Motor Learning and Virtual Reality in Down Syndrome; a Literature Review

 Down syndrome (DS) is caused by trisomy of human chromosome 21 (Hsa21) and results in a large number of phenotypes including learning difficulties, cardiac defects and distinguishing facial features. The purpose of this study was to analyse research findings about “motor learning†and “virtual reality†in patients with DS. Relevant studies were identified by searching PubMed, Web of Science and BVS. Using key words, we searched for articles that included Down syndrome, virtual reality, and motor learning. Only studies on humans were eligible. The search  identified seven relevant papers. Most studies showed that individuals with Down syndrome are able to learn new tasks, and that improvements can be enhanced via the use of virtual reality. We conclude that individuals with Down syndrome respond positively and effectively, with improvements in sensory motor control, when stimulated with tasks that are complementary to conventional therapy, including therapy involving virtual reality

Maze computer performance in Down syndrome

Introduction: These changes are the main causes of defi cits in perceptual-motor skills responsible for motor skill acquisition and performance of functional activities. AIMS: The current study aimed at verifying the quantitative performance of people with DS in undertaking a computer task to compare the performances of typical development (TD). Method: 60 subjects participated in the study, 30 with Down’s syndrome and 30 with typical development, matched by sex. Individuals were aged from 10–36. The groups were divided into three subgroups by age: Group 1 (G1) 10–18; Group 2 (G2) 18–25; Group 3 (G3) 25–36. They performed a computer maze task. During the acquisition phase all groups attempted the maze 30 times, and then after 5 minutes they performed 5 repetitions of Maze 1 for the retention phase. Finally, for the transfer phase, they performed fi ve repetitions in Maze 2. The dependent variables were submitted to a group, age group, gender and block ANOVA with repeated measures on the last factor. Results: In acquisition phase there was a significant decrease in movement time (MT) between the fi rst and last acquisition block, but only for the DS-group. In retention, there was a significant effect of Group, and an interaction between Block and Group, indicating that MTs increased from retention to transfer, but only for the DS-group. Conclusion: It was found that participants with DS improved performance during acquisition and retention, but they had diffi culty in performing the transfer of the computational task for a similar situation. The age and gender were not signifi cant in any of the stages of the study.Introduction: These changes are the main causes of defi cits in perceptual-motor skills responsible for motor skill acquisition and performance of functional activities. AIMS: The current study aimed at verifying the quantitative performance of people with DS in undertaking a computer task to compare the performances of typical development (TD). Method: 60 subjects participated in the study, 30 with Down’s syndrome and 30 with typical development, matched by sex. Individuals were aged from 10–36. The groups were divided into three subgroups by age: Group 1 (G1) 10–18; Group 2 (G2) 18–25; Group 3 (G3) 25–36. They performed a computer maze task. During the acquisition phase all groups attempted the maze 30 times, and then after 5 minutes they performed 5 repetitions of Maze 1 for the retention phase. Finally, for the transfer phase, they performed fi ve repetitions in Maze 2. The dependent variables were submitted to a group, age group, gender and block ANOVA with repeated measures on the last factor. Results: In acquisition phase there was a significant decrease in movement time (MT) between the fi rst and last acquisition block, but only for the DS-group. In retention, there was a significant effect of Group, and an interaction between Block and Group, indicating that MTs increased from retention to transfer, but only for the DS-group. Conclusion: It was found that participants with DS improved performance during acquisition and retention, but they had diffi culty in performing the transfer of the computational task for a similar situation. The age and gender were not signifi cant in any of the stages of the study

Motor learning and transfer between real and virtual environments in young people with autism spectrum disorder: a prospective randomized cross over controlled trial

Autism spectrum disorder (ASD) is associated with persistent deficits in social communication and social interaction, including impaired multisensory integration which might negatively impact cognitive and motor skill performance, and hence negatively affect learning of tasks. Considering that tasks in virtual environment may provide an engaging tool as adjuncts to conventional therapies, we set out to compare motor performance between young people with ASD and a typically developing (TD) control group that underwent coincident timing tasks based on Kinect (no physical contact) and on Keyboard (with physical contact) environments. Using a randomized repeated cross-over controlled trial design, fifty young people with ASD and fifty with TD, matched by age and sex were divided into subgroups of 25 people that performed the two first phases of the study (acquisition and retention) on the same device – real or virtual – and then switched to the other device to repeat acquisition and retention phases and finally switched on to a touch screen (transfer phase). Results showed that practice in the virtual task was more difficult (producing more errors), but led to a better performance in the subsequent practice in the real task, with more pronounced improvement in the ASD as compared to the TD group. It can be concluded that the ASD group managed to transfer the practice from a virtual to a real environment, indicating that virtual methods may enhance learning of motor and cognitive skills. A need for further exploration of its effect across a number of tasks and activities is warranted.

Motor learning through a non-immersive virtual task in people with limb-girdle muscular dystrophies

Introduction: Limb-girdle muscular dystrophies (LGMDs) are neuromuscular and genetic disorders that progress with weakness and damage of the proximal muscles, developing with loss of functionality. Virtual reality environments are suggested as an effective alternative for performance of daily life activities. However, there is no evidence in the literature on the use of virtual reality in this population. Objective: Assess motor performance through a motor learning protocol in a coincident timing task. Methods: 10 participants with LGMD and 10 healthy individuals were selected and included in the study to perform a non-immersive virtual reality task divided into three phases: acquisition (20 attempts), retention (5 attempts), and transfer (5 attempts, with speed increase). Results: It is observed that the accuracy of movement improves from the beginning to the end of the acquisition (p = 0.01); however, there is a marginal difference between the groups in block A1 (p = 0.089). Regarding the variability of touches, observed by the variable error, both groups improved performance in all phases. Conclusion: Even with lower performance than the control group at the beginning of the practice, individuals with LGMD showed the potential to optimize motor function during the practice of a non-immersive virtual reality activity and were able to match their performance with the control group after a few attempts

Verification of performance analysis in Down syndrome through a maze game on mobile phone

Introdução: A síndrome de Down (SD) é uma alteração genética caracterizada pela presença de um cromossomo extra, suas principais dificuldades são causadas pelas alterações motoras e cognitivas que interferem na capacidade de realizar atividades diárias. Para propiciar funcionalidade às pessoas com SD, uma opção é utilizar tarefas em ambiente de realidade virtual para possibilitar o ganho de habilidades motoras. Objetivo: Avaliar o desempenho de pessoas com SD em tarefa virtual em telefone móvel. Método: Foi utilizado o jogo Marble Maze Classic®, onde os participantes moviam o telefone móvel para conduzir uma bola virtual por um desenho de labirinto. Foram avaliadas 100 pessoas separadas em dois grupos, sendo o grupo 1 (controle) formado por 25 participantes com Desenvolvimento Típico e grupo 2 (experimental) formado por 25 pessoas com SD, sendo o desenho do labirinto do grupo 2 totalmente oposto ao do grupo 1. Como variável dependente utilizou-se o tempo em segundos e foram submetidas a ANOVA. As comparações post-hoc foram realizadas por meio do teste Tukey-HSD (p < 0,05). Resultados: O grupo controle manteve o desempenho na fase de retenção e conseguiram transferir tanto no labirinto 1 como no 2. Já o grupo SD conseguiu transferir a tarefa apenas no labirinto 2. No labirinto 1 não conseguiu transferir quando invertemos o início e o fim do trajeto. Conclusão: Pessoas com SD conseguiram se adaptar a tarefa proposta, porém com desempenho sempre inferior às pessoas com DT. Assim como, demonstraram dificuldade em manter o desempenho com o aumento do grau de dificuldade da tarefa, o que sugere que novas tecnologias devem ser adaptáveis às dificuldades de pessoas com SD, permitindo assim maior funcionalidadeIntroduction: Down syndrome (DS) is a genetic disorder characterized by the presence of an extra chromosome, which is typically associated with motor and cognitive changes that interfere with the ability to perform daily activities. To provide functionality to individuals with DS, one option is to use tasks in a virtual reality environment to enable gains in motor skills. Objective: To evaluate the performance of individuals with DS in a virtual task on a mobile phone. Method: The game Marble Maze Classic® was used, in which the participants moved the mobile phone to conduct a virtual marble through a maze design. We evaluated 100 individuals divided into group 1 and 2, where each group consisted of 25 participants in the control group (typical development) and 25 in the experimental group (DS), with group 2 using a maze design totally opposite to group 1. The dependent variable used was time in seconds and was subjected to ANOVA. Post-hoc comparisons were performed using Tukey\'s Honest Significant Difference test (p <0.05). Results: The control group maintained performance in the retention phase and was able to transfer both in maze 1 and 2. The DS group managed transfer to the task only in maze 2. In maze1, the DS group failed to transfer when we inverted the start and end of the path. Conclusion: People with DS have managed to adapt the proposed task, but with always underperform people with DT. As demonstrated difficulty in maintaining performance with increased task difficulty, suggesting that new technologies must be adaptable to the difficulties people with DS, thereby enabling increased functionalit

Cardiac autonomic modulation in athletes and non- athletes with spinal cord injury

Introdução: A lesão medular (LM) provoca alterações nas funções motoras, sensitivas e autonômicas abaixo da lesão, e podem ser agravadas pelo comportamento sedentário. A introdução de atividades físicas ou esportivas durante a reabilitação destes indivíduos é fundamental para minimizar esses efeitos, entretanto poucos estudos têm se dedicado a avaliação da disfunção autonômica, especialmente com uso da variabilidade da frequência cardíaca (VFC) em indivíduos com LM. Objetivo: Caracterizar e comparar a modulação autonômica de atletas e não atletas com lesão medular e associa-las aos níveis de funcionalidade dos indivíduos. Método: Um estudo transversal onde os participantes foram divididos em três grupos pareados por idade: Grupo Atletas (GA), Grupo Não Atleta (GN) e Grupo Controle (GC). Para a classificação e avaliação da funcionalidade foram aplicadas as escalas ASIA, MIF; SCIM III e os questionários Atividade Física em Atleta e LTPAQ-SCI. As medidas da VFC foram registradas pelo cardiofrequencímetro (V800, Polar) em dois momentos, 20 minutos em repouso na posição decúbito dorsal e 5 minutos na posição sentado. Resultados: 152 indivíduos foram incluídos nesse estudo, e os resultados mostraram que os não atletas apresentaram um comportamento autonômico cardíaco com menor predominância parassimpática do que o grupo de atletas e também uma função motora significativamente pior, mesmo com menor gravidade em relação à lesão. Conclusão: O exercício físico é fundamental em indivíduos com lesão medular, pois contribui no predomínio do comportamento parassimpático, mesmo em indivíduos com lesões medular alta e completa. E o comportamento autonômico de pessoas com lesão medular que praticam esportes é semelhante ao de pessoas sem lesão medular.Introduction: The spinal cord injury (SCI) causes changes in motor, sensory and autonomic functions below the injury, and can be compounded by sedentary behavior. The introduction of physical or sporting activities during rehabilitation of these individuals is essential to minimize these effects, however, few studies have been dedicated to the evaluation of autonomic dysfunction, especially using heart rate variability (HRV) in individuals with SCI. Objective: To characterize and compare the autonomic modulation of athletes and non-athletes with spinal cord injury and associate them with the levels of functionality of the individuals. Method: A cross-sectional study where the participants were divided into three groups paired by age: Athlete Group (AG), Non-Athlete Group (NG) and Control Group (CG). For the classification and evaluation of functionality the ASIA, FIM; SCIM III scales and the Physical Activity in Athletes and LTPAQ-SCI questionnaires were applied. The HRV measurements were recorded by a cardiofrequencimeter (V800, Polar) at two moments, 20 minutes at rest in the dorsal decubitus position and 5 minutes in the sitting position. Results: 152 individuals were included in this study, and the results showed that the non-athletes had a cardiac autonomic behavior with less parasympathetic predominance than the athletes group, and also a significantly worse motor function, even with less severity in relation to the injury. Conclusion: Physical exercise is fundamental in individuals with spinal cord injury, as it contributes to the predominance of parasympathetic behavior, even in individuals with high and complete spinal cord injuries. And the autonomic behavior of individuals with spinal cord injury who practice sports is similar to that of people without spinal cord injury.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Motor learning characterization in people with autism spectrum disorder: A systematic review

ABSTRACT Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder primarily characterized by deficits in social interaction, communication and implicit skill learning. OBJECTIVE: To analyse the results of research on "motor learning" and the means used for measuring "autistic disorder". METHODS: A systematic literature search was done using Medline/PubMed, Web of Science, BVS (virtual health library), and PsycINFO. We included articles that contained the keywords "autism" and "motor learning". The variables considered were the methodological aspects; results presented, and the methodological quality of the studies. RESULTS: A total of 42 studies were identified; 33 articles were excluded because they did not meet the inclusion criteria. Data were extracted from nine eligible studies and summarized. CONCLUSION: We concluded that although individuals with ASD showed performance difficulties in different memory and motor learning tasks, acquisition of skills still takes place in this population; however, this skill acquisition is related to heterogeneous events, occurring without the awareness of the individual

Motor learning characterization in people with autism spectrum disorder: A systematic review

<div><p>ABSTRACT Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder primarily characterized by deficits in social interaction, communication and implicit skill learning. OBJECTIVE: To analyse the results of research on "motor learning" and the means used for measuring "autistic disorder". METHODS: A systematic literature search was done using Medline/PubMed, Web of Science, BVS (virtual health library), and PsycINFO. We included articles that contained the keywords "autism" and "motor learning". The variables considered were the methodological aspects; results presented, and the methodological quality of the studies. RESULTS: A total of 42 studies were identified; 33 articles were excluded because they did not meet the inclusion criteria. Data were extracted from nine eligible studies and summarized. CONCLUSION: We concluded that although individuals with ASD showed performance difficulties in different memory and motor learning tasks, acquisition of skills still takes place in this population; however, this skill acquisition is related to heterogeneous events, occurring without the awareness of the individual.</p></div