[Clinical characteristics of sexually abused individuals with borderline intellectual functioning or mild intellectual disability: an overview of the literature]. / Klinische kenmerken van seksueel misbruikte mensen met een lichte verstandelijke beperking: een literatuuroverzicht.

BACKGROUND: Sexual abuse in individuals with (above) average iq is associated with a wide range of behavioural and psychological clinical characteristics, including characteristics regarding body experience. However, research on the clinical characteristics of sexually abused individuals with borderline intellectual functioning or mild intellectual disability (bif-mid) is scarce. OBJECTIVE To provide an overview of the literature on the clinical characteristics of sexually abused individuals with bif-mid.
METHOD: PubMed, Embase, PsycInfo, cinahl, Cochrane Library and Web of Science were searched for relevant publications using terms related to 'intellectual disability' and 'sexual abuse'.
RESULTS: Seven studies were included. The studies in question mostly reported behavioural and psychological characteristics such as challenging behaviour, sexualised behaviour or posttraumatic stress, anxiety or depressive symptoms associated with sexual abuse in individuals with bif-mid. None of the studies reported problems regarding body experience. CONCLUSIONS Sexual abuse in individuals with bif-mid is associated with a broad range of behavioural and psychological characteristics similar to that of individuals with (above) average iq. Whether sexually abused individuals with bif-mid have similar problems in body experience as sexually abused individuals with (higher than) average iq needs to be investigated.

Inter-individual differences in stride frequencies during running obtained from wearable data.

The purpose of the present study was to identify factors that underlie differences among runners in stride frequency (SF) as a function of running speed. Participants (N = 256; 85.5% males and 14.5% females; 44.1 ± 9.8 years; 181.4 ± 8.4 cm; 75.3 ± 10.6 kg; mean ± SD) shared their wearable data (Garmin Inc). Individual datasets were filtered to obtain representative relationships between stride frequency (SF) and speed per individual, representing in total 16.128 h of data. The group relationship between SF (72.82 to 94.73 strides · min-1) and running speed (V) (from 1.64 to 4.68 m · s-1) was best described with SF = 75.01 + 3.006 V. A generalised linear model with random effects was used to determine variables associated with SF. Variables and their interaction with speed were entered in a stepwise forward procedure. SF was negatively associated with leg length and body mass and an interaction of speed and age indicated that older runners use higher SF at higher speed. Furthermore, run frequency and run duration were positively related to SF. No associations were found with injury incidence, athlete experience or performance. Leg length, body mass, age, run frequency and duration were associated with SFs at given speeds. KEY POINTS On a group level, stride frequency can be described as a linear function of speed: SF (strides · min-1) = 75.01+ 3.006·speed (m · s-1) within the range of 1.64 to 4.68 m · s-1. On an individual level, the SF-speed relation is best described with a second order polynomial. Leg length and body mass were positively related to stride frequency while age was negatively related to stride frequency. Run frequency and run duration were positively related to stride frequency, while running experience, performance and injury incidence were unrelated.

Effects of handrail hold and light touch on energetics, step parameters, and neuromuscular activity during walking after stroke.

BACKGROUND: Holding a handrail or using a cane may decrease the energy cost of walking in stroke survivors. However, the factors underlying this decrease have not yet been previously identified. The purpose of the current study was to fill this void by investigating the effect of physical support (through handrail hold) and/or somatosensory input (through light touch contact with a handrail) on energy cost and accompanying changes in both step parameters and neuromuscular activity. Elucidating these aspects may provide useful insights into gait recovery post stroke. METHODS: Fifteen stroke survivors participated in this study. Participants walked on a treadmill under three conditions: no handrail contact, light touch of the handrail, and firm handrail hold. During the trials we recorded oxygen consumption, center of pressure profiles, and bilateral activation of eight lower limb muscles. Effects of the three conditions on energy cost, step parameters and neuromuscular activation were compared statistically using conventional ANOVAs with repeated measures. In order to examine to which extent energy cost and step parameters/muscle activity are associated, we further employed a partial least squares regression analysis. RESULTS: Handrail hold resulted in a significant reduction in energy cost, whereas light touch contact did not. With handrail hold subjects took longer steps with smaller step width and improved step length symmetry, whereas light touch contact only resulted in a small but significant decrease in step width. The EMG analysis indicated a global drop in muscle activity, accompanied by an increased constancy in the timing of this activity, and a decreased co-activation with handrail hold, but not with light touch. The regression analysis revealed that increased stride time and length, improved step length symmetry, and decreased muscle activity were closely associated with the decreased energy cost during handrail hold. CONCLUSION: Handrail hold, but not light touch, altered step parameters and was accompanied by a global reduction in muscle activity, with improved timing constancy. This suggests that the use of a handrail allows for a more economic step pattern that requires less muscular activation without resulting in substantial neuromuscular re-organization. Handrail use may thus have beneficial effects on gait economy after stroke, which cannot be accomplished through enhanced somatosensory input alone.

Differential modulations of ipsilateral and contralateral beta (de)synchronization during unimanual force production.

Unilateral movement is usually accompanied by ipsilateral activity in the primary motor cortex (M1). It is still largely unclear whether this activity reflects interhemispheric 'cross-talk' of contralateral M1 that facilitates movement, or results from processes that inhibit motor output. We investigated the role of beta power in ipsilateral M1 during unimanual force production. Significant ipsilateral beta desynchronization occurred during continuous dynamic but not during static force production. Moreover, event-related time-frequency analysis revealed bilateral desynchronization patterns, whereas post-movement synchronization was confined to the contralateral hemisphere. Our findings indicate that ipsilateral activation is not merely the result of interhemispheric cross-talk but involves additional processes. Given observations of differential blood oxygen level-dependent responses in ipsilateral and contralateral M1, and the correlation between beta desynchronization and the firing rate of pyramidal tract neurons in contralateral M1 during movement, we speculate that beta desynchronization in contra- and ipsilateral M1 arises from distinct neural activation patterns.

Walking-adaptability therapy after stroke: results of a randomized controlled trial.

BACKGROUND: The ability to adapt walking to environmental properties and hazards, a prerequisite for safe ambulation, is often impaired in persons after stroke. RESEARCH QUESTION: The aim of this study was to compare the efficacy of two walking-adaptability interventions: a novel treadmill-based C-Mill therapy (using gait-dependent augmented reality) and the standard overground FALLS program (using physical context). We expected sustained improvements for both treatment groups combined but hypothesized better outcomes for C-Mill therapy than the FALLS program due to its expected greater amount of walking practice. METHODS: In this pre-registered single-centre parallel group randomized controlled trial, forty persons after stroke (≥ 3 months ago) with walking and/or balance deficits were randomly allocated to either 5 weeks of C-Mill therapy or the FALLS program. The primary outcome measure was the standard walking speed as determined with the 10-meter walking test (10MWT). Additionally, context-specific walking speed was assessed in environments enriched with either stationary physical context (10MWT context) or suddenly appearing visual images (Interactive Walkway obstacles). The walking-adaptability scores of those enriched walking tests served as secondary outcome measures. Furthermore, a cognitive task was added to all three assessments to evaluate dual-task performance in this context. Finally, the participants' experience and amount of walking practice were scored. The outcome measures were assessed at four test moments: pre-intervention (T0), post-intervention (T1), 5-week post-intervention retention (T2), and 1-year post-intervention follow-up (T3). RESULTS: No significant group differences were found between the interventions for the primary outcome measure standard walking speed, but we found a greater improvement in context-specific walking speed with stationary physical context of the C-Mill therapy compared to the FALLS program at the post-intervention test, which was no longer significant at retention. Both interventions were well received, but C-Mill therapy scored better on perceived increased fitness than the FALLS program. C-Mill therapy resulted in twice as many steps per session of equal duration than the FALLS program. The "change-over-time" analyses for participants of both interventions combined showed no significant improvements in the standard walking speed; however, significant improvements were found for context-specific walking speed, walking adaptability, and cognitive dual-task performance. SIGNIFICANCE: This study showed no between-group differences between the novel treadmill-based C-Mill therapy and the standard overground FALLS program with respect to the primary outcome measure standard walking speed. However, the greater amount of walking practice observed for the C-Mill group, an essential aspect of effective intervention programs after stroke, may underlie the reported increased perceived fitness and observed increased context-specific walking speed for the C-Mill group directly after the intervention. Although the "change-over-time" results for all participants combined showed no improvement in the standard walking speed, context-specific walking speed and walking adaptability showed sustained improvements after the interventions, underscoring the importance of including walking-adaptability training and assessment in rehabilitation post stroke. TRIAL REGISTRATION: The Netherlands Trial Register NTR4030 . Registered 11 June 2013.

Cortico-spinal synchronization reflects changes in performance when learning a complex bimanual task.

Motor performance is accompanied by neural activity in various cortical and sub-cortical areas. This intricate network has to be delicately orchestrated. We analyzed the role of beta synchronization in motor learning using magneto-encephalography combined with electromyography. Cortico-spinal synchronization in the beta band was found to be of particular importance in establishing bimanual movement patterns in the context of a 3:2 polyrhythmic (isometric) force production task. Its dynamics correlated highly with the learning of this complex bimanual motor skill. We submit that the cortical dynamics entrains the spinal motor system by which cortico-spinal beta synchrony serves higher-level motor control functions as primary means of information transfer along the neural axis.

Tapping with intentional drift.

When tapping a desired frequency, subjects tend to drift away from this target frequency. This compromises the estimate of the correlation between inter-tap intervals (ITIs) as predicted by the two-level model of Wing and Kristofferson which consists of an internal timer ('clock') and motor delays. Whereas previous studies on the timing of rhythmic tapping attempted to eliminate drift, we compared the production of three constant frequencies (1.5, 2.0, and 2.5 Hz) to the production of tapping sequences with a linearly decreasing inter-tap interval (ITI) (corresponding to an increase in tapping frequency from 1.5 to 2.5 Hz). For all conditions a synchronization-continuation paradigm was used. Tapping forces and electromyograms of the index-finger flexor and extensor were recorded and ITIs were derived yielding interval variability and model parameters, i.e., clock and motor variances. Electromyographic recordings served to study the influence of tapping frequency on the peripheral part of the tap event. The condition with an increasing frequency was more difficult to perform, as evidenced by an increase in deviation from the intended ITIs. In general, tapping frequency affected force level, inter-tap variability, model parameters, and muscle co-activation. Parameters for the condition with a decreasing ITI were comparable to those found in the constant frequency conditions. That is, although tapping with an intentional drift is different from constant tapping and more difficult to perform, the timing properties of both forms of tapping are remarkably similar and described well by the Wing and Kristofferson model.

Fatigue-related changes in motor-unit synchronization of quadriceps muscles within and across legs.

Two experiments were conducted to examine effects of muscle fatigue on motor-unit synchronization of quadriceps muscles (rectus femoris, vastus medialis, vastus lateralis) within and between legs. We expected muscle fatigue to result in an increased common drive to different motor units of synergists within a leg and, hence, to increased synchronization, i.e., an increased coherence between corresponding surface EMGs. We further expected fatigue-related motor overflow to cause motor-unit synchronization of homologous muscles of both legs, although to a lesser extent than for synergists within a leg. In the first experiment, different levels of fatigue were induced by varying posture (knee angle), whereas in the second experiment fatigue was induced in a fixed posture by instructing participants to produce different force levels. EMG coherence was found in two distinct frequency bands (6-11 and 13-18 Hz) and was higher within a leg than between legs. The fatigue-related increase of 6-11 Hz inter-limb synchronization resembled the increased motor overflow during unimanual contractions and thus hinted at an increase in bilateral coupling. Synchronization at 13-18 Hz was clearly different and appeared to be related to posture.

An adaptive, real-time cadence algorithm for unconstrained sensor placement.

This paper evaluates a new and adaptive real-time cadence detection algorithm (CDA) for unconstrained sensor placement during walking and running. Conventional correlation procedures, dependent on sensor position and orientation, may alternately detect either steps or strides and consequently suffer from false negatives or positives. To overcome this limitation, the CDA validates correlation peaks as strides using the Sylvester's criterion (SC). This paper compares the CDA with conventional correlation methods. 22 volunteers completed 7 different circuits (approx. 140 m) at three gaits-speeds: walking (1.5 m s-1), running (3.4 m s-1), and sprinting (5.2 and 5.7 m s-1), disturbed by various gait-related activities. The algorithm was simultaneously evaluated for 10 different sensor positions. Reference strides were obtained from a foot sensor using a dedicated offline algorithm. The described algorithm resulted in consistent numbers of true positives (85.6-100.0%) and false positives (0.0-2.9%) and showed to be consistently accurate for cadence feedback across all circuits, subjects and sensors (mean ±â€¯SD: 98.9 ±â€¯0.2%), compared to conventional cross-correlation (87.3 ±â€¯13.5%), biased (73.0 ±â€¯16.2) and unbiased (82.2 ±â€¯20.6) autocorrelation procedures. This study shows that the SC significantly improves cadence detection, resulting in robust results for various gaits, subjects and sensor positions.

Fatigue-induced changes of impedance and performance in target tracking.

Kinematic variability is caused, in part, by force fluctuations. It has been shown empirically and numerically that the effects of force fluctuations on kinematics can be suppressed by increasing joint impedance. Given that force variability increases with muscular fatigue, we hypothesized that joint impedance would increase with fatigue to retain a prescribed accuracy level. To test this hypothesis, subjects tracked a target by elbow flexion and extension both with fatigued and unfatigued elbow flexor and extensor muscles. Joint impedance was estimated from controlled perturbations to the elbow. Contrary to the hypothesis, elbow impedance decreased, whereas performance, expressed as the time-on-target, was unaffected by fatigue. Further analysis of the data revealed that subjects changed their control strategy with increasing fatigue. Although their overall kinematic variability increased, task performance was retained by staying closer to the center of the target when fatigued. In conclusion, the present study reveals a limitation of impedance modulation in the control of movement variability.

Basketball jump shooting is controlled online by vision.

An experiment was conducted to examine whether basketball jump shooting relies on online visual (i.e., dorsal stream-mediated) control rather than motor preprogramming. Seventeen expert basketball players (eight males and nine females) performed jump shots under normal vision and in three conditions in which movement initiation was delayed by zero, one, or two seconds relative to viewing the basket. Shots were evaluated in terms of both outcome and execution measures. Even though most shots still landed near the basket in the absence of vision, end-point accuracy was significantly better under normal visual conditions than under the delay conditions, where players tended to undershoot the basket. In addition, an overall decrease of inter-joint coordination strength and stability was found as a function of visual condition. Although these results do not exclude a role of motor preprogramming, they demonstrate that visual sensory information plays an important role in the continuous guidance of the basketball jump shot.

Amplitude and phase dynamics associated with acoustically paced finger tapping.

To gain insight into the brain activity associated with the performance of an acoustically paced synchronization task, we analyzed the amplitude and phase dynamics inherent in magnetoencephalographic (MEG) signals across frequency bands in order to discriminate between evoked and induced responses. MEG signals were averaged with respect to motor and auditory events (tap and tone onsets). Principal component analysis was used to compare amplitude and phase changes during listening and during paced and unpaced tapping, allowing a separation of brain activity related to motor and auditory processes, respectively. Motor performance was accompanied by phasic amplitude changes and increased phase locking in the beta band. Auditory processing of acoustic stimuli resulted in a simultaneous increase of amplitude and phase locking in the theta and alpha band. The temporal overlap of auditory-related amplitude changes and phase locking indicated an evoked response, in accordance with previous studies on auditory perception. The temporal difference of movement-related amplitude and phase dynamics in the beta band, on the other hand, suggested a change in ongoing brain activity, i.e., an induced response supporting previous results on motor-related brain dynamics in the beta band.

Stochastic order parameter equation of isometric force production revealed by drift-diffusion estimates.

We address two questions that are central to understanding human motor control variability: what kind of dynamical components contribute to motor control variability (i.e., deterministic and/or random ones), and how are those components structured? To this end, we derive a stochastic order parameter equation for isometric force production from experimental data using drift-diffusion estimates. We show that the force variability increases with the required force output because of a decrease of deterministic stability and an accompanying increase of noise intensity. A structural analysis reveals that the deterministic component consists of a linear control loop, while the random component involves a noise source that scales with force output. In addition, we present evidence for the existence of a subject-independent overall noise level of human isometric force production.

Theoretical analysis of destabilization resonances in time-delayed stochastic second-order dynamical systems and some implications for human motor control.

A linear stochastic delay differential equation of second order is studied that can be regarded as a Kramers model with time delay. An analytical expression for the stationary probability density is derived in terms of a Gaussian distribution. In particular, the variance as a function of the time delay is computed analytically for several parameter regimes. Strikingly, in the parameter regime close to the parameter regime in which the deterministic system exhibits Hopf bifurcations, we find that the variance as a function of the time delay exhibits a sequence of pronounced peaks. These peaks are interpreted as delay-induced destabilization resonances arising from oscillatory ghost instabilities. On the basis of the obtained theoretical findings, reinterpretations of previous human motor control studies and predictions for future human motor control studies are provided.

MEG-compatible force sensor.

By use of an insulating material we constructed a strain gauge based sensor to measure isometric forces in parallel with magneto-encephalographic recordings (i.e. without interference). The sensor can be used in different geometries to measure force production in different dimensions. Furthermore, it can easily be adapted or modified for specific experimental applications. Finally, on-line processing of the recorded forces, e.g., for the purpose of feedback, can be realized using standard MEG equipment.

Effects of sleep deprivation on event-related fields and alpha activity during rhythmic force production.

The influence of sleep deprivation (SD) on event-related fields and the distribution of power over the scalp of MEG imaged brain activity was studied during acoustically paced rhythmic force production. At the behavioral level, SD resulted in a reduction of the lag (negative asynchrony) between produced forces and acoustic stimuli at higher movement tempos. Principal component analysis of the accompanying MEG activity showed that auditory- and motor-evoked fields were attenuated after SD and revealed an anterior shift of power towards more frontal channels. These results were interpreted in terms of a change of central processing of afferent sensory input due to SD.

Effects of correct and transformed visual feedback on rhythmic visuo-motor tracking: tracking performance and visual search behavior.

The effects of correct and transformed visual feedback on rhythmic unimanual visuo-motor tracking were examined, focusing on tracking performance (accuracy and stability) and visual search behavior. Twelve participants (reduced to 9 in the analyses) manually tracked an oscillating visual target signal in phase (by moving the hand in the same direction as the target signal) and in antiphase (by moving the hand in the opposite direction), while the frequency of the target signal was gradually increased to probe pattern stability. Besides a control condition without feedback, correct feedback (representing the actual hand movement) or mirrored feedback (representing the hand movement transformed by 180 degrees) were provided during tracking, resulting in either in-phase or antiphase visual motion of the target and feedback signal, depending on the tracking mode performed. The quality (accuracy and stability) of in-phase tracking was hardly affected by the two forms of feedback, whereas antiphase tracking clearly benefited from mirrored feedback but not from correct feedback. This finding extends previous results indicating that the performance of visuo-motor coordination tasks is aided by visual feedback manipulations resulting in coherently grouped (i.e., in-phase) visual motion structures. Further insights into visuo-motor tracking with and without feedback were garnered from the visual search patterns accompanying task performance. Smooth pursuit eye movements only occurred at lower oscillation frequencies and prevailed during in-phase tracking and when target and feedback signal moved in phase. At higher frequencies, point-of-gaze was fixated at a location that depended on the feedback provided and the resulting visual motion structures. During in-phase tracking the mirrored feedback was ignored, which explains why performance was not affected in this condition. Point-of-gaze fixations at one of the end-points were accompanied by reduced motor variability at this location, reflecting a form of visuo-motor anchoring that may support the pick up of discrete information as well as the control of hand movements to a desired location.

Effects of velocity and limb loading on the coordination between limb movements during walking.

The authors investigated the effects of velocity (increasing from 0.5 to 5.0 km/hr in steps of 0.5 km/hr) and limb loading on the coordination between arm and leg movements during treadmill walking in 7 participants. Both the consistency of the individual limb movements and the stability of their coordination increased with increasing velocity; the frequency coordination between arm and leg movements was 2:1 at the lower velocities and 1:1 at the higher velocities. The mass manipulation affected the individual limb movements but not their coordination, indicating that a stable walking pattern was preserved. The results differed qualitatively from those obtained in studies on bimanual interlimb coordination, implying that the dynamical principles identified therein are not readily applicable to locomotion.

Movement-related sensory feedback mediates the learning of a new bimanual relative phase pattern.

On the basis of findings emphasizing the role of perceptual consequences in movement coordination, the authors tested the hypothesis that the learning of a new bimanual relative phase pattern would involve the matching of the movement-related sensory consequences (rather than the motor outflow commands) to the to-be-learned pattern. Two groups of participants (n = 10 in each) practiced rhythmically moving their forearms with a phase difference of 30 degrees . In 1 group, a difference in the arms' eigenfrequencies was imposed such that synchronous generation of the left and right motor commands resulted in the required relative phase (30 degrees ), yielding incongruence between the motor commands and their sensory consequences. In the other group, the experimenter imposed no eigenfrequency difference so that the sensory consequences were congruent with the motor commands. Throughout the practice period, performance of both groups was assessed repeatedly for the congruent situation (i.e., no eigenfrequency difference). On those criterion tests, both groups performed the required pattern equally well. The authors discuss that result, which corroborated the hypothesis, from a dynamical systems perspective.