Search Results (469)

Background/Objectives: Pediatric acquired brain injury (ABI) often results in persistent challenges that extend beyond motor impairments, affecting quality of life (QoL), social participation, and engagement in physical activity. Given the complexity and chronicity of these outcomes, there is a pressing need for multidimensional interventions grounded in the International Classification of Functioning, Disability and Health (ICF). Sport-based exercise interventions, when developmentally adapted and tailored to individual interests, may promote intrinsic motivation, peer connection, and sustainable engagement—factors especially relevant in pediatric ABI populations, who often experience reduced physical activity and social isolation. However, standardized, replicable protocols specifically tailored to this population remain scarce. This study presents the protocol for a randomized controlled trial evaluating the effects of a 16-week sport-based intervention on QoL, social participation, physical activity engagement, and motor functioning tailored for adolescents with pediatric ABI. Methods: Participants will be randomly assigned to an intervention group or a control group receiving usual care. The intervention consists of one weekly 60-minute session, led by trained professionals in adapted physical activity and pediatric neurorehabilitation. It combines sport-based motor skill training, cooperative games, and group activities specifically tailored to each child’s developmental level, motor abilities, and preferences. Outcomes will be assessed at baseline and following the 16-week intervention period, focusing on QoL, participation, physical activity engagement, and motor functioning. Discussion: This study introduces a structured, child-centered model that bridges clinical rehabilitation and community-based sport. By integrating motor and psychosocial targets through a group sport-based intervention, it aims to enhance recovery across ICF domains. Findings may inform interdisciplinary practice and support the development of sustainable strategies to promote long-term engagement and well-being in adolescents with ABI. Full article

Background/Objectives: Motor difficulties are commonly reported in autistic individuals, but they are not currently part of the diagnostic criteria. A better understanding of how motor impairments are assessed in this population is critical to inform clinical practice and intervention. This systematic review aims to evaluate the existing literature on motor skill assessment in autistic children and adolescents, focusing specifically on studies that employed standardized and validated clinical motor assessment tools. Methods: Registered on PROSPERO (CRD42025637880), a systematic search was conducted on PubMed, Science Direct, and Web of Science until 31 December 2024. The review includes: (a) studies published in peer-reviewed journals; (b) randomized controlled trials (RCTs) and observational studies; (c) evaluations of motor difficulties using standardized and validated clinical assessments specifically designed to measure motor skills or coordination abilities; (d) participants diagnosed with ASD based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV or DSM-5) or the International Classification of Diseases (ICD-9 or ICD-10); and (e) participants aged ≤18 years; Results: Twenty-two studies met the inclusion criteria. Most studies reported significant motor impairments across various domains, including balance, manual dexterity, and coordination. However, there was substantial variability in the severity of motor deficits and in the assessment tools used. Methodological heterogeneity limited direct comparison across studies. Conclusions: Motor impairments are common in autistic children and adolescents; however, current assessment tools show limitations and require adaptations. The findings underscore the need for autism-specific motor assessments to improve diagnostic accuracy and guide personalized interventions. Full article

Background/Objectives: Lucid dreaming (LD), during which the dreamer becomes aware of the dream state, offers a unique opportunity for a variety of applications, including motor practice, personal well-being, and nightmare therapy. However, these applications largely depend on the dreamer’s ability to control their dreams. While LD research has traditionally focused on induction techniques to increase dream frequency, the equally important skill of dream control remains largely underexplored. This study provides an exploration into the mechanisms of LD motor practice, dream control, and its potential influencing factors. We specifically examined whether a complex motor skill—juggling—could be performed during LD, calling for relatively high levels of dream control and access to procedural memory. Methods: Four healthy participants underwent overnight polysomnography (PSG), provided detailed dream reports, and completed questionnaires assessing dream control and self-efficacy. Dream-task success was assessed using predefined in-dream motor performance criteria. Differences between high and low LD control participants were examined, and two detailed case reports of lucid dream juggling attempts provide insight into the challenges of executing complex motor tasks during LD. Results: Dream control varied between and within participants. Both dream control and self-efficacy seemed to predict participants’ ability to execute the LD motor task. Conclusions: Despite the low sample size, this study highlights the potential roles of individual traits like self-efficacy in shaping dream control abilities and motor performance during LD. By using empirical, task-based measures, this study helps build the foundation for future research aimed at optimizing LD applications in clinical and non-clinical fields. Full article

High-performance musical instrument training is a demanding discipline that engages cognitive, neurological, and physical skills. Professional musicians invest substantial time and effort into mastering their repertoire and developing the muscle memory and reflexes required to perform complex works in high-stakes settings. While existing surveys have explored the use of music in therapeutic and general training contexts, there is a notable lack of work focused specifically on the needs of professional musicians and advanced instrumental practice. This topical review explores the potential of EEG-based brain–computer interface (BCI) technologies to integrate real-time feedback of biomechanic and cognitive features in advanced musical practice. Building on a conceptual framework of technology-enhanced musical practice (TEMP), we review empirical studies of broad contexts, addressing the EEG signal decoding of biomechanic and cognitive tasks that closely relates to the specified TEMP features (movement and muscle activity, posture and balance, fine motor movements and dexterity, breathing control, head and facial movement, movement intention, tempo processing, ptich recognition, and cognitive engagement), assessing their feasibility and limitations. Our analysis highlights current gaps and provides a foundation for future development of BCI-supported musical training systems to support high-performance instrumental practice. Full article

Background/Objectives: The aim of this study was to examine the effectiveness of an exercise program based on principles of motor learning with cognitive elements (such as attention) in the correction of Forward Head Posture (FHP). Methods: A total of 55 university students from the University of Thessaly, aged between 18 and 25 years, participated in this study. Volunteers found to have a craniovertebral angle <50° were randomly divided into two groups: the intervention group IG (n = 27) and the control group CG (n = 28). The IG followed a treatment protocol consisting of three 30–45-min sessions per week for four weeks, a total of twelve sessions, while the control group received the same content instructions and group sessions upon completion. Results: After the four-week intervention period, significant improvements were observed in both static and dynamic craniovertebral angle measurements (p < 0.05) when comparing the IG to the CG. Additionally, there was a notable increase in the endurance of the deep neck flexors (p < 0.05), even though the intervention for the IG did not include specific strength exercises. Furthermore, participants with FHP were able to transfer (B–C) motor skills (p < 0.01) acquired during static position tasks to a similar but dynamically untrained task. They also retained (B–D) improvements in posture and strength during the two-week detraining period (p < 0.01), indicating sustained motor learning effects. Conclusions: The exercise intervention was successful at decreasing FHP in subjects, sustaining the results for a two-week period. This study supports the effectiveness of postural training by a program based on motor learning principles. New rehabilitation strategies based on motor control and motor learning could be introduced into physiotherapy practice to increase effectiveness. Full article

Background/Objectives: This study examines the effectiveness of equine-assisted intervention (EAI) in improving adaptive behaviour and motor skills in children with autism spectrum disorder (ASD). Methods: To that effect, a self-controlled experimental analytical study has been designed, which is longitudinal and prospective in nature, with pre- and post-intervention measures, using the Vineland Adaptive Behavior Scale II (VABS-II) as the assessment instrument. The sample consists of 19 children who participated in weekly therapeutic sessions involving horses for eight months; these sessions included horseback riding, groundwork, hygiene, and preparation of the horse. Results: The results show significant improvements both in the overall score of the VABS-II test ($\overline{\mathrm{x}}$pre: 65.84 ± 10.38–$\overline{\mathrm{x}}$post: 72.47 ± 16.21, p = 0.003) and in the areas of communication ($\overline{\mathrm{x}}$pre: 64.84 ± 15.50 ~ $\overline{\mathrm{x}}$post: 72.26 ± 21.93, p = 0.010), social skills ($\overline{\mathrm{x}}$pre: 61.26 ± 8.99 ~ $\overline{\mathrm{x}}$post: 66.53 ± 13.79, p = 0.008) and daily living skills (DLS) ($\overline{\mathrm{x}}$pre: 66.21 ± 11.15 ~ $\overline{\mathrm{x}}$post: 69.95 ± 12.32, p = 0.0004), as well as a non-significant slight improvement in motor skills ($\overline{\mathrm{x}}$pre: 72.50 ± 8.83 ~ $\overline{\mathrm{x}}$post: 75.17 ± 7.88, p = 0.363). In addition, these gains were greater in those children attending standard classroom settings and receiving early stimulation. Conclusions: This study suggests equine-assisted intervention (EAI) may contribute to improvements in adaptive behaviour, including communication, social skills, and daily living skills, in children with autism spectrum disorder (ASD). Benefits were notably enhanced in children receiving early stimulation within standard classroom settings. Full article

Parkinson’s disease (PD) is a disorder that causes a decrease in motor skills. Among the symptoms that have been observed, the most significant is the occurrence of Freezing of Gait (FoG), which manifests as an abrupt cessation of walking. This study investigates the impact of spatiotemporal gait parameters using wearable inertial measurement units (IMUs). Notably, 30 PD patients (15 with FoG, 15 without) and 20 healthy controls were enrolled. Gait data were acquired using two foot-mounted IMUs and key parameters such as stride time, gait phase distribution, cadence, stride length, speed, and foot clearance were extracted. Results indicated a tangible decline in motor abilities in PD patients, especially in those with FoG. Differences were observed in the segmentation of gait phases, with diminished swing phase duration observed in patients, and in the diminished spatial parameters of stride length, velocity, and foot clearance. Additionally, to validate the results, the accuracy of IMU-derived clearance measurements was validated against an optoelectronic system. While the IMUs accurately detected maximum points, the minimum clearance showed a higher measurement error. These findings support the use of wearable IMUs as a reliable and low-cost alternative to laboratory systems for the assessment of gait abnormalities in PD. Moreover, they highlight the potential for early detection and monitoring of FoG in both clinical and home settings. Full article

Background/Objectives: The study aimed to investigate how cognitive variables (performance IQ, verbal short-term memory, working memory, and ADHD symptomatology) impact lexical representations in children with high-functioning autism spectrum disorder (HF-ASD). Methods: Participants were two groups (n1 = n2 = 20) of monolingual Greek-speaking children, aged 7 to 12 years, with and without HF-ASD matched in age, gender, and cognitive skills. Results: Overall, the HF-ASD group had more immature lexical representations than the control group, even though the two groups were similar in naming. In both groups, naming was correlated moderately with verbal short-term memory but only age predicted significantly semantic knowledge. In the ASD group, a bilateral predictive relationship was revealed between output motor programming skills and stored phonological knowledge, supporting theoretical assumptions of the psycholinguistic model of speech. Finally, a different pattern of interrelations was observed between cognitive and lexical variables in the two groups. Conclusions: The findings of the current study indicate that ASD children may map and process new vocabulary differently compared to typically developing peers. Full article

Background: Preclinical dental training requires simulation-based tools to develop fine motor skills, but traditional models like plastic teeth often lack realistic tactile feedback, and systematic evaluations of multi-layered drilling plates are scarce. This study aimed to evaluate the educational utility and perceived realism of a novel multi-layered drilling plate designed to simulate enamel, dentin, and pulp, with null hypotheses that it would not differ in realism from natural dental tissues or in educational utility from existing tools. Methods: Seventy dental educators (mean preclinical teaching experience: 112.9 ± 116.7 months) from 14 institutions across four continents assessed the plates using standardized protocols. Statistical analysis (Mann–Whitney U Test) was performed to analyze the results. Results: Quantitative ratings (1–10 scale) showed high mean scores for drilling quality (enamel: 7.80 ± 1.55, dentin: 7.27 ± 1.94, pulp: 7.48 ± 2.33), surface smoothness (enamel: 8.17 ± 1.55, dentin: 8.17 ± 1.57), and ergonomic visibility (8.56 ± 1.58), with 90% passing grades, rejecting the null hypothesis of no difference in educational utility. Tissue transition scores (enamel/dentin: 7.09 ± 2.56; dentin/pulp: 6.86 ± 2.46) showed significant differences (p < 0.05) in realism from natural tissues, rejecting the null hypothesis of no difference. Inter-rater reliability was poor (Krippendorff’s alpha: 0.449 for failing scores, 0.211 for passing scores). Qualitative feedback praised ease of use but noted limitations in dentin haptic simulation. Conclusions: The drilling plate shows promise for skill development, though without controlled comparisons to existing tools, its relative efficacy remains preliminary. Further research on student outcomes and tool refinement is needed to validate its use in dental education. Full article

This study presents a real-time hand tracking and collision detection system for immersive mixed-reality boxing training on Apple Vision Pro (Apple Inc., Cupertino, CA, USA). Leveraging the device’s advanced spatial computing capabilities, this research addresses the limitations of traditional fitness applications that lack precision for technique-based sports like boxing with visual-only hand tracking. The system is designed to provide objective feedback by recognizing boxing-specific gestures with sub-centimeter accuracy and validating biomechanical correctness during punch execution. A three-stage pipeline consisting of geometric filtering, biomechanical validation, and punch technique assessment rejects accidental or improper motions. Experimental evaluation involving 12 participants demonstrated a gesture recognition accuracy of 96.3% and a technique validation accuracy of 88.5%. The system consistently operated at 60 FPS with low latency and high robustness across diverse lighting conditions. These results indicate the potential of Apple Vision Pro as a platform for precision sports training and highlight the educational impact of mixed reality in democratizing access to high-quality boxing instruction. The proposed framework is extensible to other skill-based sports requiring fine motor control and real-time feedback. Full article

Background/Objectives: Beyond the core characteristics of the condition, autistic individuals often significantly struggle with postural balance. This pilot study aimed to investigate the effects of an immersive virtual reality-based training administered with Gait Real-time Analysis Interactive Lab (GRAIL) on postural balance of autistic children. Methods: A total of 20 autistic participants aged 6 to 13 were enrolled in a 5-week randomized, parallel-group, open-label, controlled trial, and received either balance training with the GRAIL system or no training. The trial was registered at ClinicalTrials.gov (identifier: NCT04276571). The primary outcome measures were the change in center of pressure (CoP) metrics during GRAIL balance assessments and the change in motor skills as assessed with Movement Assessment Battery for Children-2. Secondary outcome measures included parent-report Developmental Coordination Disorder Questionnaire, center of mass metrics, and gait parameters evaluated with GRAIL. ANCOVA tests were performed for all outcomes, with time (T0 and T1) as within-subjects factor, the group (training and control groups) as between-subjects factor, and considering age as covariate. Results: Slight but significant time by group interactions were found in some CoP metrics (i.e., sway path length, velocity in the antero-posterior direction, and the jerk). Conclusions: These findings preliminarily suggest that a virtual reality-based training may induce slight modifications in postural balance strategies, which can be enhanced with longer or more intensive training. Full article

Background and Objectives: Dual-task training (DTT) is an innovative therapeutic approach that involves the simultaneous application of two tasks, which can be motor, cognitive, or a combination of both. Children with cerebral palsy (CP) often exhibit impairments in balance, motor skills, and gait, conditions that may be amenable to improvement through DTT. The aim of this study was to determine the effectiveness of DTT in enhancing balance, walking speed, and gross motor function-related balance in children with CP. Materials and Methods: In accordance with PRISMA guidelines, a comprehensive systematic review with meta-analysis (SRMA) was conducted. Electronic databases like PubMed Medline, Scopus, Web of Science, CINAHL, and PEDro were searched up to March 2025, with no language or publication date restrictions. Only randomized controlled trials (RCTs) examining the effectiveness of DTT on balance, gross motor function, and walking speed in children with CP were included. The methodological quality and risk of bias of the included RCTs were assessed using the PEDro scale. Pooled effects were calculated using Cohen’s standardized mean difference (SMD) and its 95% confidence interval (95% CI) within random-effects models. Results: Eight RCTs, providing data from 216 children, were included. Meta-analyses suggested that DTT was more effective than conventional therapies for increasing functional (SMD = 0.65; 95% CI 0.18 to 1.13), dynamic (SMD = 0.61; 95% CI 0.15 to 1.1), and static balance (SMD = 0.46; 95% CI 0.02 to 0.9), as well as standing (SMD = 0.75; 95% CI 0.31 to 1.18; p = 0.001) and locomotion dimensions (SMD = 0.65; 95% CI 0.22 to 1.08) of the Gross Motor Function Measure (GMFM) and walking speed (SMD = 0.46; 95% CI 0.06 to 0.87). Subgroup analyses revealed that a motor–cognitive dual task is better than a motor single task for functional, dynamic, and static balance and standing and locomotion dimensions for the GMFM. Conclusions: This SRMA, including the major number of RCTs to date, suggests that DTT is effective in increasing balance, walking and gross motor function-related balance in children with CP. Full article

Purpose: Integrated neuromuscular training (INT) is a multidimensional training method that integrates strength, balance, core stability, flexibility, and motor skill development. The aim of this study was to systematically evaluate the effects of INT on various physical performance indicators in athletes to provide evidence supporting the application of INT in training practices. Method: A systematic search was conducted in accordance with PRISMA guidelines across nine databases—including PubMed, Web of Science, EMBASE, Scopus, Cochrane Library, Ovid MEDLINE, WILEY, and Springer Nature Link—from inception to 26 March 2025 to identify randomized controlled trials (RCTs) examining the effects of INT on athletic performance. Result: A total of 19 randomized controlled trials were included, comprising 783 participants aged 11–25 years. The meta-analysis results indicated that INT significantly improved jump performance (SMD = 0.26, 95% CI [0.15, 0.37], p < 0.001, I² = 75%), sprint performance (SMD = −0.76, 95% CI [−0.93, −0.58], p < 0.001, I² = 76%), balance performance (SMD = 0.23, 95% CI [0.14, 0.31], p < 0.001, I² = 78%), and agility performance (SMD = −0.72, 95% CI [−1.23, −0.21], p < 0.05, I² = 74%). Sensitivity analyses revealed no substantial changes in jump, sprint, agility, or balance performance outcomes. Conclusions: INT was found to significantly improve sprint, jump, balance, and agility performance in athletes. Analysis of the included training protocols suggested that improvements in each performance indicator required emphasis on specific training components. Moreover, greater improvements in sprint and balance performance were observed in female athletes compared to their male counterparts. Subgroup analysis revealed significant differences in training effects across populations, with female athletes showing superior improvements in sprint and balance performance following INT interventions. Additionally, interventions lasting fewer than eight weeks, with training sessions shorter than 30 min and frequencies of more than three times per week, were associated with more pronounced effects. Full article

Objective: The objective of the study was to investigate the relationship between the level of physical activity and body composition, and the levels of motor skills and strength in overweight and obese men. Methods: The research involved 64 men. Body composition, physical activity, motor control, Motor Control Test (MCT), and strength variables were evaluated. Body composition was assessed by DXA, and the participants were classified into two groups according to the percentage of total fat mass: greater and less than 27.65%. Physical activity was assessed using accelerometry, and motor control was measured with posturography, which provided a composite score of motor performance and postural control effectiveness. Strength was assessed using hand, leg, and back dynamometers. Results: The participants with a higher percentage of body fat had a lower DSI (Dynamic Strength Index) (p < 0.001) and significantly reduced PAL (physical activity level) and energy expenditure (p < 0.001). No significant differences were found in the muscle strength of the upper limbs (p = 0.06) and lower limbs (p = 0.419). With regard to MCT, there was a significant difference between groups in the backward direction (p = 0.041), with the group with the highest percentage of body fat showing lower values. Conclusions: Individuals with a higher percentage of body fat tend to have lower levels of strength, physical activity, and energy expenditure, which can lead to impaired balance. The findings highlight the need for targeted interventions to improve body composition and levels of strength and physical activity, with a positive impact on general health and quality of life. Emphasis should be placed on improving physical activity levels in male individuals with a higher percentage of fat mass to improve their body composition and dynamic strength levels, which are beneficial to life, particularly to help improve postural control. Full article

The objective of this study was to investigate the temporal effectiveness of repetitive peripheral magnetic stimulation (rPMS) on lower-limb motor skill performance in individuals with chronic stroke. In this sham-controlled crossover study, we hypothesized that individuals with stroke who received rPMS would demonstrate improved motor skill performance after the stimulation and maintain this enhanced performance at 30 and 60 min after the stimulation. Sixteen participants performed a visuomotor ankle-tracking task at multiple time points following either rPMS or sham stimulation. rPMS, delivered to the tibialis anterior muscle, did not result in statistically significant changes in spatiotemporal (p = 0.725) or spatial error (p = 0.566) metrics at any post-stimulation time point. These findings suggest that a single session of rPMS does not lead to measurable improvements in lower-limb motor skill performance in individuals with stroke, underscoring the need to refine stimulation parameters and target populations in future protocols. Full article