Bilateral transfer of motor performance as a function of motor imagery training: a systematic review and meta-analysis.

Objective: The objective of this review was to evaluate the efficacy of mental imagery training (MIT) in promoting bilateral transfer (BT) of motor performance for healthy subjects. Data sources: We searched 6 online-databases (Jul-Dec 2022) using terms: "mental practice," "motor imagery training," "motor imagery practice," "mental training," "movement imagery," "cognitive training," "bilateral transfer," "interlimb transfer," "cross education," "motor learning," "strength," "force" and "motor performance." Study selection and data extraction: We selected randomized-controlled studies that examined the effect of MIT on BT. Two reviewers independently determined if each study met the inclusion criteria for the review. Disagreements were resolved through discussion and, if necessary, by a third reviewer. A total of 9 articles out of 728 initially identified studies were chosen for the meta-analysis. Data synthesis: The meta-analysis included 14 studies for the comparison between MIT and no-exercise control (CTR) and 15 studies for the comparison between MIT and physical training (PT). Results: MIT showed significant benefit in inducing BT compared to CTR (ES = 0.78, 95% CI = 0.57-0.98). The effect of MIT on BT was similar to that of PT (ES = -0.02, 95% CI = -0.15-0.17). Subgroup analyses showed that internal MIT (IMIT) was more effective (ES = 2.17, 95% CI = 1.57-2.76) than external MIT (EMIT) (ES = 0.95, 95% CI = 0.74-1.17), and mixed-task (ES = 1.68, 95% CI = 1.26-2.11) was more effective than mirror-task (ES = 0.46, 95% CI = 0.14-0.78) and normal-task (ES = 0.56, 95% CI = 0.23-0.90). No significant difference was found between transfer from dominant limb (DL) to non-dominant limb (NDL) (ES = 0.67, 95% CI = 0.37-0.97) and NDL to DL (ES = 0.87, 95% CI = 0.59-1.15). Conclusion: This review concludes that MIT can serve as a valuable alternative or supplement to PT in facilitating BT effects. Notably, IMIT is preferable to EMIT, and interventions incorporating tasks that have access to both intrinsic and extrinsic coordinates (mixed-task) are preferred over those that involve only one of the two coordinates (mirror-task or normal-task). These findings have implications for rehabilitation of patients such as stroke survivors.

Elderly may benefit more from motor imagery training in gaining muscle strength than young adults: A systematic review and meta-analysis.

Objective: The current review was aimed to determine the effectiveness of mental imagery training (MIT) on the enhancement of maximum voluntary muscle contraction (MVC) force for healthy young and old adults. Data sources: Six electronic databases were searched from July 2021 to March 2022. Search terms included: "motor imagery training," "motor imagery practice," "mental practice," "mental training," "movement imagery," "cognitive training," "strength," "force," "muscle strength," "performance," "enhancement," "improvement," "development," and "healthy adults." Study selection and data extraction: Randomized controlled trials of MIT in enhancing muscle strength with healthy adults were selected. The decision on whether a study met the inclusion criteria of the review was made by two reviewers independently. Any disagreements between the two reviewers were first resolved by discussion between the two reviewers. If consensus could not be reached, then it would be arbitrated by a third reviewer. Data synthesis: Twenty-five studies including both internal MIT and external MIT were included in meta-analysis for determining the efficacy of MIT on enhancing muscle strength and 22 internal MIT were used for subgroup analysis for examining dose-response relationship of MIT on MVC. Results: MIT demonstrated significant benefit on enhancing muscle strength when compared with no exercise, Effect Size (ES), 1.10, 95% confidence interval (CI), 0.89-1.30, favoring MIT, but was inferior to physical training (PT), ES, 0.38, 95% CI, 0.15-0.62, favoring PT. Subgroup analysis demonstrated that MIT was more effective for older adults (ES, 2.17, 95% CI, 1.57-2.76) than young adults (ES, 0.95, 95% CI, 0.74-1.17), p = 0.0002, and for small finger muscles (ES, 1.64, 95% CI, 1.06-2.22) than large upper extremity muscles (ES, 0.86, 95% CI, 0.56-1.16), p = 0.02. No significant difference was found in the comparison of small finger muscles and large lower extremity muscles, p = 0.19 although the ES of the former (ES, 1.64, 95% CI, 1.06-2.22) was greater than that of the later (ES, 1.20, 95%, 0.88-1.52). Conclusion: This review demonstrates that MIT has better estimated effects on enhancing MVC force compared to no exercise, but is inferior to PT. The combination of MIT and PT is equivalent to PT alone in enhancing muscle strength. The subgroup group analysis further suggests that older adults and small finger muscles may benefit more from MIT than young adults and larger muscles.

Brain Functional Connectivity Is Different during Voluntary Concentric and Eccentric Muscle Contraction.

Previous studies report greater activation in the cortical motor network in controlling eccentric contraction (EC) than concentric contraction (CC) of human skeletal muscles despite lower activation level of the muscle associated with EC. It is unknown, however, whether the strength of functional coupling between the primary motor cortex (M1) and other involved areas in the brain differs as voluntary movements are controlled by a network of regions in the primary, secondary and association cortices. Examining fMRI-based functional connectivity (FC) offers an opportunity to measure strength of such coupling. To address the question, we examined functional MRI (fMRI) data acquired during EC and CC (20 contractions each with similar movement distance and speed) of the right first dorsal interosseous (FDI) muscle in 11 young (20-32 years) and healthy individuals and estimated FC between the M1 and a number of cortical regions in the motor control network. The major findings from the mechanical and fMRI-based FC analysis were that (1) no significant differences were seen in movement distance, speed and stability between the EC and CC; (2) significantly stronger mean FC was found for CC than EC. Our finding provides novel insights for a better understanding of the control mechanisms underlying voluntary movements produced by EC and CC. The finding is potentially helpful for guiding the development of targeted sport training and/or therapeutic programs for performance enhancement and injury prevention.

Effects of Physical Practice and Imagery Practice on Bilateral Transfer in Learning a Sequential Tapping Task.

Recent research on bilateral transfer suggests that imagery training can facilitate the transfer of motor skill from a trained limb to that of an untrained limb above and beyond that of physical practice. To further explore this effect, the present study examined the influence of practice duration and task difficulty on the extent to which imagery training and physical training influences bilateral transfer of a sequential key pressing task. In experiment 1, participants trained on the key pressing task using their non-dominant arm under one of three conditions (physical practice, imagery practice, and no practice). In a subsequent bilateral transfer test, participants performed the sequential task using their untrained dominant arm in either an original order or mirror-ordered sequence. In experiment 2, the same procedures were followed as in experiment 1 except that participants trained with their dominant arm and performed the bilateral transfer task with their non-dominant arm. Results indicated that with extended practice beyond what has been employed in previous studies, physical practice is more effective at facilitating bilateral transfer compared to training with imagery. Interestingly, significant bilateral transfer was only observed for transfer from the non-dominant to the dominant arm with no differences observed between performing the task in an original or mirror ordered sequence. Overall, these findings suggest that imagery training may benefit bilateral transfer primarily at the initial stages of learning, but with extended training, physical practice leads to larger influences on transfer.

Hemispheric activation during planning and execution phases in reaching post stroke: a consort study.

Enhanced activation in the non-lesion hemisphere in stroke patients was widely observed during movement of the affected upper limb, but its functional role related to motor planning and execution is still unknown.This study was to characterize the activation in the non-lesion hemisphere during movement planning and execution by localizing sources of high-density electroencephalography (EEG) signal and estimating the source strength (current density [A/m]).Ten individuals with chronic stroke and shoulder/elbow coordination deficits and 5 healthy controls participated in the study.EEG (64 channels) was recorded from scalp electrodes while the subjects performed a reach task involving shoulder flexion and elbow extension of the affected (patients) or dominant (controls) upper extremity. Sources of the EEG were obtained and analyzed at 17 time points across movement preparation and execution phases. A 3-layer boundary element model was overlaid and used to identify the brain activation sources. A distributed current density model, low-resolution electromagnetic tomography (LORETA) L1 norm method, was applied to the data pre-processed by independent component analysis.Subjects with stroke had stronger source strength in the sensorimotor cortices during the movement compared with the controls. Their contralesional/lesional activation ratio (CTLR) for the primary motor cortices was significantly higher than that of the controls during the movement-planning phase, but not during the execution phase. The CTLR was higher in planning than in the execution phase in the stroke group.Excessive contralesional motor cortical activation appears to be more related to movement preparation rather than execution in chronic stroke.

Bilateral transfer for learning to control timing but not for learning to control fine force.

This study examined the characteristics of bilateral transfer of learning to control timing and fine force from a dominant limb to a nondominant limb. 20 right-handed college students (12 women, 8 men; M age = 21.5 yr., SD = 2.3) learned a sequential task consisting of timing and force control. Each participant completed a pre-test of the task with both hands and then performed 100 practice trials with the dominant hand. A post-test was conducted 1 hr. later. The results showed that after training, participants learned to control the timing and force. Nevertheless, only the time-control learning was transferred to the untrained hand, whereas the force-control learning did not transfer to the untrained hand.

Aging interferes central control mechanism for eccentric muscle contraction.

Previous studies report greater activation in the cortical motor network in controlling eccentric contraction (EC) than concentric contraction (CC) despite lower muscle activation level associated with EC vs. CC in healthy, young individuals. It is unknown, however, whether elderly people exhibiting increased difficulties in performing EC than CC possess this unique cortical control mechanism for EC movements. To address this question, we examined functional magnetic resonance imaging (fMRI) data acquired during EC and CC of the first dorsal interosseous (FDI) muscle in 11 young (20-32 years) and 9 old (67-73 years) individuals. During the fMRI experiment, all subjects performed 20 CC and 20 EC of the right FDI with the same angular distance and velocity. The major findings from the behavioral and fMRI data analysis were that (1) movement stability was poorer in EC than CC in the old but not the young group; (2) similar to previous electrophysiological and fMRI reports, the EC resulted in significantly stronger activation in the motor control network consisting of primary, secondary and association motor cortices than CC in the young and old groups; (3) the biased stronger activation towards EC was significantly greater in the old than the young group especially in the secondary and association cortices such as supplementary and premotor motor areas and anterior cingulate cortex; and (4) in the primary motor and sensory cortices, the biased activation towards EC was significantly greater in the young than the old group. Greater activation in higher-order cortical fields for controlling EC movement by elderly adults may reflect activities in these regions to compensate for aging-related impairments in the ability to control complex EC movements. Our finding is useful for potentially guiding the development of targeted therapies to counteract age-related movement deficits and to prevent injury.

Kinesthetic imagery training of forceful muscle contractions increases brain signal and muscle strength.

The purpose of this study was to compare the effect of training using internal imagery (IMI; also known as kinesthetic imagery or first person imagery) with that of external imagery (EMI; also known as third-person visual imagery) of strong muscle contractions on voluntary muscle strengthening. Eighteen young, healthy subjects were randomly assigned to one of three groups (6 in each group): internal motor imagery (IMI), external motor imagery (EMI), or a no-practice control (CTRL) group. Training lasted for 6 weeks (~15 min/day, 5 days/week). The participants' right arm elbow-flexion strength, muscle electrical activity, and movement-related cortical potential (MRCP) were evaluated before and after training. Only the IMI group showed significant strength gained (10.8%) while the EMI (4.8%) and CTRL (-3.3%) groups did not. Only the IMI group showed a significant elevation in MRCP on scalp locations over both the primary motor (M1) and supplementary motor cortices (EMI group over M1 only) and this increase was significantly greater than that of EMI and CTRL groups. These results suggest that training by IMI of forceful muscle contractions was effective in improving voluntary muscle strength without physical exercise. We suggest that the IMI training likely strengthened brain-to-muscle (BTM) command that may have improved motor unit recruitment and activation, and led to greater muscle output. Training by IMI of forceful muscle contractions may change the activity level of cortical motor control network, which may translate into greater descending command to the target muscle and increase its strength.

Variable practice versus constant practice in the acquisition of wheelchair propulsive speeds.

Previous studies have demonstrated that varied practice (involving several versions of a skill) has advantage over constant practice (involving only one version of a skill) in learning a motor skill. However, the support for variable practice mainly came from studies using discrete motor skills. Therefore, the purpose of the study was to assess if variable practice was more effective than constant practice for the purpose of learning a continuous and real-life motor skill: wheelchair propulsion. A total of 36 able-bodied undergraduate students participated in this study. There were two constant-practice groups. One group practiced wheelchair propulsion on a roller system with a single speed, 30% of the maximum speed (30%-only group), and one group practiced using 55% of the maximum speed (55%-only group). One variable-practice group (variable group) practiced the propulsion with two different speeds, 30 and 55% of the maximum speed. In addition to retention tests, two transfer tests (i.e., tests on 40 and 70% of the maximum speeds) were performed by the three groups after the 10 weeks of training. The results were mixed. The variable-practice group produced significantly fewer absolute errors on both transfer tests than the 30%-only group. However, when compared to the 55%-only group, the variable-practice group only produced significantly fewer absolute errors on the transfer test at 70% speed, but not at 40% speed.

Spatial accuracy demand in aiming movements: kinematic analysis of subtended angle and tolerance width.

Subtended angle has been assumed to be an important factor in both response programming time and kinematic characteristics of aiming movements. Support for this assumption has come mainly from studies in which circular targets have been used. However, with circular targets, the subtended angle covaries with the size of the target in the principal direction of the movement (tolerance width). The purpose of this study was to examine the effects of tolerance width and subtended angle on aiming movement with multiple targets. Participants first hit a 5-cm-diameter circular target located 8 cm to the left of a starting position and then moved another 8 cm left to hit either a 5-cm diameter circular target or a 5- x 1-cm rectangular target oriented either horizontally or vertically, depending on the condition. Analysis showed that reaction times and movement times were longer for the vertical rectangular target, which had a smaller tolerance width than the other two targets. In addition, the vertical rectangular target also showed a greater percentage of secondary-submovement trials, lower movement velocity, and higher peak vertical displacement. Overall, the results indicate that the tolerance width of the target may impose more constraints on aiming movements than subtended angle.

Roles of motor-unit recruitment in producing force variability of simulated muscle contractions.

The purpose of this study was to examine the effect of motor-unit recruitment on force variability by using computer simulated isometric contractions of a hand muscle (i.e., first dorsal interosseus). The force was simulated at 10 levels of excitation, ranging from 10 to 100% of maximum. Two recruitment conditions were simulated to compare the relative effect of motor-unit recruitment (MUR) on the relationship of force variability and level of force. One condition (40%MUR) recruited all motor units at 40% of the maximum excitation level, and the other (50%MUR) recruited all motor units at 50% of the maximum. The 40%MUR condition had a greater number of motor units than the 50%MUR group before the excitation level reached 50% of the maximum. The results showed that force variability increased at a faster rate before the completion of motor-unit recruitment and, thereafter, increased at a slower rate. In addition, the 40%MUR group showed greater force variability than the 50%MUR group. These data suggest that motor-unit recruitment is an important factor in causing force variability.

Average-KR schedule benefits generalized motor program learning.

The main purpose of this study was to examine the effects of average Knowledge of Results (KR) on generalized motor program learning and parameter learning. Two groups of participants (n = 15 per group) performed 80 acquisition trials of sequential timing tasks. All participants were asked to depress sequentially four keys (2, 4, 8, and 6) on the numeric pad portion of the computer keyboard with the index finger of the right hand. The author presented average feedback on timing errors based on 5-trial blocks and compared this feedback schedule with every-trial feedback. Analysis of the delayed no-feedback retention test indicated a strong advantage for the average KR compared with the every-trial condition in both generalized motor program learning and parameter learning. The current results suggest that the average KR schedule may have positive effects on generalized motor program learning and parameter learning.