again during a period of another no practice. Assessments were performed subjectively by a professional piano teacher and objectively by the Synthesia software. Three visual analog scales were used to record stress, fatigue, and general psychological state. The participant's motor imagery ability was recorded by the use of the Movement Imagery Questionnaire. Results: There was a statistically significant reduction in performance after no practice. There was no change in performance during motor imagery intervention. The pianist's scores moderately correlated with the general psychological state. The Synthesia scoring presented high correlations with professional piano teacher scoring. Conclusions: Motor imagery seemed to have a positive effect in maintaining the musician's performance level. Synthesia shows promise as an outcome measure for assessing music performance, although further research is needed.

Effects of Quiet Mind Training on Alpha Power Suppression and Fine Motor Skill Acquisition.

The aim of the present study was to investigate the effect of Quiet Mind Training (QMT) on Alpha power suppression and fine motor skill acquisition among novice dart players. 30 novice dart players were randomly assigned either to a QMT or a control condition. Playing skills and Alpha power suppression were assessed at four time-points: at baseline, retention test 1, under pressure conditions, at retention test 2. Over time, Alpha power suppression increased and radial errors decreased but more so in the QMT condition than in the control condition. In contrast to the control condition, darts performance and Alpha power suppression in the QMT condition were also stable under pressure conditions. Results indicated that QMT successfully suppressed Alpha power and improved implicit learning skills.

The Effects of Using Imagery to Elicit an External Focus of Attention.

Background: An external focus of attention has been shown to be superior to adopting an internal focus of attention in a variety of motor skills. Purpose: To examine the efficacy of directing attention externally toward an imagined object when performing the standing long jump. This form of practice was compared to a group of participants that practiced the same motor skill while directing their attention toward an object that was physically present in the practice environment. Method: All participants performed a series of standing long-jumps on a rubber mat. Participants were randomly assigned to either an external focus condition where they were instructed to jump as close as possible to a cone that was directly in front of them. Or they were assigned to an imagery condition in which they were instructed to jump toward an imagined cone. Following acquisition trials, a 24-hr retention and transfer test was completed by all participants. Results: Significant improvement was demonstrated by both groups during acquisition, retention and transfer phases compared to the baseline measure. However, no significant differences were observed between the two experimental conditions. Conclusion: The findings of this experiment demonstrate that attention directed externally toward a physical object and an imagined object has a similar effect.

Children's motor imagery modality dominance modulates the role of attentional focus in motor skill learning.

We investigated whether children's motor imagery dominance modulated the relationship between attentional focus and motor learning of a tossing task. One hundred and thirty-eight boys (age: M = 10.13, SD = 0.65) completed the Movement Imagery Questionnaire - Children (MIQ-C) to determine imagery modality dominance (kinesthetic, internal-visual, external-visual) and were randomly assigned to either an internal (n = 71) or external (n = 67) attentional focus group. Participants completed 60 trials of a tossing task with their non-dominant hand on day 1. Participants in the internal focus group were asked "to focus on the throwing arm", whereas participants in the external focus group were instructed "to focus on the ball." A retention test was conducted 24 h later to assess motor learning. Overall, the results from a nested, multiple linear regression analysis indicated the degree to which internal or external focus influences children's throwing accuracy is dependent upon their motor imagery modality dominance. Specifically, higher levels of external-visual imagery dominance resulted in greater motor learning for children adopting an external focus. In contrast, higher values of kinesthetic imagery dominance resulted in reduced motor learning for children who adopted an external focus. Despite the need for future research, we recommend motor imagery modality dominance assessments be considered when investigating the influence of attentional focus on motor learning, particularly when the target population is children.

Global levels of fundamental motor skills in children: A systematic review.

Competence in fundamental motor skills (FMS) facilitates physical activity participation and is important for children's holistic development. This study aimed to systematically review the FMS levels of children worldwide, using the Test of Gross Motor Development-2 (TGMD-2). In accordance with PRISMA guidelines, studies were identified from searches across 7 databases. Studies were required to: (i) include typically developing children (3-10 years), (ii) be published in English, (iii) have been published between 2004 and 2019 and, (iv) report ≥1 TGMD-2 outcome scores. Extracted data were evaluated based on importance of determinants, strength of evidence, and methodological quality. Data from 64 articles were included. Weighted mean (and standard deviation) scores were calculated for each FMS outcome score. Analyses revealed FMS competence increases across age during childhood, with greater proficiency in locomotor skills than object control skills. Additionally, boys exhibit higher object control skill proficiency than girls. Compared to TGMD-2 normative data, children demonstrate "below average" to "average" FMS levels. This review highlights the scope for FMS development among children worldwide. These findings reinforce the necessity for FMS interventions in early educational settings, as FMS competence is positively associated with physical activity and other health outcomes.

Task Transfer Learning for EEG Classification in Motor Imagery-Based BCI System.

The motor-imagery brain-computer interface system (MI-BCI) has a board prospect for development. However, long calibration time and lack of enough MI commands limit its use in practice. In order to enlarge the command set, we add the combinations of traditional MI commands as new commands into the command set. We also design an algorithm based on transfer learning so as to decrease the calibration time for collecting EEG signal and training model. We create feature extractor based on data from traditional commands and transfer patterns through the data from new commands. Through the comparison of the average accuracy between our algorithm and traditional algorithms and the visualization of spatial patterns in our algorithm, we find that the accuracy of our algorithm is much higher than traditional algorithms, especially as for the low-quality datasets. Besides, the visualization of spatial patterns is meaningful. The algorithm based on transfer learning takes the advantage of the information from source data. We enlarge the command set while shortening the calibration time, which is of significant importance to the MI-BCI application.

EA Improves the Motor Function in Rats with Spinal Cord Injury by Inhibiting Signal Transduction of Semaphorin3A and Upregulating of the Peripheral Nerve Networks.

Peripheral nerve networks (PNNs) play a vital role in the neural recovery after spinal cord injury (SCI). Electroacupuncture (EA), as an alternative medicine, has been widely used in SCI and was proven to be effective on neural functional recovery. In this study, the interaction between PNNs and semaphrin3A (Sema3A) in the recovery of the motor function after SCI was observed, and the effect of EA on them was evaluated. After the establishment of the SCI animal model, we found that motor neurons in the ventral horn of the injured spinal cord segment decreased, Nissl bodies were blurry, and PNNs and Sema3A as well as its receptor neuropilin1 (NRP1) aggregated around the central tube of the gray matter of the spinal cord. When we knocked down the expression of Sema3A at the damage site, NRP1 also downregulated, importantly, PNNs concentration decreased, and tenascin-R (TN-R) and aggrecan were also reduced, while the Basso-Beattie-Bresnahan (BBB) motor function score dramatically increased. In addition, when conducting EA stimulation on Jiaji (EX-B2) acupoints, the highly upregulated Sema3A and NRP1 were reversed post-SCI, which can lessen the accumulation of PNNs around the central tube of the spinal cord gray matter, and simultaneously promote the recovery of motor function in rats. These results suggest that EA may further affect the plasticity of PNNs by regulating the Sema3A signal and promoting the recovery of the motor function post-SCI.

Acquisition and consolidation of sequential footstep movements with physical and motor imagery practice.

Sleep-dependent performance enhancement has been consistently reported after explicit sequential finger learning, even using motor imagery practice (MIP), but whether similar sleep benefits occur after explicit sequential gross motor learning with the lower limbs has been addressed less often. Here, we investigated both acquisition and consolidation processes in an innovative sequential footstep task performed either physically or mentally. Forty-eight healthy young participants were tested before and after physical practice (PP) or MIP on the footstep task, following either a night of sleep (PPsleep and MIPsleep groups) or an equivalent daytime period (PPday and MIPday groups). Results showed that all groups improved motor performance following the acquisition session, albeit the magnitude of enhancement in the MIP groups remained lower relative to the PP groups. Importantly, only the MIPsleep group further improved performance after a night of sleep, while the other groups stabilized their performance after consolidation. Together, these findings demonstrate a sleep-dependent gain in performance after MIP in a sequential motor task with the lower limbs but not after PP. Overall, the present study is of particular importance in the context of motor learning and functional rehabilitation.