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Previous research suggests that the neural processes underlying specification of movement direction and amplitude are independently represented in the nervous system. However, our understanding of acquisition and consolidation processes in the direction and distance learning remains limited. We designed a virtual air hockey task, in which the puck direction is determined by the hand direction at impact, while the puck distance is determined by the amplitude of the velocity. In two versions of this task, participants were required to either specify the direction or the distance of the puck, while the alternate variable did not contribute to task success. Separate groups of right-handed participants were recruited for each task. Each participant was randomly assigned to one of two groups with a counter-balanced arm practice sequence (right to left, or left to right). We examined acquisition and, after 24 h, we examined two aspects of consolidation: 1) same hand performance to test the durability and 2) the opposite hand to test the effector-independent consolidation (interlimb transfer) of learning. The distance task showed symmetry between hands in the extent of acquisition as well as in both aspects of consolidation. In contrast, the direction task showed asymmetry in both acquisition and consolidation: the dominant right arm showed faster and greater acquisition and greater transfer from the opposite arm training. The asymmetric acquisition and consolidation processes shown in the direction task might be explained by lateralized control and mapping of direction, an interpretation consistent with previous findings on motor adaptation paradigms. [ABSTRACT FROM AUTHOR]

Interlimb transfer of sequential motor learning (SML) refers to the positive influence of prior experiences in performing the same sequential movements using different effectors. Despite evidence from intermanual SML, and while most daily living activities involve interlimb cooperation and coordination between the four limbs, nothing is known about bilateral SML transfer between the upper and lower limbs. We examined the transfer of bilateral SML from the upper to the lower limbs and vice versa. Twenty-four participants had to learn an initial bilateral SML task using the upper limbs and then performed the same sequence using the lower limbs during a transfer SML task. They performed the reversed situation 1 month apart. The performance was evaluated at the beginning and the end of both initial and transfer SML practice phases. Significant and reciprocal transfer gains in performance were observed regardless of the effectors. Greater transfer gains in performance were observed at the beginning of the transfer SML from the lower to the upper limbs (44 %) but these gains vanished after practice with the transfer effectors (5 %). Although smaller gains were initially achieved in the transfer of SML from the upper to the lower limbs (15 %), these gains persisted and remained significant (9 %) after practice with the transfer effectors. Our results provide evidence of a reciprocal and asymmetrical interlimb transfer of bilateral SML between the upper and lower limbs. These findings could be leveraged as a relevant strategy in the context of sports and functional rehabilitation. • Reciprocal transfer of sequential motor learning between the upper and lower effectors. • Transfer gains is asymmetrical between the upper and lower effectors. • Early and greater benefits in performance from the lower to the upper effectors. • Durable transfer gains in performance from the upper to the lower limb effectors • Upper and lower effectors transfer may be exploited in functional rehabilitation. [ABSTRACT FROM AUTHOR]

Structural learning is characterized by facilitated adaptation following training on a set of sensory perturbations all belonging to the same structure (e.g., 'visuomotor rotations'). This generalization of learning is a core feature of the motor system and is often studied in the context of interlimb transfer. However, such transfer has only been demonstrated when participants learn to counter a specific perturbation in the sensory feedback of their movements; we determined whether structural learning in one limb generalized to the contralateral limb. We trained 13 participants to counter random visual feedback rotations between +/-90 degrees with the right hand and subsequently tested the left hand on a fixed rotation. The structural training group showed faster adaptation in the left hand in both feedforward and feedback components of reaching compared to 13 participants who trained with veridical reaching, with lower initial reaching error, and straighter, faster, and smoother movements than in the control group. The transfer was ephemeral – benefits were confined to roughly the first 20 trials. The results demonstrate that the motor system can extract invariant properties of seemingly random environments in one limb, and that this information can be accessed by the contralateral limb. [ABSTRACT FROM AUTHOR]

It was previously hypothesized that the cross-education of strength is asymmetrical, where a greater transfer of strength is observed from the dominant to the non-dominant limb. The purpose of this study was to examine if the magnitude of cross-education of strength differed between dominant and non-dominant limbs following unilateral high-load resistance training. One hundred and twenty-two participants were randomized to one of the three groups: 1) training on the dominant arm (D-Only), 2) training on the non-dominant arm (ND-Only) and 3) a time-matched non-exercise control (Control). The training groups completed 6 weeks (18 sessions) of unilateral elbow flexion exercise. Each training session started with one-repetition maximum (1RM) training (≤ five attempts), followed by four sets of high-load exercise (i.e. 8–12RM). Strength changes of the untrained arm were compared between groups. Changes in the strength of the untrained arm were greater in D-Only (1.5 kg) and ND-Only (1.3 kg) compared to Control (−0.2 kg), without differences between D-Only and ND-Only. Unilateral resistance training increased strength in the opposite untrained arm, and the magnitude of this effect was similar regardless of which arm was trained. However, there is still considerable uncertainty on this topic and additional research is warranted to confirm the current findings. [ABSTRACT FROM AUTHOR]

Objective: The objective of this review was to evaluate the efficacy of mental imagery training (MIT) in promoting bilateral transfer (BT) of motor performance for healthy subjects. Data sources: We searched 6 online-databases (Jul-Dec 2022) using terms: "mental practice," "motor imagery training," "motor imagery practice," "mental training," "movement imagery," "cognitive training," "bilateral transfer," "interlimb transfer," "cross education," "motor learning," "strength," "force" and "motor performance." Study selection and data extraction: We selected randomized-controlled studies that examined the effect of MIT on BT. Two reviewers independently determined if each study met the inclusion criteria for the review. Disagreements were resolved through discussion and, if necessary, by a third reviewer. A total of 9 articles out of 728 initially identified studies were chosen for the meta-analysis. Data synthesis: The meta-analysis included 14 studies for the comparison between MIT and no-exercise control (CTR) and 15 studies for the comparison between MIT and physical training (PT). Results: MIT showed significant benefit in inducing BT compared to CTR (ES = 0.78, 95% CI = 0.57-0.98). The effect of MIT on BT was similar to that of PT (ES = -0.02, 95% CI = -0.15-0.17). Subgroup analyses showed that internal MIT (IMIT) was more effective (ES = 2.17, 95% CI = 1.57-2.76) than external MIT (EMIT) (ES = 0.95, 95% CI = 0.74-1.17), and mixed-task (ES = 1.68, 95% CI = 1.26-2.11) was more effective than mirror-task (ES = 0.46, 95% CI = 0.14-0.78) and normal-task (ES = 0.56, 95% CI = 0.23-0.90). No significant difference was found between transfer from dominant limb (DL) to non-dominant limb (NDL) (ES = 0.67, 95% CI = 0.37-0.97) and NDL to DL (ES = 0.87, 95% CI = 0.59-1.15). Conclusion: This review concludes that MIT can serve as a valuable alternative or supplement to PT in facilitating BT effects. Notably, IMIT is preferable to EMIT, and interventions incorporating tasks that have access to both intrinsic and extrinsic coordinates (mixed-task) are preferred over those that involve only one of the two coordinates (mirror-task or normal-task). These findings have implications for rehabilitation of patients such as stroke survivors. [ABSTRACT FROM AUTHOR]

Motor skills learned with one effector are known to transfer to an untrained effector. However, which of the many mechanisms that drive learning principally predict interlimb transfer, is less clear. Recent studies of motor adaptation suggest that transfer is tied to the state of an implicit mechanism that evolves gradually during learning. Interestingly, this "slow" process also promotes spontaneous recovery, or adaptation rebound, when error feedback is clamped to zero following adaptation-extinction training. If this mechanism also drives transfer, then recovery must occur in an arm performing zero-error-clamp movements after adaptation-extinction training with the opposite arm. Here we show this to be the case in participants who undergo visuomotor learning with their left arm and perform error-clamp movements with the right, but not vice versa. The performance of control participants reveals that the absence of a rebound in this latter group is not due to an inability to recover past learning when using the left arm. Our findings firstly advance the view that interlimb transfer following visuomotor adaptation is asymmetric. Secondly, since spontaneous recovery is a hallmark of the slow process, they lend strong support to the idea that it is this specific mechanism that provides a gateway for post-learning transfer to occur. Public Significance Statement: Motor learning with one limb results in performance benefits in an untrained limb, a phenomenon known as interlimb transfer of learning. Here we show that in error-driven learning, interlimb transfer is asymmetric, and is facilitated by an implicit learning mechanism that slowly updates our internal representations and produces a more stable memory trace. [ABSTRACT FROM AUTHOR]

ObjectiveThe objective of this review was to evaluate the efficacy of mental imagery training (MIT) in promoting bilateral transfer (BT) of motor performance for healthy subjects.Data sourcesWe searched 6 online-databases (Jul-Dec 2022) using terms: “mental practice,” “motor imagery training,” “motor imagery practice,” “mental training,” “movement imagery,” “cognitive training,” “bilateral transfer,” “interlimb transfer,” “cross education,” “motor learning,” “strength,” “force” and “motor performance.”Study selection and data extractionWe selected randomized-controlled studies that examined the effect of MIT on BT. Two reviewers independently determined if each study met the inclusion criteria for the review. Disagreements were resolved through discussion and, if necessary, by a third reviewer. A total of 9 articles out of 728 initially identified studies were chosen for the meta-analysis.Data synthesisThe meta-analysis included 14 studies for the comparison between MIT and no-exercise control (CTR) and 15 studies for the comparison between MIT and physical training (PT).ResultsMIT showed significant benefit in inducing BT compared to CTR (ES = 0.78, 95% CI = 0.57–0.98). The effect of MIT on BT was similar to that of PT (ES = –0.02, 95% CI = –0.15–0.17). Subgroup analyses showed that internal MIT (IMIT) was more effective (ES = 2.17, 95% CI = 1.57–2.76) than external MIT (EMIT) (ES = 0.95, 95% CI = 0.74–1.17), and mixed-task (ES = 1.68, 95% CI = 1.26–2.11) was more effective than mirror-task (ES = 0.46, 95% CI = 0.14–0.78) and normal-task (ES = 0.56, 95% CI = 0.23–0.90). No significant difference was found between transfer from dominant limb (DL) to non-dominant limb (NDL) (ES = 0.67, 95% CI = 0.37–0.97) and NDL to DL (ES = 0.87, 95% CI = 0.59–1.15).ConclusionThis review concludes that MIT can serve as a valuable alternative or supplement to PT in facilitating BT effects. Notably, IMIT is preferable to EMIT, and interventions incorporating tasks that have access to both intrinsic and extrinsic coordinates (mixed-task) are preferred over those that involve only one of the two coordinates (mirror-task or normal-task). These findings have implications for rehabilitation of patients such as stroke survivors.

Gait retraining, which typically focuses on the most severely affected limb or joint, has shown promising results in treating faulty running and walking patterns. The closed-chain nature of gait during the stance phase may influence kinematic changes in the adjacent joints of the trained leg. In addition, the coupled nature of the lower extremity motion of gait suggests that changes in one leg may transfer to the other. This study aimed to assess the intra- and inter-limb transfer of kinematic changes following gait retraining to reduce knee extension in individuals with hyperextension walking patterns. Seventeen women with knee hyperextension gait patterns participated in six treadmill retraining sessions. All participants received verbal and real-time visual kinematic feedback in the form of knowledge of results. This intervention study took place at the Gait Analysis Laboratory at the University of Iowa. Mean peak sagittal-plane lower extremity joint kinematics during overground walking at pretraining, post-training, and 1- and 8-month follow-ups were calculated for analysis and comparisons. The post-training changes in ankle range of motion returned to baseline values by the 8-month follow-up. There was a significant transfer effect of kinematic changes to the untrained knee following gait retraining. Training one knee did not result in long-term compensatory kinematic changes in the other joints. In addition, the improvements in knee extension range of motion were transferred to the untrained knee and retained at the 8-month follow-up. This study supports the use of gait retraining as an effective clinical intervention. • Effect of gait retraining on untrained joints' kinematics were assessed. • Gait retraining successfully reduced knee hyperextension during walking. • Reduction in knee extension pattern transferred to untrained knee post-training. • No long-term changes in untrained joints' kinematics were observed. • This study supports the use of gait retraining as an effective clinical intervention. [ABSTRACT FROM AUTHOR]

Sensory input can modify motor function and magnify interlimb transfer. We examined the effects of low-intensity somatosensory electrical stimulation (SES) on motor practice-induced skill acquisition and intermanual transfer. Participants practiced a visuomotor skill for 25 min and received SES to the practice or the transfer arm. Responses to single- and double-pulse transcranial magnetic stimulation were measured in both extensor carpi radialis. SES did not further increase skill acquisition (motor practice with right hand [RMP]: 30.8% and motor practice with right hand + somatosensory electrical stimulation to the right arm [RMP + RSES]: 27.8%) and intermanual transfer (RMP: 13.6% and RMP + RSES: 9.8%) when delivered to the left arm (motor practice with right hand + somatosensory electrical stimulation to the left arm [RMP + LSES]: 44.8% and 18.6%, respectively). Furthermore, transcranial magnetic stimulation measures revealed no changes in either hand. Future studies should systematically manipulate SES parameters to better understand the mechanisms of how SES affords motor learning benefits documented but not studied in patients. [ABSTRACT FROM AUTHOR]

Training one limb with a high-load has been shown to augment strength changes in the opposite limb training with a low-load (via cross-education of strength), indicating that within-subject models can be problematic when investigating strength changes. This study examined if the cross-education of strength from unilateral high-load training could augment the strength changes in the opposite arm undergoing the same unilateral high-load training. 160 participants were randomized to one of four groups: (1) training on the dominant arm followed by the non-dominant arm (D + ND), (2) training on the dominant arm only (D-Only), (3) training on the non-dominant arm only (ND-Only), and (4) a non-exercise control. All exercise groups performed 18 sessions of unilateral high-load elbow flexion exercise over 6 weeks. Participants were compared for changes in 1RM strength and muscle thickness. Changes in strength of the non-dominant arm were greater in D + ND (2.7 kg) and ND-Only (2.6 kg) compared to D-Only (1.5 kg) and control (-0.2 kg), while the changes were greater in D-Only compared to control. The same finding was observed in the dominant arm. Only the arms being directly trained observed increases in muscle thickness. Unilateral high-load resistance training increased strength in the opposite untrained arm, without changes in muscle thickness. This cross-education of strength did not augment the strength changes in the contralateral arm undergoing the same unilateral high-load training. However, it does not necessarily indicate that within-subject models are methodologically sound to investigate strength change if both limbs are trained with a high-load., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

• The contralateral benefits of unimanual limb training are preserved in later life. • Ipsilateral descending pathways are unlikely to contribute to cross education (CE). • Adaptations local to the untrained M1 do not appear to mediate CE. • CE in older persons may be characterised by altered engagement of premotor areas. • Transcallosal and thalamocortical projections are candidate mediators of CE. CALVERT, G.H.M., and CARSON, R.G. Neural mechanisms mediating cross education: With additional considerations for the ageing brain. NEUROSCI BIOBEHAV REV 21(1) XXX-XXX, 2021. - Cross education (CE) is the process whereby a regimen of unilateral limb training engenders bilateral improvements in motor function. The contralateral gains thus derived may impart therapeutic benefits for patients with unilateral deficits arising from orthopaedic injury or stroke. Despite this prospective therapeutic utility, there is little consensus concerning its mechanistic basis. The precise means through which the neuroanatomical structures and cellular processes that mediate CE may be influenced by age-related neurodegeneration are also almost entirely unknown. Notwithstanding the increased incidence of unilateral impairment in later life, age-related variations in the expression of CE have been examined only infrequently. In this narrative review, we consider several mechanisms which may mediate the expression of CE with specific reference to the ageing CNS. We focus on the adaptive potential of cellular processes that are subserved by a specific set of neuroanatomical pathways including: the corticospinal tract, corticoreticulospinal projections, transcallosal fibres, and thalamocortical radiations. This analysis may inform the development of interventions that exploit the therapeutic utility of CE training in older persons. [ABSTRACT FROM AUTHOR]

Fariñas, J, Mayo, X, Giraldez-García, MA, Carballeira, E, Fernandez-Del-Olmo, M, Rial-Vazquez, J, Kingsley, JD, and Iglesias-Soler, E. Set configuration in strength training programs modulates the cross education phenomenon. J Strength Cond Res 35(9): 2414-2420, 2021-This study aimed to compare the strength gains in the nontrained arm after 2 independent unilateral training programs differing in the set configuration. Thirty-five subjects were randomly assigned to 3 groups: traditional training (TT; n = 12), cluster training (CT; n = 11), or control (CON; n = 12). The experimental groups performed a 5-week training program of a unilateral biceps curl exercise with the dominant limb using the 10 repetition maximum (10RM) load. Traditional training performed 5 sets of 6 repetitions and 135 seconds of rest between sets. Cluster training completed 30 repetitions with 18.5 seconds of rest between each repetition. Anthropometry (ANT), muscle thickness (MT), 1RM, the number of repetitions with 10RM (n10RM), and isometric maximal voluntary contraction (MVC) were measured before and after the intervention. Regarding the nontrained arm, TT improved 1RM (7.3%, p < 0.001). No changes were observed in CT. Regarding the trained arm, TT improved 1RM (9.1%, p < 0.001), n10RM (p = 0.005), and MVC (p = 0.011), whereas CT only showed a trend for improvement of 1RM (3.4%, p = 0.052). These results suggest that when total volume and repetition-to-rest ratio are equated, a more fatiguing set configuration causes a higher effect on the non-trained limb. [ABSTRACT FROM AUTHOR]

Background: Continuous passive motion (CPM) is frequently used during rehabilitation following total knee arthroplasty (TKA). Low-load resistance training (LLRT) using continuous active motion (CAM) devices is a promising alternative. We investigated the effectiveness of CPM compared to LLRT using the affected leg (CAMuni) and both legs (CAMbi) in the early post-operative rehabilitation. Hypotheses: (I) LLRT (CAMuni and CAMbi) is superior to CPM, (II) additional training of the unaffected leg (CAMbi) is more effective than unilateral training (CAMuni).Materials and Methods: Eighty-five TKA patients were randomly assigned to three groups, respectively: (i) unilateral CPM of the operated leg; (ii) unilateral CAM of the operated leg (CAMuni); (iii) bilateral alternating CAM (CAMbi). Patients were assessed 1 day before TKA (pre-test), 1 day before discharge (post-test), and 3 months post-operatively (follow-up). Primary outcome: active knee flexion range of motion (ROMFlex). Secondary outcomes: active knee extension ROM (ROMExt), swelling, pain, C-reactive protein, quality of life (Qol), physical activity, timed-up-and-go performance, stair-climbing performance, quadriceps muscle strength. Analyses of covariances were performed (modified intention-to-treat and per-protocol).Results: Hypothesis I: Primary outcome: CAMbi resulted in a higher ROMFlex of 9.0° (95%CI −18.03–0.04°, d = 0.76) and 6.3° (95%CI −14.31–0.99°, d = 0.61) compared to CPM at post-test and follow-up, respectively. Secondary outcomes: At post-test, C-reactive protein was lower in both CAM groups compared with CPM. Knee pain was lower in CAMuni compared to CPM. Improved ROMExt, reduced swelling, better stair-climbing and timed-up-and-go performance were observed for CAMbi compared to CPM. At follow-up, both CAM groups reported higher Qol and CAMbi showed a better timed-up-and-go performance. Hypothesis II: Primary outcome: CAMbi resulted in a higher knee ROMFlex of 6.5° (95%CI −2.16–15.21°, d = 0.56) compared to CAMuni at post-test. Secondary outcomes: At post-test, improved ROMExt, reduced swelling, and better timed-up-and-go performance were observed in CAMbi compared to CAMuni.Conclusions: Additional LLRT of the unaffected leg (CAMbi) seems to be more effective for recovery of function than training of the affected leg only (CAMuni), which may be mediated by positive transfer effects from the unaffected to the affected limb (cross education) and/or preserved neuromuscular function of the trained, unaffected leg.Trial Registration:ClinicalTrials.gov Identifier: NCT02062138.

The purpose of this study was to determine the effects of training load (25% vs. 75% of one repetition maximum [1RM]) and fatigue (failure vs. non‐failure) during four weeks of unilateral knee extension resistance training (RT) on maximal voluntary force in the trained and the untrained knee extensors. Healthy young adults (n = 42) were randomly assigned to control (CON, n = 9, 24 ± 4.3 years), low‐load RT to failure (LLF, n = 11, 21 ± 1.3 years, three sets to failure at 25% of 1RM), high‐load RT to failure (HLF, n = 11, 21 ± 1.4 years, three sets to failure at 75% of 1RM), and high‐load RT without failure (HLNF, n = 11, 22 ± 1.5 years, six sets of five repetitions at 75% of 1RM) groups. Before and after the four weeks of training, 1RM, maximal voluntary isometric force, and corticospinal excitability (CSE) were measured. 1RM in the trained (20%, d = 0.70, 15%, d = 0.61) and the untrained knee extensors (5%, d = 0.27, 6%, d = 0.26) increased only in the HLF and HLNF groups, respectively. MVIC force increased only in the trained leg of the HLF (5%, d = 0.35) and HLNF groups (12%, d = 0.67). CSE decreased in the VL of both legs in the HLNF group (−19%, d = 0.44) and no changes occurred in the RF. In conclusion, high‐ but not low‐load RT improves maximal voluntary force in the trained and the untrained knee extensors and fatigue did not further enhance these adaptations. Voluntary force improvements were unrelated to CSE changes in both legs. [ABSTRACT FROM AUTHOR]

This study compared the effects of contralateral eccentric‐only (ECC) and concentric‐/eccentric‐coupled resistance training (CON‐ECC) of the elbow flexors on immobilized arm. Thirty healthy participants (18‐34 y) were randomly allocated to immobilization only (CTRL; n = 10), immobilization and ECC (n = 10), or immobilization and CON‐ECC group (n = 10). The non‐dominant arms of all participants were immobilized (8 h·day−1) for 4 weeks, during which ECC and CON‐ECC were performed by the dominant (non‐immobilized) arm 3 times a week (3‐6 sets of 10 repetitions per session) with an 80%‐120% and 60%‐90% of one concentric repetition maximum (1‐RM) load, respectively, matching the total training volume. Arm circumference, 1‐RM and maximal voluntary isometric contraction (MVIC) strength, biceps brachii surface electromyogram amplitude (sEMGRMS), rate of force development (RFD), and joint position sense (JPS) were measured for both arms before and after immobilization. CTRL showed decreases (P <.05) in MVIC (−21.7%), sEMGRMS (−35.2%), RFD (−26.0%), 1‐RM (−14.4%), JPS (−87.4%), and arm circumference (−5.1%) of the immobilized arm. These deficits were attenuated or eliminated by ECC and CON‐ECC, with greater effect sizes for ECC than CON‐ECC in MVIC (0.29: +12.1%, vs −0.18: −0.1%) and sEMGRMS (0.31:17.5% vs −0.15: −5.9%). For the trained arm, ECC showed greater effect size for MVIC than CON‐ECC (0.47 vs 0.29), and increased arm circumference (+2.9%), sEMGRMS (+77.9%), and RDF (+31.8%) greater (P <.05) than CON‐ECC (+0.6%, +15.1%, and + 15.8%, respectively). The eccentric‐only resistance training of the contralateral arm was more effective to counteract the negative immobilization effects than the concentric‐eccentric training. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to evaluate the benefits of adding electromuscular stimulation (EMS) to the flexors of wrist muscles on the nonparetic limb in conventional stroke training to strengthen homologous agonist and antagonist muscles on the paretic side in patients with subacute stroke. Methods: The EMS group patients (n = 15) received conventional therapy for 30 sessions for 6 weeks (60 min/session) with 30 min of electrical stimulation to their nonparetic forearm using wrist flexors, with 5 min of pre- and post-warm-up. The transcutaneous electrical nerve stimulation (TENS) group patients (n = 15) received the same conventional rehabilitation training with 30 min of conventional antalgic TENS at a barely sensible level to their nonparetic forearm. The Fugl–Meyer motor function assessment for upper extremity (FMA-UE), functional independence measure (FIM), Brunnstrom staging of recovery for hand, maximum and mean wrist flexion force (flexionmax and flexionmean), and wrist extension force (extensionmax and extensionmean) of paretic untrained limb were evaluated before and after the treatment. Results: EMS and TENS group patients improved similarly in terms of FMA-UE, FIM, and Brunnstrom staging for hand recovery. However, flexionmax and flexionmean of the paretic limb increased more in the EMS group than in the TENS group. Extensionmax and extensionmean on the paretic side increased in the EMS group but did not differ in the TENS group. Conclusion: Cross-education via EMS may have a beneficial effect as an adjunct to conventional treatment methods. This study is retrospectively registered and is available at www.clinicaltrials.gov (ID: NCT04113369). [ABSTRACT FROM AUTHOR]

These hypotheses were tested: (1) Freely chosen frequency in unilateral index finger tapping is correlated between the two index fingers, and (2) A 3-min bout of unilateral index finger tapping followed by 10 min rest results in an increase of the freely chosen tapping frequency performed by the contralateral index finger in a second bout. Thirty-two adults participated. Freely chosen tapping frequencies from first bouts were 167.2 ± 79.0 and 161.5 ± 69.4 taps/min for the dominant and non-dominant hand, respectively (p=.434). These variables correlated (R=.86, p<.001). When bout one and two were performed with the dominant and non-dominant hand, respectively, the frequency increased by 8.1%±17.2% in bout two (p=.011). In opposite order, the frequency increased by 14.1%±17.5% (p<.001), which was not different from the ∼8% (p=.157). [ABSTRACT FROM AUTHOR]

Learning from motor errors that occur across different limbs is essential for effective tool use, sports training, and rehabilitation. To probe the neural organization of error-driven learning across limbs, we asked whether learning opposing visuomotor mappings with the two arms would interfere. Young right-handers first adapted to opposite visuomotor rotations A and B with different arms and were then reexposed to A 24 h later. We observed that relearning of A was never faster nor were initial errors smaller than prior A learning, which would be expected if there was no interference from B. Rather, errors were greater than or similar to, and learning rate was slower than or comparable to, previous A learning depending on the order in which the arms learned. This indicated robust interference between the motor memories of A and B when they were learned with different arms in close succession. We then proceeded to uncover that the order-dependent asymmetry in performance upon reexposure resulted from asymmetric transfer of learning from the left arm to the right but not vice versa and that the observed interference was retrograde in nature. Such retrograde interference likely occurs because the two arms require the same neural resources for learning, a suggestion consistent with that of our past work showing impaired learning following left inferior parietal damage regardless of the arm used. These results thus point to a common neural basis for formation of new motor memories with different limbs and hold significant implications for how newly formed motor memories interact. NEW & NOTEWORTHY In a series of experiments, we demonstrate robust retrograde interference between competing motor memories developed through error-based learning with different arms. These results provide evidence for shared neural resources for the acquisition of motor memories across different limbs and also suggest that practice with two effectors in close succession may not be a sound approach in either sports or rehabilitation. Such training may not allow newly acquired motor memories to be stabilized. [ABSTRACT FROM AUTHOR]

Learning a motor task in one condition typically generalizes to another, although it is unclear why it generalizes substantially in certain situations, but only partially in other situations (e.g., across movement directions and motor effectors). Here, we demonstrate that generalization of motor learning across directions and effectors can be enhanced substantially by inducing use-dependent learning, that is, by having subjects experience motor actions associated with a desired trajectory repeatedly during reaching movements. In Experiments 1 and 2, healthy human adults adapted to a visuomotor rotation while concurrently experiencing repetitive passive movements guided by a robot. This manipulation increased the extent of generalization across movement directions (Expt. 1) and across the arms (Expt. 2) by up to 50% and 42%, respectively, indicating crucial contribution of use-dependent learning to motor generalization. In Experiment 3, we applied repetitive transcranial magnetic stimulation (rTMS) to the left primary motor cortex (M1) of the human subjects prior to passive training with the right arm to increase cortical excitability. This intervention resulted in increased motor-evoked potentials (MEPs) and decreased short-interval intracortical inhibition (SICI) in the rTMS group, but not in the sham group. These changes observed in the rTMS group were accompanied by enhanced generalization of visuomotor adaptation across the arms, which was not the case in the sham group. Collectively, these findings confirm the involvement of M1 in use-dependent learning, and suggest that use-dependent learning can contribute not only to motor learning, but also to motor generalization. [ABSTRACT FROM AUTHOR]

The "interlimb transfer" phenomenon consists of improved performance of the trained and untrained contralateral limbs after unilateral motor practice. We here assessed whether a visuomotor learning task can be transferred from one hemisphere to the other, whether this occurs symmetrically, and the cortical neurophysiological correlates of this phenomenon, focusing on interhemispheric connectivity measures. We enrolled 33 healthy subjects (age range: 24-73 years). Participants underwent two randomized sessions, which investigated the transfer from the dominant to the nondominant hand and vice versa. Measures of cortical and intracortical excitability and interhemispheric inhibition were assessed through transcranial magnetic stimulation before and after a visuomotor task. The execution of the visuomotor task led to an improvement in motor performance with the dominant and nondominant hands and induced a decrease in intracortical inhibition in the trained hemisphere. Participants were also able to transfer the visuomotor learned skill. The interlimb transfer, however, only occurred from the dominant to the nondominant hand and positively correlated with individual learning-related changes in interhemispheric inhibition. We here demonstrated that the "interlimb transfer" of a visuomotor task occurs asymmetrically and relates to the modulation of specific inhibitory interhemispheric connections. The study results have pathophysiological, clinical, and neuro-rehabilitative implications., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permission@oup.com.)

Background: Cross-education refers to the increase in motor output of the untrained limb following unilateral training of the opposite limb. Cross education has been shown to be beneficial in clinical settings., Objectives: This systematic literature and meta-analysis aims to assess the effects of cross-education on strength and motor function in post stroke rehabilitation., Data Sources: MEDLINE, CINAHL, Cochrane Library, PubMed, PEDro, Web of Science, ClinicalTrails.gov and Cochrane Central registers were searched up to 1st October 2022., Study Selection: Controlled trials using unilateral training of the less affected limb in individuals diagnosed with stroke and English language., Data Synthesis: Methodological quality was assessed using Cochrane Risk-of-Bias tools. Quality of evidence was evaluated using Grading of Recommendations Assessment, Development and Evaluation. Meta-analyses were performed using RevMan 5.4.1., Results: Five studies capturing 131 participants were included in the review and three studies capturing 95 participants were included in the meta-analysis. Cross education was shown to have a statistically and clinically significant effect on upper limb strength (p < 0.003; SMD 0.58; 95% CI 0.20-0.97; n = 117) and upper limb function (p = 0.04; SMD 0.40; 95% CI 0.02-0.77; n = 119)., Limitations: Small number of studies, with all studies identified as having some risk of bias. Quality of evidence graded 'low' due to limitations and imprecision., Conclusion: Cross education may be beneficial in improving strength and motor function in the more affected upper limb post stroke. Further studies are needed as the research into the benefits of cross education in stroke rehabilitation is still limited. Systematic Review Registration Number: PROSPERO (CRD42020219058)., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

This experiment tested the hypothesis that interlimb transfer of motor performance depends on recruitment of motor control processes that are specialized to the hemisphere contralateral to the arm that is initially trained. Right-handed participants performed a single-joint task, in which reaches were targeted to 4 different distances. While the speed and accuracy was similar for both hands, the underlying control mechanisms used to vary movement speed with distance were systematically different between the arms: the amplitude of the initial acceleration profiles scaled greater with movement speed for the right-dominant arm, while the duration of the initial acceleration profile scaled greater with movement speed for the left-non-dominant arm. These two processes were previously shown to be differentially disrupted by left and right hemisphere damage, respectively. We now hypothesize that task practice with the right arm might reinforce left-hemisphere mechanisms that vary acceleration amplitude with distance, while practice with the left arm might reinforce right-hemisphere mechanisms that vary acceleration duration with distance. We thus predict that following right arm practice, the left arm should show increased contributions of acceleration amplitude to peak velocities, and following left arm practice, the right arm should show increased contributions of acceleration duration to peak velocities. Our findings support these predictions, indicating that asymmetry in interlimb transfer of motor performance, at least in the task used here, depends on recruitment of lateralized motor control processes. [ABSTRACT FROM AUTHOR]

Insights into the neural representation of motor learning can be obtained by investigating how learning transfers to novel task conditions. We recently demonstrated that visuomotor rotation learning transferred strongly between left and right limbs when the task was performed in a sagittal workspace, which afforded a consistent remapping for the two limbs in both extrinsic and joint-based coordinates. In contrast, transfer was absent when performed in horizontal workspace, where the extrinsically defined perturbation required conflicting joint-based remapping for the left and right limbs. Because visuomotor learning is thought to be supported by both implicit and explicit forms of learning, however, it is unclear to what extent these distinct forms of learning contribute to interlimb transfer. In this study, we assessed the degree to which interlimb transfer, following visuomotor rotation training, reflects explicit vs. implicit learning by obtaining verbal reports of participants' aiming direction before each movement. We also determined the extent to which these distinct components of learning are constrained by the compatibility of coordinate systems by comparing transfer between groups of participants who reached to targets arranged in the horizontal and sagittal planes. Both sagittal and horizontal conditions displayed complete transfer of explicit learning to the untrained limb. In contrast, transfer of implicit learning was incomplete, but the sagittal condition showed greater transfer than the horizontal condition. These findings suggest that explicit strategies developed with one limb can be fully implemented in the opposite limb, whereas implicit transfer depends on the degree to which new sensorimotor maps are spatially compatible for the two limbs. [ABSTRACT FROM AUTHOR]

Performance benefits conferred in the untrained limb after unilateral motor practice are termed cross-limb transfer. Although the effect is robust, the neural mechanisms remain incompletely understood. In this study we used noninvasive brain stimulation to reveal that the neural adaptations that mediate motor learning in the trained limb are distinct from those that underlie cross-limb transfer to the opposite limb. Thirty-six participants practiced a ballistic motor task with their right index finger (150 trials), followed by intermittent theta-burst stimulation (iTBS) applied to the trained (contralateral) primary motor cortex (cM1 group), the untrained (ipsilateral) M1 (iM1 group), or the vertex (sham group). After stimulation, another 150 training trials were undertaken. Motor performance and corticospinal excitability were assessed before motor training, pre- and post-iTBS, and after the second training bout. For all groups, training significantly increased performance and excitability of the trained hand, and performance, but not excitability, of the untrained hand, indicating transfer at the level of task performance. The typical facilitatory effect of iTBS on MEPs was reversed for cM1, suggesting homeostatic metaplasticity, and prior performance gains in the trained hand were degraded, suggesting that iTBS interfered with learning. In stark contrast, iM1 iTBS facilitated both performance and excitability for the untrained hand. Importantly, the effects of cM1 and iM1 iTBS on behavior were exclusive to the hand contralateral to stimulation, suggesting that adaptations within the untrained M1 contribute to crosslimb transfer. However, the neural processes that mediate learning in the trained hemisphere vs. transfer in the untrained hemisphere appear distinct. [ABSTRACT FROM AUTHOR]

Purpose: Unilateral strength training strengthens not only the muscles on the trained side but also the homologous muscles on the untrained side; however, the magnitude of this interlimb cross-education is modest. We tested the hypothesis that heightened sensory feedback by mirror viewing the exercising hand would augment cross education by modulating neuronal excitability. Methods: Healthy adults were randomized into a mirror training group (MG, N= 11) and a no-mirror training group (NMG, N= 12) and performed 640 shortening muscle contractions of the right wrist flexors at 80% maximum voluntary contraction (MVC) during 15 sessions for 3 wk. Maximal strength and specific transcranial magnetic stimulation metrics of neuronal excitability, measured in the mirror and no-mirror setup at rest and during unilateral contractions at 60% MVC, were assessed before and after the strength intervention. Results: Trained wrist flexor MVC increased 72% across groups, whereas cross-education was higher for the MG (61%) than NMG (34%, P = 0.047). The MG showed a reduction (15%-16%) in the contralateral silent period duration measured from the contracting left-untrained flexor carpi radialis, whereas the NMG showed an increase (12%, P ≤ 0.030). Interhemispheric inhibition, measured from the trained to the untrained primary motor cortex, increased in the MG (11%) but decreased in the NMG (15%) when measured in the mirror setup at rest (P = 0.048). Other transcranial magnetic stimulation measures did not change. Conclusion: Viewing the exercising hand in a mirror can augment the cross-education effect. The use of a mirror in future studies can potentially accelerate functional recovery from unilateral impairment due to stroke or upper limb fracture. [ABSTRACT FROM AUTHOR]

Humans are able to adapt their motor commands to make accurate movements in novel sensorimotor environments, such as when wielding tools that alter limb dynamics. However, it is unclear to what extent sensorimotor representations, obtained through experience with one limb, are available to the opposite, untrained limb and in which form they are available. Here, we compared crosslimb transfer of force-field compensation after participants adapted to a velocity-dependent curl field, oriented either in the sagittal or the transverse plane. Due to the mirror symmetry of the limbs, the force field had identical effects for both limbs in joint and extrinsic coordinates in the sagittal plane but conflicting joint-based effects in the transverse plane. The degree of force-field compensation exhibited by the opposite arm in probe trials immediately after initial learning was significantly greater after sagittal (26 ± 5%) than transverse plane adaptation (9 ± 4%; P < 0.001), irrespective of whether participants learned initially with the left or the right arm or via abrupt or gradual exposure to the force field. Thus transfer was impaired when the orientation of imposed dynamics conflicted in intrinsic coordinates for the two limbs. The data reveal that neural representations of novel dynamics are only partially available to the opposite limb, since transfer is incomplete even when force-field perturbation is spatially compatible for the two limbs, according to both intrinsic and extrinsic coordinates. [ABSTRACT FROM AUTHOR]

Purpose: Sensory input can modify voluntary motor function. We examined whether somatosensory electrical stimulation (SES) added to motor practice (MP) could augment motor learning, interlimb transfer, and whether physiological changes in neuronal excitability underlie these changes.Methods: Participants (18-30 years, n = 31) received MP, SES, MP + SES, or a control intervention. Visuomotor practice included 300 trials for 25 min with the right-dominant wrist and SES consisted of weak electrical stimulation of the radial and median nerves above the elbow. Single- and double-pulse transcranial magnetic stimulation (TMS) metrics were measured in the intervention and non-intervention extensor carpi radialis.Results: There was 27 % motor learning and 9 % (both p < 0.001) interlimb transfer in all groups but SES added to MP did not augment learning and transfer. Corticospinal excitability increased after MP and SES when measured at rest but it increased after MP and decreased after SES when measured during contraction. No changes occurred in intracortical inhibition and facilitation. MP did not affect the TMS metrics in the transfer hand. In contrast, corticospinal excitability strongly increased after SES with MP + SES showing sharply opposite of these effects.Conclusion: Motor practice and SES each can produce motor learning and interlimb transfer and are likely to be mediated by different mechanisms. The results provide insight into the physiological mechanisms underlying the effects of MP and SES on motor learning and cortical plasticity and show that these mechanisms are likely to be different for the trained and stimulated motor cortex and the non-trained and non-stimulated motor cortex. [ABSTRACT FROM AUTHOR]

Intermanual transfer, i.e., generalization of motor learning across hands, is a well-accepted phenomenon of motor learning. Yet, there are open questions regarding the characteristics of this transfer, particularly the intermanual transfer of dynamic learning. In this study, we investigated intermanual transfer in a force field adaptation task concerning the direction and the coordinate frame of transfer as well as the influence of a 24-h consolidation period on the transfer. We tested 48 healthy human subjects for transfer from dominant to nondominant hand, and vice versa. We considered two features of transfer. First, we examined transfer to the untrained hand using force channel trials that suppress error feedback and learning mechanisms to assess intermanual transfer in the form of a practicedependent bias. Second, we considered transfer by exposing the subjects to the force field with the untrained hand to check for faster learning of the dynamics (interlimb savings). Half of the subjects were tested for transfer immediately after adaptation, whereas the other half were tested after a 24-h consolidation period. Our results showed intermanual transfer both from dominant to nondominant hand and vice versa in extrinsic coordinates. After the consolidation period, transfer effects were weakened. Moreover, the transfer effects were negligible compared with the subjects' ability to rapidly adapt to the force field condition. We conclude that intermanual transfer is a bidirectional phenomenon that vanishes with time. However, the ability to transfer motor learning seems to play a minor role compared with the rapid adaptation processes. [ABSTRACT FROM AUTHOR]

We continuously adapt our movements in daily life, forming new internal models whenever necessary and updating existing ones. Recent work has suggested that this flexibility is enabled via sensorimotor cues, serving to access the correct internal model whenever necessary and keeping new models apart from previous ones. While research to date has mainly focused on identifying the nature of such cue representations, here we investigated whether and how these cue representations generalize, interfere, and transfer within and across effector systems. Subjects were trained to make two-stage reaching movements: a premovement that served as a cue, followed by a targeted movement that was perturbed by one of two opposite curl force fields. The direction of the premovement was uniquely coupled to the direction of the ensuing force field, enabling simultaneous learning of the two respective internal models. After training, generalization of the two premovement cues’ representations was tested at untrained premovement directions, within both the trained and untrained hand. We show that the individual premovement representations generalize in a Gaussian-like pattern around the trained premovement direction. When the force fields are of unequal strengths, the cue-dependent generalization skews toward the strongest field. Furthermore, generalization patterns transfer to the nontrained hand, in an extrinsic reference frame. We conclude that contextual cues do not serve as discrete switches between multiple internal models. Instead, their generalization suggests a weighted contribution of the associated internal models based on the angular separation from the trained cues to the net motor output. [ABSTRACT FROM AUTHOR]

Humans can learn to make accurate movements when the required map between vision and motor commands changes, but can visuomotor maps obtained through experience with one limb benefit the other? Complete transfer would require new maps to be both fully compatible and accessible between limbs. However, when this question is addressed by providing subjects with rotated visual feedback during reaching, transfer is rarely apparent in the first few trials with the unpracticed limb and is sometimes absent altogether. Partial transfer might be explained by limited accessibility to remapped brain circuits, since critical visuomotor transformations mediating unilateral movements appear to be lateralized. Alternatively, if adaptation involves movement representations associated with both extrinsic (i.e., direction of motion in space) and intrinsic (i.e., joint or muscle based) frames of reference, new visuomotor maps might be incompatible with opposite limb use when visual distortions have opposite effects for the two limbs in intrinsic coordinates. Here we addressed this issue when subjects performed an isometric aiming task with the index finger. We manipulated the alignment of visuomotor distortion for the two hands in different reference frames by altering body posture relative to the orientation of the finger and the visual display. There was strong, immediate transfer of adaptation between limbs only when visuomotor distortion had identical effects in eye- and joint-based coordinates bilaterally. This implies that new visuomotor maps are encoded in neural circuits associated with both intrinsic and extrinsic movement representations and are available to both limbs. [ABSTRACT FROM AUTHOR]

Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Abstract: Interlimb transfer of motor learning, indicating an improvement in performance with one limb following training with the other, often occurs asymmetrically (i.e., from non-dominant to dominant limb or vice versa, but not both). In the present study, we examined whether interlimb transfer of the same motor task could occur asymmetrically and in opposite directions (i.e., from right to left leg vs. left to right leg) depending on individuals’ conception of the task. Two experimental conditions were tested: In a dynamic control condition, the process of learning was facilitated by providing the subjects with a type of information that forced them to focus on dynamic features of a given task (force impulse); and in a spatial control condition, it was done with another type of information that forced them to focus on visuomotor features of the same task (distance). Both conditions employed the same leg extension task. In addition, a fully-crossed transfer paradigm was used in which one group of subjects initially practiced with the right leg and were tested with the left leg for a transfer test, while the other group used the two legs in the opposite order. The results showed that the direction of interlimb transfer varied depending on the condition, such that the right and the left leg benefited from initial training with the opposite leg only in the spatial and the dynamic condition, respectively. Our finding suggests that manipulating the conception of a leg extension task has a substantial influence on the pattern of interlimb transfer in such a way that the direction of transfer can even be opposite depending on whether the task is conceived as a dynamic or spatial control task. [Copyright &y& Elsevier]

This study was designed to investigate sequential effects after practice with the dominant and non-dominant hand on the acquisition of a new motor task. A total of 64 middle school children were asked to practise a cent-slide task, which required them to slide coins from one side of a cardboard into a circular target on the opposite side. Four groups practised this task within different practice schedules: (1) participants practised only with their dominant hand (right-only group); (2) participants used only their non-dominant hand (left-only group); (3) participants started to practise the skill with their dominant hand and then switched to their non-dominant hand (right-to-left group); or (4) participants started to practise the skill with their non-dominant hand and then switched to their dominant hand (left-to-right group). The acquisition of the task was facilitated after initial practice with the non-dominant hand. This was reflected in a better retention of the task and a stronger performance under a modified testing situation of the left-to-right group when compared to all other groups. Also, the left-only group showed larger interlimb transfer effects to the untrained hand than the right-only group. It is concluded that the sequence in which the dominant and non-dominant hands are used to practise influences the acquisition of new motor tasks. [ABSTRACT FROM AUTHOR]

Does the brain use a separate internal model for cursor mechanics during visuomotor adaptation? We compared the amount of adaptation and transfer to the opposite arm when subjects reached the targets under different viewing conditions of the arm during reaching. If the brain forms separate models, we predict a difference in the amount of adaptation and transfer for each viewing condition. If the brain forms one model, we predict equivalent amounts of adaptation and transfer between the two hands for each viewing condition. Separate groups of subjects performed a reaching task with either a rotated view of cursor motion representing their unseen hand or a rotated view of their actual hand. The two groups were further divided so that the magnitude of the rotation was either 45° or 75° counter-clockwise. After adapting to the rotation with one hand, subjects reached the same targets under the same viewing condition but with the opposite hand. Similar amounts of adaptation and intermanual transfer were found across the different magnitudes of rotation and across patterns of hand-order. Our results suggest that the brain may not be learning a distinct model for cursor mechanics, or if it is, it must be equivalent or overlapping with the arm model. [ABSTRACT FROM AUTHOR]

Previous research has shown that training of a novel task can improve subsequent performance in the opposite arm owing to anticipation of the previously learned task conditions. Interestingly, we recently reported preliminary evidence that such transfer might also include modulation of feedback-mediated responses. We now test interlimb transfer of load compensation responses, measured through kinematic and EMG recordings during rapid 20° elbow flexion movements. Two subject groups, LR and RL, each comprising six right-handed subjects, first performed using either the left (LR) or right (RL) arm, followed by opposite arm performance. After 30 trials of consistent performance, five random trials within a background of 50 trials were loaded with a 2-kg mass prior to the “go” signal. We compared load compensation responses for naïve performance with those following opposite arm exposure. Under naïve conditions, the resulting load compensation responses began about 50 ms following movement onset, and were substantially more effective for the nondominant arm. Opposite arm exposure substantially improved the accuracy of only dominant arm responses. This, however, did not occur through changes in the short latency components of the load compensation response. Instead, changes in muscle activities, associated with interlimb transfer, began some 150 ms following movement onset. We expect that these changes represent transfer in the “volitional” component of the load compensation response. Because the shorter latency response was unaffected by opposite arm exposure, modulation of this component likely requires prior experience with limb specific effectors. [ABSTRACT FROM AUTHOR]

Recently, Criscimagna-Hemminger et al. (2003) reported a pattern of generalization of force-field adaptation between arms that differs from the pattern that occurs across different configurations of the same arm. Although the intralimb pattern of generalization points to an intrinsic encoding of dynamics, the interlimb transfer described by these authors indicates that information about force is represented in a frame of reference external to the body. In the present study, subjects adapted to a viscous curl-field in two experimental conditions. In one condition, the field was introduced suddenly and produced clear deviations in hand paths; in the second condition, the field was introduced gradually so that at no point during the adaptation process could subjects observe or did they have to correct for a substantial kinematic error. In the first case, a pattern of interlimb transfer consistent with Criscimagna-Hemminger et al. (2003) was observed, whereas no transfer of learning between limbs occurred in the second condition. The findings suggest that there is limited transfer of fine compensatory-force adjustment between limbs. Transfer, when it does occur, may be primarily the result of a cognitive strategy that arises as a result of the sudden introduction of load and associated kinematic error. [ABSTRACT FROM AUTHOR]