Age-related decline in GABAergic intracortical inhibition can be counteracted by long-term learning of balance skills.

Ageing induces a decline in GABAergic intracortical inhibition, which seems to be associated not only with decremental changes in well-being, sleep quality, cognition and pain management but also with impaired motor control. So far, little is known regarding whether targeted interventions can prevent the decline of intracortical inhibition in the primary motor cortex in the elderly. Therefore, the present study investigated whether age-related cortical dis-inhibition could be reversed after 6 months of balance learning and whether improvements in postural control correlated with the extent of reversed dis-inhibition. The results demonstrated that intracortical inhibition can be upregulated in elderly subjects after long-term balance learning and revealed a correlation between changes in balance performance and intracortical inhibition. This is the first study to show physical activity-related upregulation of GABAergic inhibition in a population with chronic dis-inhibition and may therefore be seminal for many pathologies in which the equilibrium between inhibitory and excitatory neurotransmitters is disturbed. KEY POINTS: Ageing induces a decline in GABAergic intracortical inhibition. So far, little is known regarding whether targeted interventions can prevent the decline of intracortical inhibition in the primary motor cortex in the elderly. After 6 months of balance learning, intracortical inhibition can be upregulated in elderly subjects. The results of this study also revealed a correlation between changes in balance performance and intracortical inhibition. This is the first study to show physical activity-related upregulation of GABAergic inhibition in a population with chronic dis-inhibition.

What to train first: Balance or explosive strength? Impact on performance and intracortical inhibition.

Explosive strength and balance training are commonly applied to enhance explosive strength and balance performance. Even though both training methods are frequently implemented, ordering effects have largely been neglected. Therefore, the present study aimed to investigate ordering effects of balance and explosive strength training on explosive strength and balance performance as well as changes in short-interval intracortical inhibition (SICI). Two groups of subjects either participated in 4 weeks of balance training followed by 4 weeks of explosive strength training (BT-ET) or vice versa (ET-BT). Before, after 4 and 8 weeks, balance performance, as well as explosive strength, was tested. Additionally, SICI was tested during rest as well as during balance perturbations and explosive contractions. The results show a training specific increase in performance with an increase in balance control followed by an increase in explosive strength in the BT-ET, while the ET-BT increased its balance and explosive strength in the opposite order. There were no significant ordering effects. Both groups showed a significant decrease in SICI during the explosive contractions after the eight weeks of training. When SICI was tested during the balance perturbations, SICI initially increased after the first 4 weeks of training but returned to baseline until the end of the eight weeks. It is suggested that the decrease in SICI with prolonged training might show a disengagement of the motor cortex during the balance task. During the explosive contractions, the low SICI levels are beneficial to provide the necessary level of excitatory cortical drive.

How to Serve Faster in Tennis: The Influence of an Altered Focus of Attention and Augmented Feedback on Service Speed in Elite Players.

ABSTRACT: Keller, M, Kuhn, YA, Lüthy, F, and Taube, W. How to serve faster in tennis: the influence of an altered focus of attention and augmented feedback on service speed in elite players. J Strength Cond Res 35(4): 1119-1126, 2021-Different approaches, such as providing augmented feedback (AF) or adopting an external focus of attention (EF), have been shown to directly enhance performance in recreational athletes. Furthermore, research has shown that combining AF with EF (AF + EF) results in superior performance compared to AF and EF alone. Here, we tested the influence of AF, EF, AF + EF, and an internal focus of attention (IF) on service speed in elite tennis players. High-level national tennis players (19.2 ± 3.7 years) were asked to serve flat serves to a target zone with maximum speed. With respect to service speed, a significant main effect of condition was found (p ≤ 0.001). Post hoc comparisons revealed faster serves for AF compared to control serves without instruction/feedback (p < 0.01) and compared to EF (p < 0.05), whereas no significant difference was found between EF and IF (p = 0.81). The fastest service speeds were found in the AF condition, whereas the combination of AF + EF did not further promote performance. The number of serves landed in the target zone did not differ between conditions (p = 0.17). Thus, no speed-accuracy trade-off was found, indicating that enhanced service speeds did not result in less serves landed in the target zone. Augmented feedback seems most beneficial to instantly enhance tennis serve performance. In contrast to previous studies with recreational sportsmen, EF did not differ from IF, providing further evidence that expertise level and task-relevant instructions mediate the influence of attentional focus on motor performance.

Testing-Specific Skating Performance in Ice Hockey.

ABSTRACT: Hajek, F, Keller, M, Taube, W, von Duvillard, SP, Bell, JW, and Wagner, H. Testing-specific skating performance in ice hockey. J Strength Cond Res 35(12S): S70-S75, 2020-Skating performance generally determines overall performance in ice hockey but has not been measured adequately in the past. Consequently, the aim of the study was to develop and validate a specific overall skating performance test for ice hockey (SOSPT) that includes similar movements and intensities as in competition. Ten male elite under-14-year and under-18-year old ice hockey players performed the SOSPT (2 heats only) and a 40-m on-ice sprinting test twice within 8 days. Additionally, 14 under-15, 18 under-17, and 20 under-20 male elite ice hockey players performed only the SOSPT (4 heats). Time was measured from the first subject's movement during a V-start until crossing the line (40-m on-ice sprinting test), first touch of the shoulder on the mat (heat #1 in the SOSPT) or first touch of the puck with the stick (heat #2 in the SOSPT) using a hand stopwatch. We found a high test-retest reliability of the SOSPT and 40-m on-ice sprinting test (interclass correlation coefficient, >0.7; coefficient of variation, <5%) with highly significant differences (p < 0.001) between the under-15, under-17, and under-20 players, a high correlation (r > 0.70) between an expert rating and the SOSPT, and a low correlation between the 40-m on-ice sprinting test and the SOSPT in the under-14 and under-18 players. The results of the study reveal that the SOSPT is a reliable and valid test to determine the specific overall skating performance in ice hockey players and is more suitable compared with straight skating tests of the 40-m on-ice sprinting test.

Training-, muscle- and task-specific up- and downregulation of cortical inhibitory processes.

Motor cortical contribution was shown to be important for balance control and for ballistic types of movements. However, little is known about the role of cortical inhibitory mechanisms and even less about long(er)-term adaptations of these inhibitory processes. Therefore, the aim of the present study was to investigate the role of intracortical inhibition before and after four weeks of explosive or balance training. Two groups of subjects participated for four weeks either in an explosive training programme of the plantar flexor muscles or in a balance training programme on unstable devices. Adaptations in short-interval intracortical inhibition (SICI) were assessed by applying paired-pulse TMS to the soleus muscle during dynamic plantar flexions, balance perturbations and at rest. Furthermore, SICI was assessed for the untrained tibialis anterior muscle. The results show task-, muscle- and group-specific adaptations in SICI after the training (p = .021) with significantly increased SICI after balance training in the balance task and decreased SICI after explosive training in the ballistic task. The training also caused task- and group-specific behavioural adaptations indicated by improved balance performance after balance training and increased ballistic performance after explosive training. There were no changes in SICI when measured at rest or in the untrained tibialis anterior muscle. This study shows that long(er)-term training improves the ability to modulate cortical inhibitory processes in a task- and muscle-specific manner.

Alterations in the cortical control of standing posture during varying levels of postural threat and task difficulty.

Cortical excitability increases during the performance of more difficult postural tasks. However, it is possible that changes in postural threat associated with more difficult tasks may in themselves lead to alterations in the neural strategies underlying postural control. Therefore, the purpose of this study was to examine whether changes in postural threat are responsible for the alterations in corticospinal excitability and short-interval intracortical inhibition (SICI) that occur with increasing postural task difficulty. Fourteen adults completed three postural tasks (supported standing, free standing, or standing on an unstable board) at two surface heights (ground level or 3 m above ground). Single- and paired-pulse magnetic stimuli were applied to the motor cortex to compare soleus (SOL) and tibialis anterior (TA) test motor-evoked potentials (MEPs) and SICI between conditions. SOL and TA test MEPs increased from 0.35 ± 0.29 to 0.82 ± 0.41 mV (SOL) and from 0.64 ± 0.51 to 1.96 ± 1.45 mV (TA), respectively, whereas SICI decreased from 52.4 ± 17.2% to 39.6 ± 15.4% (SOL) and from 71.3 ± 17.7% to 50.3 ± 19.9% (TA) with increasing task difficulty. In contrast to the effects of task difficulty, only SOL test MEPs were smaller when participants stood at high (0.49 ± 0.29 mV) compared with low height (0.61 ± 0.40 mV). Because the presence of postural threat did not lead to any additional changes in the excitability of the motor corticospinal pathway and intracortical inhibition with increasing task difficulty, it seems unlikely that alterations in perceived threat are primarily responsible for the neurophysiological changes that are observed with increasing postural task difficulty. NEW & NOTEWORTHY We examined how task difficulty and postural threat influence the cortical control of posture. Results indicated that the motor corticospinal pathway and intracortical inhibition were modulated more by task difficulty than postural threat. Furthermore, because the presence of postural threat during the performance of various postural tasks did not lead to summative changes in motor-evoked potentials, alterations in perceived threat are not responsible for the neurophysiological changes that occur with increasing postural task difficulty.

Differences in motor cortical control of the soleus and tibialis anterior.

The tibialis anterior (TA) and the soleus (SOL) are ankle joint muscles with functionally very different tasks. Thus, differences in motor cortical control between the TA and the SOL have been debated. This study compared the activity of the primary motor cortex during dynamic plantarflexions and dorsiflexions and compared this with measures obtained during rest. Single- and paired-pulse transcranial magnetic stimulations known as short-interval intracortical inhibition (SICI) were applied to the cortical representation of either the SOL or the TA muscle. The results show that the range of SICI from rest to activity is significantly greater in the TA than in the SOL. Furthermore, when the TA acts as the agonist during dorsiflexions of the ankle, SICI is almost absent (2.9%). When acting as the antagonist during plantarflexions, intracortical inhibition is significantly increased (28.7%). This task-specific modulation is far less pronounced in the SOL, which displayed higher levels of SICI when acting as the agonist (10.9%) during plantarflexion, but there was no significant inhibition (6.5%) as the antagonist during dorsiflexion. Furthermore, the cortical silent period (CSP) during plantarflexions was significantly longer in the SOL than in the TA during dorsiflexions, accompanied by a greater corticospinal excitability in the TA. Thus, cortical control considerably differs between the SOL and the TA in a way that inhibitory cortical control (SICI and CSP) of the TA is task-specifically adapted in a broader range of movements, whereas inhibition in the SOL muscle is less specific and more limited in its magnitude of modulation.

Age-related reversal of spinal excitability during anticipatory postural control.

INTRODUCTION: An internal perturbation of standing balance activates muscles critical for maintaining balance and is preceded by anticipatory postural adjustments (APAs). In healthy younger adults, a measure of spinal excitability in the form of the Hoffmann (H) reflex becomes depressed during APAs but how aging affects the reflex control of APAs is unknown. METHODS: We compared H reflex excitability profiles in the right soleus muscle, indirectly indicating APA, between younger (n = 11, age 19-24 years), middle-aged (n = 10, age 37-56 years), and older healthy adults (n = 11, age 63-78 years). Subjects rapidly raised the right-dominant arm in response to an auditory cue. The H reflex was evoked 120 ms, 100 ms, 80 ms, 60 ms, 40 ms, 20 ms, and 0 ms before as well as 20 ms after the onset of the right anterior deltoid muscle activation. For data processing, each trial was controlled for the corresponding background EMG activity before normalizing the standing data to the data in sitting in the 8 time bins. RESULTS: All subjects showed a silent period in the soleus background electromyographic activity, suggesting the presence of APA. We found that the stereotypical H reflex depression associated with APAs in younger adults was reduced in middle-aged adults and reversed to facilitation in older adults. The depression occurred in 10 out of 11 younger adults, whereas all 11 older adults exhibited facilitation. CONCLUSION: Because APAs are organized at the supraspinal level, we speculate a supraspinal origin of the age-related reflex facilitation during APAs.

Motor Imagery during Action Observation of Locomotor Tasks Improves Rehabilitation Outcome in Older Adults after Total Hip Arthroplasty.

This study aimed at determining whether the combination of action observation and motor imagery (AO + MI) of locomotor tasks could positively affect rehabilitation outcome after hip replacement surgery. Of initially 405 screened participants, 21 were randomly split into intervention group (N = 10; mean age = 64 y; AO + MI of locomotor tasks: 30 min/day in the hospital, then 3×/week in their homes for two months) and control group (N = 11, mean age = 63 y, active controls). The functional outcomes (Timed Up and Go, TUG; Four Step Square Test, FSST; and single- and dual-task gait and postural control) were measured before (PRE) and 2 months after surgery (POST). Significant interactions indicated better rehabilitation outcome for the intervention group as compared to the control group: at POST, the intervention group revealed faster TUG (p = 0.042), FSST (p = 0.004), and dual-task fast-paced gait speed (p = 0.022), reduced swing-time variability (p = 0.005), and enhanced cognitive performance during dual tasks while walking or balancing (p < 0.05). In contrast, no changes were observed for body sway parameters (p ≥ 0.229). These results demonstrate that AO + MI is efficient to improve motor-cognitive performance after hip surgery. Moreover, only parameters associated with locomotor activities improved whereas balance skills that were not part of the AO + MI intervention were not affected, demonstrating the specificity of training intervention. Overall, utilizing AO + MI during rehabilitation is advised, especially when physical practice is limited.

Is Young Age a Limiting Factor When Training Balance? Effects of Child-Oriented Balance Training in Children and Adolescents.

PURPOSE: Balance training (BT) studies in children reported conflicting results without evidence for improvements in children under the age of 8. The aim of this study therefore was to compare BT adaptations in children of different age groups to clarify whether young age prevents positive training outcomes. METHODS: The effects of 5 weeks of child-oriented BT were tested in 77 (38 girls and 39 boys) participants of different age groups (6-7 y, 11-12 y, and 14-15 y) and compared with age-matched controls. Static and dynamic postural control, explosive strength, and jump height were assessed. RESULTS: Across age groups, dynamic postural sway decreased (-18.7%; P = .012; [Formula: see text]) and explosive force increased (8.6%; P = .040; [Formula: see text]) in the intervention groups. Age-specific improvements were observed in dynamic postural sway, with greatest effects in the youngest group (-28.8%; P = .026; r = .61). CONCLUSION: In contrast to previous research using adult-oriented balance exercises, this study demonstrated for the first time that postural control can be trained from as early as the age of 6 years in children when using child-oriented BT. Therefore, the conception of the training seems to be essential in improving balance skills in young children.

Peripheral and central fatigue after high intensity resistance circuit training.

INTRODUCTION: The aim of this study was to investigate the effects of high intensity resistance circuit (HIRC) and traditional strength training (TST) on neuromuscular fatigue and metabolic responses. METHODS: Twelve trained young subjects performed HIRC and TST in a counterbalanced order with 1 week rest in-between. The amount of workload and the inter-set time for each local muscle group were matched (180 s), however, the time between successive exercises differed. The twitch interpolation technique was used to test neuromuscular function of the knee extensor muscles. Blood lactate concentration was used to evaluate metabolic responses. RESULTS: Maximum voluntary contraction and resting potentiated twitch amplitude (Qtw ) were significantly reduced after HIRC, but there were not changes after TST, while reductions in voluntary activation were similar. Lactate concentration increased significantly more after HIRC. CONCLUSIONS: The higher lactate concentration after HIRC probably impaired excitation-contraction coupling, indicating larger peripheral fatigue than after TST. Muscle Nerve 56: 152-159, 2017.

Changes in balance coordination and transfer to an unlearned balance task after slackline training: a self-organizing map analysis.

How humans maintain balance and change postural control due to age, injury, immobility or training is one of the basic questions in motor control. One of the problems in understanding postural control is the large set of degrees of freedom in the human motor system. Therefore, a self-organizing map (SOM), a type of artificial neural network, was used in the present study to extract and visualize information about high-dimensional balance strategies before and after a 6-week slackline training intervention. Thirteen subjects performed a flamingo and slackline balance task before and after the training while full body kinematics were measured. Range of motion, velocity and frequency of the center of mass and joint angles from the pelvis, trunk and lower leg (45 variables) were calculated and subsequently analyzed with an SOM. Subjects increased their standing time significantly on the flamingo (average +2.93 s, Cohen's d = 1.04) and slackline (+9.55 s, d = 3.28) tasks, but the effect size was more than three times larger in the slackline. The SOM analysis, followed by a k-means clustering and marginal homogeneity test, showed that the balance coordination pattern was significantly different between pre- and post-test for the slackline task only (χ 2 = 82.247; p < 0.001). The shift in balance coordination on the slackline could be characterized by an increase in range of motion and a decrease in velocity and frequency in nearly all degrees of freedom simultaneously. The observation of low transfer of coordination strategies to the flamingo task adds further evidence for the task-specificity principle of balance training, meaning that slackline training alone will be insufficient to increase postural control in other challenging situations.

Behavioral and neural adaptations in response to five weeks of balance training in older adults: a randomized controlled trial.

BACKGROUND: While the positive effect of balance training on age-related impairments in postural stability is well-documented, the neural correlates of such training adaptations in older adults remain poorly understood. This study therefore aimed to shed more light on neural adaptations in response to balance training in older adults. METHODS: Postural stability as well as spinal reflex and cortical excitability was measured in older adults (65-80 years) before and after 5 weeks of balance training (n = 15) or habitual activity (n = 13). Postural stability was assessed during one- and two-legged quiet standing on a force plate (static task) and a free-swinging platform (dynamic task). The total sway path was calculated for all tasks. Additionally, the number of errors was counted for the one-legged tasks. To investigate changes in spinal reflex excitability, the H-reflex was assessed in the soleus muscle during quiet upright stance. Cortical excitability was assessed during an antero-posterior perturbation by conditioning the H-reflex with single-pulse transcranial magnetic stimulation. RESULTS: A significant training effect in favor of the training group was found for the number of errors conducted during one-legged standing (p = .050 for the static and p = .042 for the dynamic task) but not for the sway parameters in any task. In contrast, no significant effect was found for cortical excitability (p = 0.703). For spinal excitability, an effect of session (p < .001) as well as an interaction of session and group (p = .009) was found; however, these effects were mainly due to a reduced excitability in the control group. CONCLUSIONS: In line with previous results, older adults' postural stability was improved after balance training. However, these improvements were not accompanied by significant neural adaptations. Since almost identical studies in young adults found significant behavioral and neural adaptations after four weeks of training, we assume that age has an influence on the time course of such adaptations to balance training and/or the ability to transfer them from a trained to an untrained task.

Repetitive activation of the corticospinal pathway by means of rTMS may reduce the efficiency of corticomotoneuronal synapses.

Low-frequency rTMS applied to the primary motor cortex (M1) may produce depression of motor-evoked potentials (MEPs). This depression is commonly assumed to reflect changes in cortical circuits. However, little is known about rTMS-induced effects on subcortical circuits. Therefore, the present study aimed to clarify whether rTMS influences corticospinal transmission by altering the efficiency of corticomotoneuronal (CM) synapses. The corticospinal transmission to soleus α-motoneurons was evaluated through conditioning of the soleus H-reflex by magnetic stimulation of either M1 (M1-conditioning) or the cervicomedullary junction (CMS-conditioning). The first facilitation of the H-reflex (early facilitation) was determined after M1- and CMS-conditioning. Comparison of the early facilitation before and after 20-min low-frequency (1 Hz) rTMS revealed suppression with M1- (-17 ± 4%; P = 0.001) and CMS-conditioning (-6 ± 2%; P = 0.04). The same rTMS protocol caused a significant depression of compound MEPs, whereas amplitudes of H-reflex and M-wave remained unaffected, indicating a steady level of motoneuronal excitability. Thus, the effects of rTMS are likely to occur at a premotoneuronal site-either at M1 and/or the CM synapse. As the early facilitation reflects activation of direct CM projections, the most likely site of action is the synapse of the CM neurons onto spinal motoneurons.

Intracortical inhibition in the soleus muscle is reduced during the control of upright standing in both young and old adults.

PURPOSE: In a previous study, we reported that a short-interval intracortical inhibition (SICI) decreases in old but not in young adults when standing on foam vs. a rigid surface. Here, we examined if such an age by task difficulty interaction in motor cortical excitability also occurs in easier standing tasks. METHODS: Fourteen young (23 ± 2.7 years) and fourteen old (65 ± 4.1 years) adults received transcranial magnetic brain stimulation and peripheral nerve stimulation, while they stood with or without support on a force platform. RESULTS: In the soleus, we found that SICI was lower in unsupported (35 % inhibition) vs. supported (50 %) standing (p = 0.007) but similar in young vs. old adults (p = 0.591). In the tibialis anterior, SICI was similar between conditions (p = 0.597) but lower in old (52 %) vs. young (72 %) adults (p = 0.030). Age and standing with or without support did not affect the Hoffmann reflex in the soleus. CONCLUSIONS: The current data suggest that the motor cortex is involved in standing control, and that its role becomes more prominent with an increase in task difficulty.

Accuracy of PARTwear Inertial Sensor and Optojump Optical Measurement System for Measuring Ground Contact Time During Running.

Ammann, R, Taube, W, and Wyss, T. Accuracy of PARTwear inertial sensor and Optojump optical measurement system for measuring ground contact time during running. J Strength Cond Res 30(7): 2057-2063, 2016-The aim of this study was to validate the detection of ground contact time (GCT) during running in 2 differently working systems: a small inertial measurement sensor, PARTwear (PW), worn on the shoe laces, and the optical measurement system, Optojump (OJ), placed on the track. Twelve well-trained subjects performed 12 runs each on an indoor track at speeds ranging from 3.0 to 9.0 m·s. GCT of one step per run (total 144) was simultaneously obtained by the PW, the OJ, and a high-speed video camera (HSC), whereby the latter served as reference system. The sampling rate was 1,000 Hz for all methods. Compared with the HSC, the PW and the OJ systems underestimated GCT by -1.3 ± 6.1% and -16.5 ± 6.7% (p-values ≤ 0.05), respectively. The intraclass correlation coefficients between PW and HSC and between OJ and HSC were 0.984 and 0.853 (p-values < 0.001), respectively. Despite the constant systematic underestimation of GCT, analyses indicated that PW successfully recorded GCT over a wide range of speeds. However, results showed only moderate validity for the OJ system, with increasing errors when speed decreased. In conclusion, the PW proved to be a highly useful and valid application, and its use can be recommended not only for laboratory settings but also for field applications. In contrast, data on GCT obtained by OJ during running must be treated with caution, specifically when running speed changes or when comparisons are made with GCT data collected by other measurement systems.

Enhanced jump performance when providing augmented feedback compared to an external or internal focus of attention.

Factors such as an external focus of attention (EF) and augmented feedback (AF) have been shown to improve performance. However, the efficacy of providing AF to enhance motor performance has never been compared with the effects of an EF or an internal focus of attention (IF). Therefore, the aim of the present study was to identify which of the three conditions (AF, EF or IF) leads to the highest performance in a countermovement jump (CMJ). Nineteen volunteers performed 12 series of 8 maximum CMJs. Changes in jump height between conditions and within the series were analysed. Jump heights differed between conditions (P < 0.001), resulting in best performance with AF (32.04 ± 7.11 cm), followed by EF (31.21 ± 6.67 cm) and IF (30.77 ± 6.87 cm). Significantly different (P < 0.001) within-series effects of higher jump heights at the end of the series in AF (+1.60%) and lower jump heights at the end of the series in EF (-1.79%) and IF (-1.68%) were observed. Muscle activity did not differ between conditions. The differences between conditions and within the series provide evidence that AF leads to higher performance and better progression within one series than EF and IF. Consequently, AF seems to outperform EF and IF when maximising jump height.

Online and post-trial feedback differentially affect implicit adaptation to a visuomotor rotation.

Multiple motor learning processes can be discriminated in visuomotor rotation paradigms. At least four processes have been proposed: Implicit adaptation updates an internal model based on prediction errors. Model-free reinforcement reinforces actions that achieve task success. Use-dependent learning favors repetition of prior movements, and strategic learning uses explicit knowledge about the task. The current experiment tested whether the processes involved in motor learning differ when visual feedback is altered. Specifically, we hypothesized that online and post-trial feedback would cause different amounts of implicit adaptation. Twenty subjects performed drawing movements to targets under a 45° counterclockwise visuomotor rotation while aiming at a clockwise adjacent target. Subjects received visual feedback via a cursor on a screen. One group saw the cursor throughout the movement (online feedback), while the other only saw the final position after movement execution (post-trial feedback). Both groups initially hit the target by applying the strategy. After 80 trials, subjects with online feedback had drifted in clockwise direction [mean direction error: 15.1° (SD 11.2°)], thus overcompensating the rotation. Subjects with post-trial feedback remained accurate [mean: 0.7° (SD 2.0°), TIME × GROUP: F = 3.926, p = 0.003]. We interpret this overcompensation to reflect implicit adaptation isolated from other mechanisms, because it is driven by prediction error rather than task success (model-free reinforcement) or repetition (use-dependent learning). The current findings extend previous work (e.g., Mazzoni and Krakauer in J Neurosci 26:3642-3645, 2006; Hinder et al. in Exp Brain Res 201:191-207, 2010) and suggest that online feedback promotes more implicit adaptation than does post-trial feedback.

Immediate effects of visuomotor tracking with the head on cervical sensorimotor function and pain in chronic neck pain patients.

BACKGROUND: Working in awkward and sustained postures is, besides psychosocial risk factors, the most reported physical risk factor for neck pain. Accurate proprioception is fundamental to correcting awkward head-to-trunk positions, but impaired proprioceptive performance has been found in patients with chronic neck pain. OBJECTIVE: The aim was to compare the effectiveness of two different interventions in a workplace set-up on sensorimotor performance and pain sensitivity in people with chronic neck pain. METHODS: A total of 25 patients with chronic neck pain participated in this double-blind study. Patients were randomly allocated to the visuomotor tracking task group or the video group (watching a massage video, imagining themselves being massaged). The primary outcomes were cervical joint position sense acuity and pressure pain threshold of the cervical spine, evaluated by a blinded assessor. RESULTS: There were significant time by group interactions for cervical joint position sense acuity (F1;23: 4.38; p= 0.048) and pressure pain threshold (F1;23: 5.78; p= 0.025), with the tracking task group being more accurate in cervical joint position sense testing and less pain sensitive for pressure pain threshold. CONCLUSIONS: The visuomotor tracking task improves cervical joint position sense acuity and reduces pressure pain threshold immediately after intervention in people with chronic neck pain.

What interventions can treat arthrogenic muscle inhibition in patients with chronic ankle instability? A systematic review with meta-analysis.

PURPOSE: To identify, critically appraise, and synthesize the existing evidence regarding the effects of therapeutic interventions on arthrogenic muscle inhibition (AMI) in patients with chronic ankle instability (CAI). MATERIALS AND METHODS: Two reviewers independently performed exhaustive database searches in Web of Science, PubMed, Medline, CINAHL, and SPORTDiscus. RESULTS: Nine studies were finally included. Five types of disinhibitory interventions were identified: focal ankle joint cooling (FAJC), manual therapy, fibular reposition taping (FRT), whole-body vibration (WBV), and transcranial direct current stimulation (tDCS). There were moderate effects of FAJC on spinal excitability in ankle muscles (g = 0.55, 95% CI = 0.03-1.08, p = 0.040 for the soleus and g = 0.54, 95% CI = 0.01-1.07, p = 0.046 for the fibularis longus). In contrast, manual therapy, FRT, WBV were not effective. Finally, 4 weeks of tDCS combined with eccentric exercise showed large effects on corticospinal excitability in 2 weeks after the intervention (g = 0.99, 95% CI = 0.14-1.85 for the fibularis longus and g = 1.02, 95% CI = 0.16-1.87 for the tibialis anterior). CONCLUSIONS: FAJC and tDCS may be effective in counteracting AMI. However, the current evidence of mainly short-term studies to support the use of disinhibitory interventions is too limited to draw definitive conclusions.

Therapeutic interventions on arthrogenic muscle inhibition (AMI) in patients with chronic ankle instability are scarce.Current studies incorporate mainly short-term therapeutic interventions.Focal ankle joint cooling seems effective to treat AMI.Several weeks of transcranial direct current stimulation may also be effective to counteract arthrogenic muscle inhibition but more studies are needed.