A brief review on motor development: fundamental motor skills as a basis for motor skill learning

In this study, we review the relationship between motor development and motor learning, and present a new metaphor that represents the sequence of motor development, which highlights fundamental motor skills as an important phase in the process. As one of the most relevant phases of motor development, several studies that analyzed fundamental motor skills were reviewed in typical developing children as well as in children with disabilities. Most studies revealed motor performance levels below expected since proficiency was not observed. We discuss these results considering fundamental motor skills as essential for the motor development process. Such results raise the awareness of the need to offer children conditions to explore and experience motor activities in order to enhance motor competence.

Bimanual Motor Skill Learning With Robotics in Chronic Stroke

Background. Most activities of daily life (ADL) require cooperative bimanual movements. A unilateral stroke may severely impair bimanual ADL. How patients with stroke (re)learn to coordinate their upper limbs (ULs) is largely unknown.The objectives are to determine whether patients with chronic supratentorial stroke could achieve bimanual motor skill learning (bim-MSkL). To compare bim-MSkL between patients and healthy individuals (HIs).Methods. Twenty-four patients and ten HIs trained over 3 consecutive days on an asymmetrical bimanual coordination task (CIRCUIT) implemented as a serious game in the REAplan® robot. With a common cursor controlled by coordinated movements of the ULs through robotic handles, they performed as many laps as possible (speed constraint) on the CIRCUIT while keeping the cursor within the track (accuracy constraint). The primary outcome was a bimanual speed/accuracy trade-off (biSAT), we used a bimanual coordination factor (biCO) and bimanual forces (biFOP) for the secondary outcomes. Several clinical scales were used to evaluate motor and cognitive functions.Results. Overall, the patients showed improvements on biSAT and biCO. Based on biSAT progression, the HI achieved a larger bim-MSkL than the patients with mild to moderate impairment (Fugl-Meyer Assessment Upper Extremity (FMA-UE): 28-55, n=15) but not significantly different from those with minimal motor impairment (FMA-UE: 66, n=9). There was a significant positive correlation between biSAT evolution and the FMA-UE and Stroke Impact Scale.Conclusions. Both HI and patients with chronic stroke training on a robotic device achieved bim-MSkL, although the more impaired patients were less efficient. Bim-MSkL with REAplan® may be interesting for neurorehabilitation after stroke.Trial registration. ClinicalTrial.gov identifier: NCT03974750. Registered 05 June 2019.https://clinicaltrials.gov/ct2/show/NCT03974750?cond=NCT03974750&draw=2&rank=1

Timing-Dependent Effects of Transcranial Direct Current Stimulation on Hand Motor Function in Healthy Individuals: A Randomized Controlled Study

The timing of transcranial direct current stimulation (tDCS) is essential for enhancing motor skill learning. Previously, tDCS, before or concurrently, with motor training was evaluated in healthy volunteers or elderly patients, but the optimal timing of stimulation has not been determined. In this study, we aimed to optimize the existing tDCS protocols by exploring the timing-dependent stimulation effects on finger movements in healthy individuals. We conducted a single-center, prospective, randomized controlled trial. The study participants (n = 39) were randomly assigned into three groups: tDCS concurrently with finger tapping training (CON), tDCS prior to finger tapping training (PRI), and SHAM-tDCS simultaneously with finger tapping training (SHAM). In all groups, the subjects participated in five 40-min training sessions for one week. Motor performance was measured before and after treatment using the finger-tapping task (FTT), the grooved pegboard test (GPT), and hand strength tests. tDCS treatment prior to finger tapping training significantly improved motor skill learning, as indicated by the GPT and hand strength measurements. In all groups, the treatment improved the FTT performance. Our results indicate that applying tDCS before training could be optimal for enhancing motor skill learning. Further research is required to confirm these findings.

Motor skill training without online visual feedback enhances feedforward control

Motor skill learning involves improvement in feedforward control, the ability to execute a motor plan more reliably, and feedback control, the ability to adjust the motor plan on the fly. The dependence between these control components and the association between training conditions and their improvement have not been directly examined. This study characterizes the contribution of feedforward and feedback control components to motor skill learning using the Arc Pointing Task (APT), a drawing task that requires high motor acuity. In experiment 1, 3 groups of subjects were tested with online visual feedback before and after training with online visual feedback (OF group), with knowledge of performance feedback that was presented after movement completion (KP group), and with both online and KP feedback (KP+OF group). While the improvement of OF group was not different from the improvement of KP+OF group, comparison of the KP and KP+OF groups revealed an advantage to the KP group in the fast test speed, suggesting that training without online feedback leads to a greater improvement in feedforward control. In experiment 2, subject's improvement was examined using test probes for estimating feedback and feedforward control. Both KP+OF and KP groups showed improvement in feedforward and feedback conditions with a trend toward a greater improvement of the KP group. Our results suggest that online visual feedback suppresses improvement in feedforward control during motor skill learning.

Effects of Augmented Feedback with Error Self-estimates on Vocational High School Students’ Motor Skill Learning

The influence of augmented feedback and self-estimation of errors on the welding skill learning of vocational high school students was the focus of this study. A quasi-experimental research design was utilized by randomly assigning two classes of car repair students to an experimental group and a control group. Each participant had 9 practice trials, took 3 tests (pre, post, and delayed), and received augmented feedback 3 times during the skill acquisition phase. The experimental group was additionally requested to self-estimate their errors by reviewing their work in comparison to a benchmark piece, assessing the differences, and completing a checklist of criteria, while the control group did not undergo this process. The performance of participants improved through the practice period with the experimental group showing significantly greater changes than those in the control condition. For the delayed-test, both groups declined to some extent from the post-test, but the experimental subjects did better comparatively. Augmented feedback with self-estimation of errors appeared beneficial for vocational high school students’ motor skill learning.