Process-oriented evaluation of fundamental movement skills in children with cerebral palsy

Symposium IIIpostprintThe 3rd HKASMSS Student Conference on Sport Medicine, Rehabilitation and Exercise Science, Hong Kong, 19 June 2010. In Conference Proceedings, 2010, p. 30-3

The possible benefits of reduced errors in the motor skills acquisition of children

An implicit approach to motor learning suggests that relatively complex movement skills may be better acquired in environments that constrain errors during the initial stages of practice. This current concept paper proposes that reducing the number of errors committed during motor learning leads to stable performance when attention demands are increased by concurrent cognitive tasks. While it appears that this approach to practice may be beneficial for motor learning, further studies are needed to both confirm this advantage and better understand the underlying mechanisms. An approach involving error minimization during early learning may have important applications in paediatric rehabilitation. © 2012 Capio et al; licensee BioMed Central Ltd.published_or_final_versio

Assessment of Measures of Physical Activity of Children with Cerebral Palsy at Home and School: A Pilot Study

Home and school are important settings where children can accrue health promoting physical activity (PA). Little is known about the PA levels and associated environmental characteristics at home and school in children with cerebral palsy (CP). An observational tool - Behaviors of Eating and Activity for Children’s Health Evaluation System (BEACHES) - offers potential for providing information. Objective: To validate BEACHES against Actigraph accelerometer and to document PA of children with CP at a special residential school facility for children with physical disabilities. Methods: Five children with CP (2 girls, 3 boys; aged 9.82 ± 2.39 years) in Level I of the Gross Motor Function Classification System (GMFCS) participated. PA monitoring was conducted once a week during four consecutive weeks at morning recess at school and during after school hours at the children’s residence. Estimates of time spent being sedentary and being active were derived from the Actigraph and compared to estimates obtained with BEACHES. Results: Children’s PA observed using BEACHES was comparable to the Actigraph estimations. In general, children were more active at recess than after school and the physical locations assessed by BEACHES were associated with objectively measured PA time. Conclusion: This pilot study indicates that BEACHES appears to be a suitable measure of PA for children with CP in both home and school settings. Additional study with a larger and more diverse sample is recommended to verify the results

Psychophysical effects of subtle modification of the built environment: a quasi-experimental field study

Background: China’s rapid urban growth is associated with an increasingly unhealthy population. Urban planners can design cities to promote healthy lifestyles, but to re-engineer the existing built environment is no simple task. We assessed whether a simple modification of the built environment was associated with altered perceptions of, and ambulation in, that environment. Methods: We adjusted a single-rail stair banister (length 3 m, height 1 m) in an urban area of Hong Kong, China, to increase or decrease the convergence angle with the stairs by 10% (plus or minus 1.91°). When positioned conventionally, the banister was parallel to the stairs (2.19 m width, 26.5° incline). 92 participants (mean age 19.71 [0.79], 54 male and 38 female) who were unaware that the banister diverged from (n=32), converged with (n=30), or was parallel to the stairs (n=30), visually estimated the angle of incline of the stairs from the top by rotating a disk to match the slant of the staircase. Walking speed (metres per second) was video-recorded surreptitiously as a sub-sample of the participants (n=36) approached the stairs with the banister in each position. Data were analysed using one-way analysis of variance followed by Bonferroni comparisons. Ethical approval of the study was obtained from the University of Hong Kong Research Ethics Committee, and participants provided written informed consent to participate. Findings: Visual estimations differed between the groups (F2,70=3.11, p=0.05, ηp2=0.08); estimates of angle were smaller when the banister converged with the stairs (32.53 [8.39]°) than when it diverged (39.69 [9.50]°) (p=0.007) or was parallel (39.88 [8.92]°) (p=0.006). Walking speeds in the final three strides preceding transition to stair descent also differed (F2,70,70=3.11, p=0.05, ηp2=0.08) with mean walking speed slower when the banister diverged (1.24 [0.26] m/s) than when it converged (1.36 [0.19] m/s) (p=0.046). Interpretation: Modification of the angle of a stair banister was associated with differences in perception of the steepness of stairs and in walking behavior during approach to the stairs. Problems associated with rapid urban development, including falls in older people and physical inactivity, are high on the health agenda of the Chinese government. Future work should examine whether stairs that appear less steep are more readily climbed, thus promoting physical activity, and whether stepping parameters are improved, thus promoting fewer falls

Movement pattern components and mastery of an object control skill with error-reduced learning

Objectives: This paper reports the effects of error-reduced learning on movement components and mastery of overhand throwing in children with and without intellectual disability. Methods: Secondary data analysis was performed on two samples of children (typically developing, TD; intellectual disability, ID) who practiced overhand throwing in either an error-reduced (ER) or error-strewn (ES) condition. Movement pattern components were assessed using a sub-skill of Test of Gross Motor Development-2. Results: In TD participants, ER learners displayed improved follow-through while ES learners did not. Among children with ID, ER learners displayed greater improvements of hip/shoulder rotation and follow-through, than ES learners. Discriminant function analysis confirmed that changes in these components differentiated learning groups. Greater percentage of ER, compared to ES, participants progressed to mastery. Conclusions: With suppressed errors, the follow-through component of overhand throwing is likely to emerge, particularly in children with inferior abilities, and cognitive limitations. Error-reduced learning facilitates mastery

Propensity for movement specific reinvestment by physiotherapists: Implications for education

© 2018 Taylor & Francis. Previous studies have shown that the propensity for conscious monitoring and control of movement (i.e. movement specific reinvestment) influences the acquisition of movement skills. Physiotherapists, whose primary function is to promote effective human movement, also develop specialized movement skills that are necessary to perform diagnostic and therapeutic procedures. To explore the implications for promoting expertise, this current study examined physiotherapists’ propensity for movement-specific reinvestment. Practitioners and students in physiotherapy, and other rehabilitation, and non-health professionals, completed the Movement Specific Reinvestment Scale, which measures two dimensions of reinvestment: 1) conscious motor processing (CMP); and 2) movement self-consciousness (MS-C). Physiotherapists scored significantly higher than other professionals on both CMP and MS-C. Specifically among physiotherapists, those with relatively fewer years of practice tended to have higher MS-C scores. Movementspecific reinvestment appears to be a characteristic of physiotherapists that could be relevant for understanding the ways in which novices think and act as they progress to expertise. Further research is recommended to examine the role of reinvestment in performance of different tasks of varying complexity by novice physiotherapists

Movement specific reinvestment and allocation of attention by older adults during walking

© 2015, Marta Olivetti Belardinelli and Springer-Verlag Berlin Heidelberg. Older repeat fallers have previously been shown to have a higher propensity to consciously monitor and control their movements (i.e. reinvestment) than non-fallers, yet to direct their attention equally between their limb movements and the external environment during locomotion (Wong et al. in J Am Geriatr Soc 57: 920–922, 2009). Whether increased attention to their movements is a result of falling or originates from a prior inclination to reinvest remains unclear. In order to better understand the interaction between reinvestment and attention during locomotion, this study examined the allocation of attention by older adults who had not fallen but displayed a high or low inclination for reinvestment. Twenty-eight low and twenty-eight high reinvestors were required to perform 30 walking trials. Their allocation of attention during walking was evaluated by asking tone-related attentional focus questions shortly after finishing each walking trial. High reinvestors were found to be more aware of their limb movements and less aware of the external environment. Low reinvestors, on the contrary, were more aware of the surrounding environment and less aware of their movement mechanics. Given that focusing internally to body movements has been proposed to utilise working memory capacity, the ability of high reinvestors to pick up all the environmental information necessary for successful locomotion might be compromised and requires further examination

The Effects of Fatigued Working Memory Functions on Hypothesis Testing During Acquisition of a Motor Skill

Implicit motor learning paradigms aim to minimize verbal-analytical engagement in motor performance. Some paradigms do this by decreasing working memory activity during practice, which reduces explicit processes associated with the search for motor solutions (e.g., hypothesis testing). Here we designed a mentally demanding motor task to fatigue working memory prior to motor practice and then tested whether it reduced hypothesis testing. Fifty-nine participants were randomly assigned to complete the mentally demanding motor task (cognitive fatigue group) or to complete an undemanding motor task (nonfatigued control group). Feelings of fatigue, working memory functions, electroencephalography (EEG) Fz power, and vagal control were assessed pre and posttask to quantify the effect of the mentally demanding motor task on cognitive fatigue. Thereafter, an adapted shuffleboard task was completed to determine the impact on hypothesis testing. Hypothesis testing was assessed by self-report, technique changes, and equipment-use solutions. Additionally, verbal-analytical engagement in motor performance was (indirectly) gauged with EEG T7-Fz connectivity and T7 power measures. Participants in the cognitive fatigue group reported more fatigue and displayed moderated working memory functions and Fz theta power. During practice of the shuffleboard task, participants also displayed more technique changes and higher verbal-analytical engagement in motor planning (EEG T7-Fz connectivity), compared with participants in the control group. The mentally demanding motor task suppressed workingmemory functions, but resulted in more, rather than less, hypothesis testing during shuffleboard practice. The implications are discussed in the context of implicit motor learning theory

Acquiring visual information for locomotion by older adults: A systematic review

© 2015. Developments in technology have facilitated quantitative examination of gaze behavior in relation to locomotion. The objective of this systematic review is to provide a critical evaluation of available evidence and to explore the role of gaze behavior among older adults during different forms of locomotion. Database searches were conducted to identify research papers that met the inclusion criteria of (1) study variables that included direct measurement of gaze and at least one form of locomotion, (2) participants who were older adults aged 60 years and above, and (3) reporting original research. Twenty-five papers related to walking on a straight path and turning (n = 4), stair navigation (n = 3), target negotiation and obstacle circumvention (n = 13) and perturbation-evoked sudden loss of balance (n = 5) were identified for the final quality assessment. The reviewed articles were found to have acceptable quality, with scores ranging from 47.06% to 94.12%. Overall, the current literature suggests that differences in gaze behavior during locomotion appear to change in late adulthood, especially with respect to transfer of gaze to and from a target, saccade-step latency, fixation durations on targets and viewing patterns. These changes appear to be particularly pronounced for older adults with high risk of falling and impaired executive functioning

Comparing the effects of conscious monitoring and conscious control on motor performance

We compared the effects of conscious monitoring and control on motor performance. Participants were instructed to adopt an internal or external focus of attention in different blocks of a darts task. For one group, the internal as well as external focus instructions emphasized monitoring. For another group, the instructions emphasized control in the two focus conditions. Furthermore, participants’ propensity for monitoring and control was gauged via two factors of the Movement Specific Reinvestment Scale (MSRS) (Masters, Eves, & Maxwell, 2005). These factors were Movement Self-Consciousness (MS-C) and Conscious Motor Processing (CMP), which measure propensity for conscious monitoring and control, respectively. Performance differences between the internal and external focus blocks were expressed as mean radial error (MRE). Results revealed a 3-way interaction between CMP, instruction type (monitoring versus control) and an order effect. Only in the conscious control-group, but not the conscious monitoring-group was there a 2-way interaction between CMP and order. In the conscious control-group, participants with high CMP scores showed worse performance in whichever focus block (internal or external) was presented last. There were no significant effects in the monitoring-group or of MS-C. These findings indicate that conscious control has a stronger effect on motor performance than conscious monitoring