Dr Mario Inacio

Developmental coordination disorder (DCD) is characterized by motor learning deficits that are poorly understood within whole-body activities context.  Here we present results of one of the largest nonrandomized interventional trials combining brain imaging and motion capture techniques to examine motor skill acquisition and its underpinning mechanisms in adolescents with and without DCD. A total of 86 adolescents with low fitness levels (including 48 with DCD) were trained on a novel stepping task for a duration of 7 weeks. Motor performance during the stepping task was assessed under single and dual-task conditions. Concurrent cortical activation in the prefrontal cortex (PFC) was measured using functional near-infrared spectroscopy (fNIRS). Additionally, structural and functional magnetic resonance imaging (MRI) was conducted during a similar stepping task at the beginning of the trial.

The results indicate that adolescents with DCD performed similarly to their peers with lower levels of fitness in the novel stepping task and demonstrated the ability to learn and improve motor performance. Both groups showed significant improvements in both tasks and under single- and dual-task conditions at post-intervention and follow-up compared to baseline. While both groups initially made more errors in the Stroop task under dual-task conditions, at follow-up, a significant difference between single- and dual-task conditions was observed only in the DCD group. Notably, differences in prefrontal activation patterns between the groups emerged at different time points and task conditions. Adolescents with DCD exhibited distinct prefrontal activation responses during the learning and performance of a motor task, particularly when complexity was increased by concurrent cognitive tasks. Furthermore, a relationship was observed between MRI brain structure and function measures and initial performance in the novel stepping task. Overall, these findings suggest that strategies that address task and environmental complexities, while simultaneously enhancing brain activity through a range of tasks, offer opportunities to increase the participation of adolescents with low fitness in physical activity and sports.

Purpose: Diabetes mellitus (DM) is a clinical condition that affects gait performance and control in millions of individuals worldwide. Contrary to basic spatiotemporal parameters, gait-based spectral analysis may provide useful insights into gait neuromotor control. This study is to answer that whether there is a difference between differential application of spectral gait analysis and spatiotemporal gait outcomes, and their differences between those with and without DM.

Materials and Methods: Total 1117 individuals [658 DM and 649 healthy adults (HA)] performed a 10m walk while wearing an inertial measurement unit over the fourth lumbar vertebra. Mann-Whitney-U test was used for between-group gait parameters comparisons.

Results: DM group had a slower step time (1.2%, ppHz vs HA:0.25Hz on average, pHz vs HA:1.76Hz on average, pvs HA:5.96%, p

Conclusions: It was demonstrated for the first time that the gait spectral content, not only corroborates spatiotemporal characteristics, but also provides further insight into their neuromotor control deficits in diabetic patients. Ultimately, this type of analysis in the diabetic population can help guide the therapeutic interventions to prevent diabetic foot. achieve more adequate and effective outcomes.[zj1] 

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Background: Developmental coordination disorder affects approximately 6% of children, interfering with participation in physical activity and can persist through adulthood. However, no studies have investigated the neuromotor mechanisms of learning of a novel task with rhythmic cueing.

Methods: Movement Assessment Battery for Children-2nd edition was used to identify 48 children with probable developmental coordination disorder (13.9±0.05 yrs, 27% male) and 37 typically developed (13.9±0.10 yrs, 54% male). While instrumented with an inertial measurement unit, both groups performed a novel rhythmic stepping task and with a concurrent auditory stroop test (dual-task), underwent seven weeks of intervention with step training with rhythmic cuing and were tested for retention five weeks post-intervention.

Findings: Initially, the group with probable developmental coordination disorder had a higher variability of step timing (coefficient of variation: 0.08±0.003-typically developed – 0.09±0.004-probable developmental coordination disorder, ppppppp

Interpretation: Rhythmic cueing shows strong promise for enhancing motor learning in children with probable developmental coordination disorder.

Trial registration: Retrospectively registered on ClinicalTrials.gov with reference: NCT03150784

Keywords: Developmental Coordination Disorder, stepping, motor learning, intervention, rhythmic cueing.

Background: Despite extensive literature regarding laboratory-based balance perturbations, there is no up-to-date systematic review of methods. This systematic review aimed to assess current perturbation methods, and outcome variables used to report participant biomechanical responses during walking.
​​​​​​​Methods: Web of Science, CINAHL and PubMed online databases were searched, for records from 2015, the last search was on 30th of May 2022. Studies were included where participants were 18+ years, with or without clinical conditions, conducted in non-hospital settings. Reviews were excluded. Participant descriptive, perturbation method, outcome variables and results were extracted and summarised. Bias was assessed using the Appraisal tool for Cross-sectional Studies risk of bias assessment tool. Qualitative analysis was performed as the review aimed to investigate methods used to apply perturbations.
Results: 644 records were identified and 33 studies were included, totaling 779 participants. The most frequent method of balance perturbation during gait was by means of a treadmill translation. The most frequent outcome variable collected was participant step width, closely followed by step length. Most studies reported at least one spatiotemporal outcome variable. All included studies showed some risk of bias, generally related to reporting of sampling approaches. Large variation in perturbation type, duration and intensity and outcome variables were reported.
Conclusions: This review shows the wide variety of published laboratory perturbation methods. Also demonstrating the significant impact on outcome measures of a study based on the type of perturbation used.
Registration: PROSPERO ID: CRD42020211876