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Multiple sclerosis is a neurodegenerative disease that causes balance deficits, even in early stages. Evidence suggests that people with multiple sclerosis (PwMS) rely more on vision to maintain balance, and challenging balance with optical flow perturbations may be a practical screening for balance deficits. Whether these perturbations affect standing balance in PwMS is unknown. Therefore, the purpose of this study was to examine how optical flow perturbations affect standing balance in PwMS. We hypothesized that perturbations would cause higher variability in PwMS compared with matched controls during standing and that standing balance would be more susceptible to anterior–posterior (A–P) perturbations than medial–lateral (M–L) perturbations. Thirteen PwMS and 13 controls stood under 3 conditions: unperturbed, M–L perturbation, and A–P perturbations. A–P perturbations caused significantly higher A–P trunk sway variability in PwMS than controls, although both groups had similar center-of-pressure variability. Both perturbations increased variability in A–P trunk sway and center of pressure. Trunk variability data supported the hypothesis that PwMS were more susceptible to optical flow perturbations than controls. However, the hypothesis that A–P perturbations would affect balance more than M–L perturbations was partially supported. These results suggest potential for optical flow perturbations to identify balance deficits in PwMS. [ABSTRACT FROM AUTHOR]

Active video games (AVG) have been used as training tools and are known to ameliorate balance performance in children with Developmental Coordination Disorder (DCD). Our aim was to evaluate balance using clinical tests and by measuring body sway using a force plate with a mixed design of vision (eyes open/eyes closed), surface (rigid/soft). and support (stance/semitandem) before, and after, training and 4 months later (follow-up). Thirty-six DCD children and 40 typically developing children participated in the study, of which 50 children (26 DCD; 24 typically developing) were retested after 4 months. Balance improved on the clinical measures after the training, which was independent of type of AVG (Wii-Fit and Xbox Kinect) used, and this effect was still present after 4 months. The AVG training did not influence general sway behavior, but only sway in the eyes-open condition. corresponding with task demands of the training and indicating a training-specific effect. Overall, DCD children and typically developing children responded comparably to the AVG training, thereby maintaining the gap in performance between the two groups. The changes iii postural sway are interpreted as a sign of more confidence and less freezing of the joints, enabling greater flexibility of movements and balance strategies as supported by the improved performance on balance tests in the DCD children. This is the first study that showed long-term effects of AVG training on balance performance. However. these follow-up results should be interpreted with caution given that 35% of the children were lost in follow-up. [ABSTRACT FROM AUTHOR]

Whether visuomotor plasticity of postural control is a trainable feature in older age remains an open question despite the wealth of visually guided exercise games promising to improve balance skill. We asked how aging affects adaptation and learning of a visual feedback (VF) reversal during visually guided weight shifting and whether this skill is modulated by explicit knowledge. Twenty-four older (71.43 + 2.54 years) and 24 young (24.04 1 0.93 years) participants were exposed to a 180° VF reversal while tracking a horizontally moving target by voluntarily weight shifting between two force platforms. An explicit strategy was available to half of the participants with detailed instruction to counter the VF rotation. Individual error data were fitted to an exponential function to assess adaptation. Fewer older (12/24) than younger (21/24) participants adapted to the VF reversal, displaying error curves that fitted the exponential function. Older adults who adapted to the VF reversal (responders. n= 12) reached an asymptote in performance in the same weight shifting cycle and displayed a similar mean asymptotic error compared with young participants. Young but not older responders exhibited an aftereffect when the VF reversal was removed. Instruction did not influence spatial error modulations regardless of age. The large individual variations within the older adults' group during early adaptation suggest age-specific limitations in using explicit cognitive strategies when older adults are exposed to an abrupt mirror feedback reversal that requires a change in weight shifting direction during whole-body postural tracking. [ABSTRACT FROM AUTHOR]

Background: Regular moderate–vigorous intensity exercise is recommended for adults as it can improve longevity and reduce health risks associated with a sedentary lifestyle. However, there are barriers to achieving intense exercise that may be addressed using virtual reality (VR) as a tool to promote exercise intensity and adherence, particularly through visual feedback and competition. The purpose of this work is to compare visual feedback and competition within fully immersive VR to enhance exercise intensity and user experience of exercise for young adults; and to describe and compare visual attention during each of the conditions. Methods: Young adults (21–34 years old) bicycled in three 5 min VR conditions (visual feedback, self-competition, and competition against others). Exercise intensity (cycling cadence and % of maximum heart rate) and visual attention (derived from a wearable eye tracking sensor) were measured continuously. User experience was measured by an intrinsic motivation questionnaire, perceived effort, and participant preference. A repeated-measures ANOVA with paired t-test post hoc tests was conducted to detect differences between conditions. Results: Participants exercised at a higher intensity and had higher intrinsic motivation in the two competitive conditions compared to visual feedback. Further, participants preferred the competitive conditions and only reached a vigorous exercise intensity during self-competition. Visual exploration was higher in visual feedback compared to self-competition. Conclusions: For young adults bicycling in VR, competition promoted higher exercise intensity and motivation compared to visual feedback. [ABSTRACT FROM AUTHOR]

Purpose: Virtual Reality (VR) has proven to be an effective tool for motor (re)learning. Furthermore, with the current commercialization of low-cost head-mounted displays (HMDs), immersive virtual reality (IVR) has become a viable rehabilitation tool. Nonetheless, it is still an open question how immersive virtual environments should be designed to enhance motor learning, especially to support the learning of complex motor tasks. An example of such a complex task is triggering steps while wearing lower-limb exoskeletons as it requires the learning of several sub-tasks, e.g., shifting the weight from one leg to the other, keeping the trunk upright, and initiating steps. This study aims to find the necessary elements in VR to promote motor learning of complex virtual gait tasks. Methods: In this study, we developed an HMD-IVR-based system for training to control wearable lower-limb exoskeletons for people with sensorimotor disorders. The system simulates a virtual walking task of an avatar resembling the sub-tasks needed to trigger steps with an exoskeleton. We ran an experiment with forty healthy participants to investigate the effects of first- (1PP) vs. third-person perspective (3PP) and the provision (or not) of concurrent visual feedback of participants' movements on the walking performance – namely number of steps, trunk inclination, and stride length –, as well as the effects on embodiment, usability, cybersickness, and perceived workload. Results: We found that all participants learned to execute the virtual walking task. However, no clear interaction of perspective and visual feedback improved the learning of all sub-tasks concurrently. Instead, the key seems to lie in selecting the appropriate perspective and visual feedback for each sub-task. Notably, participants embodied the avatar across all training modalities with low cybersickness levels. Still, participants' cognitive load remained high, leading to marginally acceptable usability scores. Conclusions: Our findings suggest that to maximize learning, users should train sub-tasks sequentially using the most suitable combination of person's perspective and visual feedback for each sub-task. This research offers valuable insights for future developments in IVR to support individuals with sensorimotor disorders in improving the learning of walking with wearable exoskeletons [ABSTRACT FROM AUTHOR]

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Background: A Stroke is classically characterized as a neurological deficit attributed to an acute focal injury of the central nervous system by a vascular cause and is a major cause of disability and death worldwide.(1) Balance problems are thought to be common after stroke and they have been implicated in the poor recovery of activities of daily living and mobility and increased risk of falls.(2) Postural sway for patients with hemiplegia can be twice that of their age matched peers. Many balance training are used but No general physiotherapy approach has proven to be superior for promoting balance recovery from stroke.(3) Novel biofeedback devices based on Virtual reality (VR)technology are now being used for neuromotor rehabilitation. Traditional balance training is based on the automatic repetition of specific movements. These methods can become repetitive and thus reduce the motivation of the patient and adherence to treatment. So the need of my study is to compare the effectiveness of visual feedback balance training on equiboard and traditional balance training in post stroke patients. Aims and objectives: To study and compare the effectiveness of visual feedback balance training on equiboard versus traditional balance training in post stroke patients. Methodology: 30 patients with stroke were equally divided into two groups. patients in group A received the conventional physiotherapy while the patients in group B received visual feedback balance training on equiboard. All the subjects were treated for 1 month, 5 days a week. BBS-Berg Balance Scale and step test was used as the outcome measure at the beginning and end of study. Results: Results showed significant improvement within both the groups for both the outcome measure(p,0.05), while there was no significant difference between two groups in BBS(p>0.5), but there was significant difference in the step test of experimental group(p<0.5) Conclusion: It can be concluded that visual feedback balance training is more effective than the traditional balance training alone in stroke patients. [ABSTRACT FROM AUTHOR]

Background: Previous studies have suggested that the Pro-Kin visual feedback balance system can promote the recovery of balance function in stroke patients. Objectives: However, this system has not been used effectively in the early stages of stroke rehabilitation. This study aimed to investigate the effect of Pro-Kin system combined with weight loss system for the early recovery of balance and walking ability following a stroke. Methods: A total of 62 patients who underwent radiological diagnosis of stroke were randomly divided into two groups: a control group (n = 31) and a treatment group (n = 31). Both groups received conventional balance training. The treatment group also received training on the Pro-Kin system in conjunction with a weight loss system. Balance was measured using the Berg Balance Scale (BBS), Timed 'Up & Go' (TUG) test and Pro-Kin system. Walking ability was assessed using the Functional Ambulation Classification (FAC). The tests were performed before the start of treatment and on the 4th week following the training. There was no statistically significant difference between the groups before training. Results: After 4 weeks of training in both groups, there were significant improvements in balance and walking ability. BBS values and FAC were significantly higher (p < 0.01), TUG times, ellipse area and motion trajectory length were significantly reduced (p < 0.01, p < 0.05) after training. The treatment group outperformed the control group (p < 0.05). In addition, there was a positive correlation between balance function and walking ability (p < 0.01). Conclusion: The Pro-Kin system combined with weight loss system is a viable method that promotes early reconstruction of balance and walking ability following a stroke. Trial registration: Clinical trial number ChiCTR1900026370. https://www.chictr.org.cn/showprojEN.html?proj=43736 [ABSTRACT FROM AUTHOR]

Humans rely on predictive and integrative mechanisms during visual processing to efficiently resolve incomplete or ambiguous sensory signals. Although initial low-level sensory data are conveyed by feedforward connections, feedback connections are believed to shape sensory processing through automatic conveyance of statistical probabilities based on prior exposure to stimulus configurations. Individuals with autism spectrum disorder (ASD) show biases in stimulus processing toward parts rather than wholes, suggesting their sensory processing may be less shaped by statistical predictions acquired through prior exposure to global stimulus properties. Investigations of illusory contour (IC) processing in neurotypical (NT) adults have established a well-tested marker of contour integration characterized by a robust modulation of the visually evoked potential (VEP)—the IC-effect—that occurs over lateral occipital scalp during the timeframe of the visual N1 component. Converging evidence strongly supports the notion that this IC-effect indexes a signal with significant feedback contributions. Using high-density VEPs, we compared the IC-effect in 6- to 17-yr-old children with ASD (n = 32) or NT development (n = 53). Both groups of children generated an IC-effect that was equivalent in amplitude. However, the IC-effect notably onset 21 ms later in ASD, even though initial VEP afference was identical across groups. This suggests that feedforward information predominated during perceptual processing for 15% longer in ASD compared with NT children. This delay in the feedback-dependent IC-effect, in the context of known developmental differences between feedforward and feedback fibers, suggests a potential pathophysiological mechanism of visual processing in ASD, whereby ongoing stimulus processing is less shaped by visual feedback. NEW & NOTEWORTHY: Children with autism often present with an atypical visual perceptual style that emphasizes parts or details over the whole. Using electroencephalography (EEG), this study identifies delays in the visual feedback from higher-order sensory brain areas to primary sensory regions. Because this type of visual feedback is thought to carry information about prior sensory experiences, individuals with autism may have difficulty efficiently using prior experience or putting together parts into a whole to help make sense of incoming new visual information. This provides empirical neural evidence to support theories of disrupted sensory perception mechanisms in autism. [ABSTRACT FROM AUTHOR]

This study investigates how feedback from different modalities affect window navigation tasks performed on a touchscreen by younger and older users. Thirty-two younger and 32 older users moved a window toward one of four or eight target areas with no feedback or visual, tactile or visual–tactile feedback. Visual feedback produced significantly higher accuracy and shorter task completion times than tactile feedback. Generally, visual–tactile feedback did not produce statistically higher accuracy or shorter task completion time than visual feedback. However, visual–tactile feedback prevented both younger and older users from overshooting the windows. Additionally, when users attempted to move the window to one of the eight target areas, the visual–tactile feedback helped younger users perform better. According to theories about human processing, the reason for the subtle advantage of visual–tactile feedback is that the unintuitive tactile force induces a higher cognitive load than straightforward visual information during window navigation. Nevertheless, visual–tactile feedback elicited the best user experience, as measured by questionnaires on emotion and fatigue, gesture usability and preference. Furthermore, more older users prefer visual–tactile feedback than younger users. Therefore, visual–tactile feedback should be considered, and the tactile feedback should be modified to be more intuitive in window navigation tasks. Research Highlights Visual feedback improved task performance more than tactile feedback in window navigation task. Visual–tactile feedback did not improve task performance compared to visual feedback. Visual–tactile feedback prevented users from overshooting the window. More older users than younger users prefer visual–tactile feedback. [ABSTRACT FROM AUTHOR]

Studies have demonstrated that high-speed jaw-opening exercises are effective in improving swallowing function. However, there has been no objective tool available for monitoring jaw-opening pace. This study aimed to develop an objective tool for monitoring and validating jaw-opening pace and compare it between young and old ages from different age groups. A load cell plug-in jaw pad connected to an automatic recording and analysis system was used to record jaw-opening motions for offline analysis. We recruited 58 healthy volunteers from different age groups (20–39 y/o; 40-59y/o; 60-79y/o). During a 2-min recording session, each participant was instructed to fully open and close their jaw as quickly as possible while wearing a sensor. Bland-Altman plot, paired t -test and Pearson's correlation test were used to compare the number of jaw-opening motions between manual counting and automatic software analysis. The number of jaw-opening motions during the 2-min recording was compared between the three age groups. Automated analysis of jaw-opening pace was efficient and equally comparable with the traditional manual counting method across the three age groups. A declining trend in jaw-opening pace among the old age group was found but with no statistically significant difference. A jaw-opening motion monitoring tool with reliable automatic pace analysis software was validated in young and old ages The jaw-opening pace demonstrated a tendency to decline with age. [ABSTRACT FROM AUTHOR]

Hand hygiene (HH) among health care workers (HCWs) is crucial in preventing infections in nursing homes. However, HH compliance (HHC) among HCWs remains low. This study aimed to investigate the effect of feedback lights on HCWs' HHC. A 5-month interventional study was conducted in 3 wards in a nursing home in Denmark. During the intervention period, a green light with a smiley appeared on the alcohol-based hand rub (ABHR) dispensers when HCWs used the ABHR, acknowledging HCWs for using the ABHR. HHC was monitored using an automatic HH monitoring system (AHHMS). A total of 64 HCWs were enrolled. The AHHMS collected 23,696 HH opportunities in apartments and dirty utility rooms. Overall, HHC in the apartments increased from 50% at baseline (95% CI: 48, 53) to 56% (95% CI: 54, 58) during the intervention. However, the increased HHC level was not sustained during follow-up. The AHHMS enabled the assessment of the intervention. We found a significant effect of light-guided feedback in the apartments. However, the increased HHC was not sustained after the light was switched off. • Feedback with light on alcohol-based hand rub was investigated in nursing home wards. • Hand hygiene compliance (HHC) was measured using an automatic hand hygiene system. • The light had an immediate, significant effect on health care workers' (HCWs') HHC. • The increased HHC level was not sustained over time. • The light did not change HCWs' HHC in dirty utility rooms. [ABSTRACT FROM AUTHOR]

The aim of the present work was to identify the influence of visual feedback on the quality of users' work with variant human–computer interfaces and on the mastering of interfaces. The studies assessed the features of the generation of control commands by operators of ergatic (man–machine) systems using an oculographic interface, and hand- and head-based movement control interfaces were assessed. The presence of visual feedback was found to be important for accurate command generation in all cases. However, when controlling with the head and eyes, the presence of visual feedback led to greater deviations from the ideal trajectory and increases in the distance traveled by the cursor before reaching the target in untrained users. Analysis of typical reactions in all experiments allowed three types of control to be identified, these being different for eye and head movements but not for hand movements in the ergatic system. The first and second types showed greater numbers of errors in the presence of feedback than the third type. The results obtained here may be of value in the development of promising interfaces for ergatic systems, including determination of the required visual feedback components for this class of technical devices. [ABSTRACT FROM AUTHOR]

Abstract The home-based training approach benefits stroke survivors by providing them with an increased amount of training time and greater feasibility in terms of their training schedule, particularly for those with severe motor impairment. Computer-guided training systems provide visual feedback with correct movement patterns during home-based training. This study aimed to investigate the improvement in motor performance among stroke survivors with moderate to severe motor impairment after 800 min of training using a home-based guidance training system with interactive visual feedback. Twelve patients with moderate to severe stroke underwent home-based training, totaling 800 min (20–40 min per session, with a frequency of 3 sessions per week). The home-based guidance training system uses Kinect to reconstruct the 3D human body skeletal model and provides real-time motor feedback during training. The training exercises consisted of six core exercises and eleven optional exercises, including joint exercises, balance control, and coordination. Pre-training and post-training assessments were conducted using the Fugl-Meyer Assessment-Upper Limb (FMA-UE), Fugl-Meyer Assessment-Lower Limb (FMA-LE), Functional Ambulation Categories (FAC), Berg Balance Scale (BBS), Barthel Index (BI), Modified Ashworth Scale (MAS), as well as kinematic data of joint angles and center of mass (COM). The results indicated that motor training led to the attainment of the upper limit of functional range of motion (FROM) in hip abduction, shoulder flexion, and shoulder abduction. However, there was no improvement in the active range of motion (AROM) in the upper extremity (U/E) and lower extremity (L/E) joints, reaching the level of the older healthy population. Significant improvements were observed in both left/right and superior/inferior displacements, as well as body sway in the mediolateral axis of the COM, after 800 min of training. In conclusion, the home-based guidance system using Kinect aids in improving joint kinematics performance at the level of FROM and balance control, accompanied by increased mediolateral body sway of the COM for stroke survivors with moderate to severe stroke. Additionally, spasticity was reduced in both the upper and lower extremities after 800 min of home-based training.

Background: Studies have demonstrated that high-speed jaw-opening exercises are effective in improving swallowing function. However, there has been no objective tool available for monitoring jaw-opening pace. This study aimed to develop an objective tool for monitoring and validating jaw-opening pace and compare it between young and old ages from different age groups. Materials and methods: A load cell plug-in jaw pad connected to an automatic recording and analysis system was used to record jaw-opening motions for offline analysis. We recruited 58 healthy volunteers from different age groups (20–39 y/o; 40-59y/o; 60-79y/o). During a 2-min recording session, each participant was instructed to fully open and close their jaw as quickly as possible while wearing a sensor. Bland-Altman plot, paired t-test and Pearson's correlation test were used to compare the number of jaw-opening motions between manual counting and automatic software analysis. The number of jaw-opening motions during the 2-min recording was compared between the three age groups. Results: Automated analysis of jaw-opening pace was efficient and equally comparable with the traditional manual counting method across the three age groups. A declining trend in jaw-opening pace among the old age group was found but with no statistically significant difference. Conclusion: A jaw-opening motion monitoring tool with reliable automatic pace analysis software was validated in young and old ages The jaw-opening pace demonstrated a tendency to decline with age.

Although the ability to recover balance in the lateral direction has important implications with regard to fall risk in older adults, the effect of visual input on balance recovery in response to lateral perturbation and the effect of age are not well studied. We investigated the effect of visual input on balance recovery response to unpredictable lateral surface perturbations and its age-related changes. Ten younger and 10 older healthy adults were compared during balance recovery trials performed with the eyes open and eyes closed (EC). Compared with younger adults, older adults showed increased electromyography (EMG) peak amplitude of the soleus and gluteus medius, reduced EMG burst duration of the gluteus maximus and medius, and increased body sway (SD of the body's center of mass acceleration) in EC. In addition, older adults exhibited a smaller % increase (EC—eyes open) of the ankle eversion angle, hip abduction torque, EMG burst duration of the fibularis longus, and a greater % increase of body sway. All kinematics, kinetics, and EMG variables were greater in EC compared with eyes open in both groups. In conclusion, the absence of visual input negatively affects the balance recovery mechanism more in older adults compared with younger adults. [ABSTRACT FROM AUTHOR]

In today's world, there is a high pressure to change lifestyle, which is increasing the incidence of neurological diseases, such as Parkinson's disease. To assess motor dysfunction in these patients, approaches based on markerless motion capture (MMC) technology have been tested in recent years. Despite the high sampling rate and accuracy of commercial depth sensors such as the Leap Motion Controller (LMC), their versatile use is limited due to irregular sensing or processing errors. These affect their reliability and question clinically meaningful data. To mitigate the impact of errors during measurements, we introduce visual feedback for the specialist physician in the form of a real-time display of the measurement data recorded by the LMC. In this proof-of-concept study, we evaluate data from 10 patients with Parkinson's disease and 12 healthy subjects during the finger tapping test (FTT). To verify the suitability of using the LMC sensor for this purpose, we validate the results by simultaneous measurement with digital camera and two contact sensors: an accelerometer and two three-axis gyroscopes placed on the fingertips. The preliminary results confirmed the effectiveness of introducing visual feedback when performing FTT by reducing the impact of LMC sensor failure by 4.3%. Additionally, we used machine learning techniques to determine the clinical relevance of the measured and extracted features, achieving an average classification accuracy of 90.41%. [ABSTRACT FROM AUTHOR]

In the present study, we examined the immediate effect of allowing healthy participants to view their mirror-reflected body image on static and dynamic balance. We placed a mirror to allow participants to frontally view their own body image while maintaining a quiet stance or while engaged in a dynamic postural standing task. On measures of body sway during quiet stance, there were no effects of this visual feedback, supporting the view that human beings have no central mechanism for viewing the mirror-reflected body image to control body sway during quiet stance. However, the body deviated forward during quiet stance while viewing the mirror-reflected body image, indicating that viewing the mirror-reflected body image contributed to the anterior-posterior positioning of the body, as mediated by an ankle control strategy. For the dynamic standing task, viewing the body image induced unstable peaks of rhythmic lateral shifting of the body weight over the feet. This indicates that viewing the body image caused unstable motor commands for rhythmic lateral weight shifting. When participants made a transition from a bipedal to a unipedal stance in response to a cue, viewing the body image shortened the onset latency of the body sway. Accordingly, viewing the body image seemed to accelerate the motor execution involved in lateral weight shifting, possibly due to predictive activation of the motor system before movement onset. Considered collectively, we found static and dynamic stance balance to be influenced by viewing one's mirror-reflected body image. Viewing the mirror-reflected body image may be a means of changing static and dynamic balance in patients with impaired postural control. [ABSTRACT FROM AUTHOR]

Curvatures of the body can disrupt fluid flow and affect hydrodynamic resistance. The purpose of this study was to evaluate the effect of a feedback intervention on glide performance and torso morphology. Eleven male and female national swimmers performed glides before and after augmented feedback. Feedback consisted of self-modelling visual feedback and verbal cuing, to manipulate body curvatures that affect hydrodynamic resistance. Two-dimensional landmark position data (knee, hip and shoulder) were used to enable computation of glide factor and glide coefficient as indicators of glide efficiency; posture (trunk incline and hip angle); and performance (horizontal velocity). Underwater images of the swimmers were manually traced to derive transverse and sagittal diameters, cross-sectional areas, and continuous form outlines (anterior and posterior) of the torso. Maximum rate of change in cross-sectional area and form gradient progressing caudally, were calculated for torso segments: shoulder-chest, chest-waist, waist-hip. Mean velocity, glide factor and glide coefficient values significantly (p< 0.001) improved due to the intervention, with large effect size (d) changes 0.880 (p= 0.015), 2.297 and 1.605, respectively. Significant changes to form gradients were related to reductions in lumbar lordosis and chest convexity. The study provides practical cuing phrases for coaches and swimmers to improve glide efficiency and performance. [ABSTRACT FROM AUTHOR]

People usually reach for objects to place them in some position and orientation, but the placement component of this sequence is often ignored. For example, reaches are influenced by gaze position, visual feedback, and memory delays, but their influence on object placement is unclear. Here, we tested these factors in a task where participants placed and oriented a trapezoidal block against two-dimensional (2-D) visual templates displayed on a frontally located computer screen. In experiment 1, participants matched the block to three possible orientations: 0° (horizontal), +45° and −45°, with gaze fixated 10° to the left/right. The hand and template either remained illuminated (closed-loop), or visual feedback was removed (open-loop). Here, hand location consistently overshot the template relative to gaze, especially in the open-loop task; likewise, orientation was influenced by gaze position (depending on template orientation and visual feedback). In experiment 2, a memory delay was added, and participants sometimes performed saccades (toward, away from, or across the template). In this task, the influence of gaze on orientation vanished, but location errors were influenced by both template orientation and final gaze position. Contrary to our expectations, the previous saccade metrics also impacted placement overshoot. Overall, hand orientation was influenced by template orientation in a nonlinear fashion. These results demonstrate interactions between gaze and orientation signals in the planning and execution of hand placement and suggest different neural mechanisms for closed-loop, open-loop, and memory delay placement. NEW & NOTEWORTHY: Eye-hand coordination studies usually focus on object acquisition, but placement is equally important. We investigated how gaze position influences object placement toward a 2-D template with different levels of visual feedback. Like reach, placement overestimated goal location relative to gaze and was influenced by previous saccade metrics. Gaze also modulated hand orientation, depending on template orientation and level of visual feedback. Gaze influence was feedback-dependent, with location errors having no significant effect after a memory delay. [ABSTRACT FROM AUTHOR]

Background: Movement feedback is used to promote anatomically correct movement patterns. Two primary forms of movement feedback exist: verbal cues and visual cues. There is ongoing debate regarding which type of feedback yields superior effects for learning desired movements. This study investigated how a combination of visual and verbal cues improved shoulder stability in four arm movements, Biceps Curls, Reverse Flys, Rowing, and Shoulder Extensions. Methods: Twelve participants were allocated to three different conditions and instructed to perform four different arm movements: Condition 1 (no specific instructions), Condition 2 (image only), and Condition 3 (verbal cues and image). Measurements of acromioclavicular (AC) joint displacement, and electromyography (EMG) peak and burst duration were taken for each arm movement within each condition. Results: Condition 3 exhibited a significant reduction in AC displacement and prolonged EMG burst duration. Variations in EMG peak and burst duration across different arm movements were attributed to anticipated muscle activation specific to each movement. Conclusions: The combination of visual and verbal cues through the "reConnect Your Dots" movement language was found to improve scapular stabilization and associated muscle activation. This approach to movement patterns practice holds promise for injury rehabilitation and risk mitigation for future occurrences. [ABSTRACT FROM AUTHOR]

Trunk compensatory movements frequently manifest during robotic-assisted arm reaching exercises for upper limb rehabilitation following a stroke, potentially impeding functional recovery. These aberrant movements are prevalent among stroke survivors and can hinder their progress in rehabilitation, making it crucial to address this issue. This study evaluated the efficacy of visual feedback, facilitated by an RGB-D camera, in reducing trunk compensation. In total, 17 able-bodied individuals and 18 stroke survivors performed reaching tasks under unrestricted trunk conditions and visual feedback conditions. In the visual feedback modalities, the target position was synchronized with trunk movement at ratios where the target moved at the same speed, double, and triple the trunk's motion speed, providing real-time feedback to the participants. Notably, trunk compensatory movements were significantly diminished when the target moved at the same speed and double the trunk's motion speed. Furthermore, these conditions exhibited an increase in the task completion time and perceived exertion among stroke survivors. This outcome suggests that visual feedback effectively heightened the task difficulty, thereby discouraging unnecessary trunk motion. The findings underscore the pivotal role of customized visual feedback in correcting aberrant upper limb movements among stroke survivors, potentially contributing to the advancement of robotic-assisted rehabilitation strategies. These insights advocate for the integration of visual feedback into rehabilitation exercises, highlighting its potential to foster more effective recovery pathways for post-stroke individuals by minimizing undesired compensatory motions. [ABSTRACT FROM AUTHOR]

Visual biofeedback (vFB) during quiet stance has been shown to improve postural control. While this improvement has been quantified by a reduction in the center of pressure (COP) sway, the effect on COP complexity remains unexplored. As such, 20 young adults (12 females; aged 23.63 ± 3.17 years) were asked to remain in a static upright posture under different visual biofeedback magnitude (no feedback [NoFB], magnified by 1 [vFB1], magnified by 5 [vBF5] and magnified by 10 [vBF10]). In addition to confirming, through traditional COP variables (i.e. standard deviation, mean velocity, sway area), that vFB scaling improved postural control, results also suggested changes in COP complexity. Specifically, sample entropy and wavelet analysis showed that increasing the vFB scale from 1:1 to 1:5 and 1:10 led to a more irregular COP and a shift toward higher frequency. Together, and particularly from a complexity standpoint, these findings provided additional understandings of how vFB and vFB scaling improved postural control. [ABSTRACT FROM AUTHOR]

Upper and lower limb amputations are frequently associated with phantom limb pain (PLP). Recently, virtual reality (VR) and augmented reality (AR) have been reported as a potential therapy of PLP. We have conducted a systematic review of literature to evaluate the efficacy of VR and AR in managing PLP. Four databases were searched: PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, and Web of Science. We utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for our organization. The initial search resulted in 164 results. After title, abstract, and full-text screening, 9 studies were included. One study was of good quality and 8 studies were of fair to poor quality. Seven studies utilized VR and 2 studies utilized AR. The number of treatment sessions ranged from 1 to 28 and the duration ranged from 10 minutes to 2 hours. Several pain scales were used to evaluate PLP pre- and postintervention including Numeric Rating Scale, Pain Rating Index, McGill Pain Questionnaire, and Visual Analog Scale. All the studies reported improvement of PLP on one or more of pain scales after one or more sessions of VR or AR. Despite the promising results reported by literature, we cannot recommend using VR or AR for PLP. Most of the studies are of poor design and have limited sample size with high bias levels. Therefore, no substantial evidence can be derived from them. However, we do believe further research with high-quality randomized controlled trials should take place to increase the knowledge of the potential advantages. [ABSTRACT FROM AUTHOR]

Background: Landing from a step or stairs is a basic motor skill but high incidence of lateral ankle sprain has been reported during landing with inverted foot. Objects: This study aimed to investigate the effect of landing height and visual feedback on the kinematics of landing and supporting lower limbs before and after the touch down and the ground reaction force(GRF)s. Methods: Eighteen healthy females were voluntarily participated in landing from the lower (20 cm) and the higher (40 cm) steps with and without visual feedback. To minimize the time to plan the movement, the landing side was randomly announced as a starting signal. Effects of the step height, the visual feedback, or the interaction on the landing duration, the kinematic variables and the GRFs at each landing event point were analyzed. Results: With eyes blindfolded, the knee flexion and ankle dorsiflexion on landing side significantly decreased before and after the touch down. However, there was no significant effect of landing height on the anticipatory kinematics on the landing side. After the touch down, the landings from the higher step increased the knee flexion and ankle dorsiflexion on both landing and supporting sides. From the higher steps, the vertical GRF, anterior GRF, and lateral GRF increased. No interaction between step height and visual feedback was significant. Conclusion: Step height and visual feedback affected the landing limb kinematics independently. Visual feedback affected on the landing side while step height altered the supporting side prior to the touch down. After the touch down, the step height had greater influence on the lower limb kinematics and the GRFs than the visual feedback. Findings of this study can contribute to understanding of the injury mechanisms and preventing the lateral ankle sprain.

Introduction Running-related injuries are prevalent in the military and are often related to physical fitness test training. Non-rearfoot striking while running is known to increase the risk of Achilles tendon injuries because of the high eccentric energy absorption by the elastic components of the planarflexor muscle-tendon complex. However, there is limited evidence to suggest benefits of converting runners with Achilles tendon pain to use a rearfoot strike. Methods This is a case series of two active-duty Service members with chronic, running-related Achilles tendon pain that utilized a natural non-rearfoot strike pattern. Both patients were trained to utilize a rearfoot strike while running through the use of real-time visual feedback from wearable sensors. Results The trained rearfoot strike pattern was retained for over one month after the intervention, and both patients reported improvements in pain and self-reported function. Conclusions This case series demonstrated the clinical utility of converting two non-rearfoot strike runners to a rearfoot strike pattern to decrease eccentric demands on the plantarflexors and reduce Achilles tendon pain while running. [ABSTRACT FROM AUTHOR]

Increased visual information about a task impairs force control in older adults. To date, however, it remains unclear how increased visual information changes the activation of the motor unit pool differently for young and older adults. Therefore, this study aimed to determine how increased visual information alters the activation of the motor neuron pool and influences force control in older adults. Fifteen older adults (66–86 years, seven women) and fifteen young adults (18–30 years, eight women) conducted a submaximal constant force task (15% of maximum) with ankle dorsiflexion for 20 s. The visual information processing was manipulated by changing the amount of force visual feedback into a low-gain (0.05°) or high-gain (1.2°) condition. Older adults exhibited greater force variability, especially at high-gain visual feedback. This exacerbated force variability from low- to high-gain visual feedback was associated with modulations of multiple motor units, not single motor units. Specifically, increased modulation of multiple motor units from 10 to 35 Hz may contribute to the amplification in force variability. Therefore, our findings suggest evidence that high-gain visual feedback amplifies force variability of older adults which is related to increases in the activation of motor neuron pool from 10 to 35 Hz. [ABSTRACT FROM AUTHOR]

Although studies have indicated that the prior use of video feedback and music listening separately improves physical performance and positive feelings in various sports, to our knowledge, no studies have investigated their combined effect in combat-sports-specific tasks. The aim of this study was to determine the combined effect of listening to preferred music and video feedback on aerobic and anaerobic performance in male kickboxers. In a counterbalanced crossover study design, twenty kickboxers underwent three kicking exercises under one of three conditions: (1) control condition, (2) combined listening to preferred music and video feedback, and (3) video feedback during 10-min of rope warm-up. Kickboxers performed a ten-second kicking test, multiple ten-second kick test, and progressive taekwondo test. The total number of kicks, fatigue index, heart rate, rate of perceived exertion, and feeling scale were measured. The combined music and video feedback condition improved the number of kicks with a better positive feeling scale (F ≥ 7.4, p ≤ 0.002, ηp2 ≥ 0.28) than the video feedback and control conditions in all three kicking exercises, while the video feedback alone led to better kick performances and a better feeling scale than the control condition in the ten-second and multiple ten-second kicking tests (p ≤ 0.016). The combined listening to preferred music and video feedback condition was more effective at enhancing the positive feeling scale and repeated roundhouse kick performance. Future investigations should examine the application of video feedback and listening to music in various kickboxing tasks including punches and kicks. [ABSTRACT FROM AUTHOR]

This review aimed to explore the effect of mirror therapy (MT) on upper limb function in children and adolescents with hemiplegic cerebral palsy (HCP). MEDLINE, CENTRAL, Scopus, PEDro, and Web of Science were systematically searched. PEDro scale was used for the quality assessment of included trials. Risk of Bias assessment was done using Cochrane Risk-of-bias tool version 2. Meta-analysis was performed on four of the seven studies included. The majority of the trials included in this review found MT efficacious in improving motor function in HCP. Quantitative analysis of the included trials using QUEST scores for evaluation of quality of upper extremity function revealed positive but non-significant difference between the groups (MD = −0.12; 95% CI = −2.57,2.33; Z = 0.09, p =.92). Pooled analysis of the included trials using BBT, however, favored control (MD = 4.98; 95% CI = 2.32,7.63; Z = 3.67, p =.0002). [ABSTRACT FROM AUTHOR]

In the future, a situation in which operators switch between different machine classes in teleoperated hydraulic excavator is envisioned. In such a case, because the classes have different dynamic characteristics, the operator is expected to acquire an internal model for each class and switch models each time the operator switches between machines. However, in the case of teleoperated hydraulic excavator, the operator cannot obtain information such as the size and dynamic characteristics of the machine to be switched to; thus, the operator may not be able to switch internal models properly, which may affect the operation efficiency. Therefore, this study proposes a method in which images and videos are used to present the dynamic characteristics of the next machine to be operated during machine changeover in teleoperated hydraulic excavator. To verify the effectiveness of the proposed method, a simulator that imitates teleoperated hydraulic excavator was built and tested on test subjects. The swing operation time significantly increased when the machine was switched without presentation, compared with the case without switching. Meanwhile, the proposed method did not increase the swing operation time associated with machine switching, suggesting its effectiveness. The video presentation method was more effective than the image presentation method for suppressing the increase in swing operation time, indicating that the operator can immediately switch to an appropriate internal model with the presentation of the dynamic characteristics of the machine in advance using video. [ABSTRACT FROM AUTHOR]

Corticostriatal regions play a pivotal role in visuomotor learning. However, less research has been done on how fMRI activity in their subregions is related to task performance, which is provided as visual feedback during motor learning. To address this, we conducted an fMRI experiment in which participants acquired a complex de novo motor skill using continuous or binary visual feedback related to performance. We found a highly selective response related to performance in the entire striatum in both conditions and a relatively higher response in the caudate nucleus for the binary feedback condition. However, the ventromedial prefrontal cortex (vmPFC) response was significant only for the continuous feedback condition. Furthermore, we also found functional distinction of the striatal subregions in random versus goal-directed motor control. These findings underscore the substantial effects of the visual feedback indicating performance on distinct corticostriatal responses, thereby elucidating its significance in reinforcement-based motor learning. [ABSTRACT FROM AUTHOR]

Introduction: Visual experience has a substantial effect on how individuals construct a template of their own bodies in space. Whether the absence of total or partial visual exposure in individuals of both genders allows the buffering of harmful effects has yet to be tested. This study examined the role of vision among congenitally blind and later blind subjects for the expression of body esteem and sociocultural attitudes toward appearance. Methods: Participants comprised 101 subjects, 53 sighted and 48 visually impaired men and women. For the purpose of the study, we took into consideration congenitally blind, late blind, and typically sighted individuals. The Sociocultural Attitudes toward Appearance Questionnaire-3 (SATAQ-3) and the Body-Esteem Scale Questionnaire (BESQ) were used as measures. Results: Although congenitally blind, late blind, and typically sighted individuals showed similar awareness of media content and beauty ideals, typically sighted women displayed higher pressure to conform and had higher levels of social comparison. Congenitally blind women placed less emphasis on mass media as an influential aspect of their body perception and showed reduced internalization of beauty ideals and higher levels of body esteem. Moreover, men with visual impairments considered siblings and family to be the most influential information sources for their own body perception, while showing reduced levels of athlete internalization. Discussion: In this research, it was identified that the absence of sight influences an individual's body image beyond its physical, metric representation. Susceptibility to detrimental messages linked to sociocultural standards of attractiveness is interiorized by individuals with and without visual impairments, regardless of their gender. Implications for Practitioners: Further studies on body esteem and sociocultural pressures could enable practitioners to better understand how to support individuals with visual impairments in coping with an unhealthy social environment and with feelings of unhappiness related to their appearance. [ABSTRACT FROM AUTHOR]

Background: The evaluation of muscle pain and sensitivity by manual palpation is an important part of the clinical examination in patients with myalgia. However, the effects of clinical experience and visual feedback on palpation of the masticatory muscles with or without a palpometer are not known. Objective: To estimate the effects of clinical experience and visual feedback on the accuracy of palpation in standardized settings. Methods: Thirty‐two dentists (age 35 ± 11 years) classified as either specialists (n = 16) or generalists (n = 16) participated in this experiment. All dentists were instructed to target force levels of 500‐ or 1000‐gf, as determined on an electronic scale using either standardized palpometers or manual palpation (MP). All dentists participated in four different tests: MP, MP with visual feedback (MPVF), palpometer (PAL) and PAL with visual feedback (PALVF). Actual force values for each type of palpation from 0 to 2, 2 to 5 and 0 to 5 s were analysed by calculating target force level. Results: The relative differences during 2–5 and 0–5 s with 1000 gf were significantly lower for generalists than for specialists (p <.05). In generalists and specialists, the coefficients of variation and the relative differences during 2–5 s were significantly lower for PAL and PALVF than for MP (p <.05). Conclusions: These findings suggest that the use of a palpometer, but not clinical experience with palpation of masticatory muscles, increases the accuracy of palpation, and ≥2 s of palpation with a palpometer is optimal for masticatory muscles. [ABSTRACT FROM AUTHOR]

Collision feedback about instrument and environment interaction is often lacking in robotic surgery training devices. The PoLaRS virtual reality simulator is a newly developed desk trainer that overcomes drawbacks of existing robot trainers for advanced laparoscopy. This study aimed to assess the effect of haptic and visual feedback during training on the performance of a robotic surgical task. Robotic surgery-naïve participants were randomized and equally divided into two training groups: Haptic and Visual Feedback (HVF) and No Haptic and Visual Feedback. Participants performed two basic virtual reality training tasks on the PoLaRS system as a pre- and post-test. The measurement parameters Time, Tip-to-tip distance, Path length Left/Right and Collisions Left/Right were used to analyze the learning curves and statistically compare the pre- and post-tests performances. In total, 198 trials performed by 22 participants were included. The visual and haptic feedback did not negatively influence the time to complete the tasks. Although no improvement in skill was observed between pre- and post-tests, the mean rank of the number of collisions of the right grasper (dominant hand) was significantly lower in the HVF feedback group during the second post-test (Mean Rank = 8.73 versus Mean Rank = 14.27, U = 30.00, p = 0.045). Haptic and visual feedback during the training on the PoLaRS system resulted in fewer instrument collisions. These results warrant the introduction of haptic feedback in subjects with no experience in robotic surgery. The PoLaRS system can be utilized to remotely optimize instrument handling before commencing robotic surgery in the operating room. [ABSTRACT FROM AUTHOR]

This study delved into the effectiveness of Visual Feedback (VF) as a tool for enhancing the Voice Onset Time (VOT) of Iranian learners of English. In the realm of pronunciation instruction, VF is gaining recognition as a novel approach. The present research study involved an experimental group, and statistical analysis, along with visual data inspection, revealed consistent performance across the study's three phases. Surprisingly, the VF paradigm did not lead to significant changes in VOT. However, there were noticeable variations among participants regarding their average VOTs, with some showing improvement in English VOTs for the phonemes /p/, /t/, and /k/, while others did not. In the pretest, most participants exhibited English-like VOTs, suggesting a potential ceiling effect. Factors such as immersion in the target language and the prominence of English likely influenced participants' VOT scores before the study. The findings of this study indicate that visual feedback can serve as a different instructional approach for teaching pronunciation in the classroom. This approach is more student-centered, as it enables students to analyse visual representations of their own speech. The participants' VOT ratings may have been influenced by the frequency at which they were exposed to the target language prior to the study. Nevertheless, in order to obtain more reliable conclusions, it is important to carry out studies including a larger number of subjects with varying levels of exposure. [ABSTRACT FROM AUTHOR]

Abstract Corticostriatal regions play a pivotal role in visuomotor learning. However, less research has been done on how fMRI activity in their subregions is related to task performance, which is provided as visual feedback during motor learning. To address this, we conducted an fMRI experiment in which participants acquired a complex de novo motor skill using continuous or binary visual feedback related to performance. We found a highly selective response related to performance in the entire striatum in both conditions and a relatively higher response in the caudate nucleus for the binary feedback condition. However, the ventromedial prefrontal cortex (vmPFC) response was significant only for the continuous feedback condition. Furthermore, we also found functional distinction of the striatal subregions in random versus goal-directed motor control. These findings underscore the substantial effects of the visual feedback indicating performance on distinct corticostriatal responses, thereby elucidating its significance in reinforcement-based motor learning.

Through phase-amplitude analysis, this study investigated how low-frequency postural fluctuations interact with high-frequency scalp electroencephalography (EEG) amplitudes, shedding light on age-related mechanic differences in balance control during uneven surface navigation. Twenty young ( $24.1~\pm ~1.9$ years) and twenty older adults ( $66.2~\pm ~2.7$ years) stood on a training stabilometer with visual guidance, while their scalp EEG and stabilometer plate movements were monitored. In addition to analyzing the dynamics of the postural fluctuation phase, phase-amplitude coupling (PAC) for postural fluctuations below 2 Hz and within EEG sub-bands (theta: 4-7 Hz, alpha: 8-12 Hz, beta: 13-35 Hz) was calculated. The results indicated that older adults exhibited significantly larger postural fluctuation amplitudes(p ${p} =0.005$ ) than young adults. The PAC between postural fluctuation and theta EEG (FCz and bilateral temporal-parietal-occipital area), as well as that between postural fluctuation and alpha EEG oscillation, was lower in older adults than in young adults (p ${p}=0.006$ ), was higher in older adults than in young adults. In summary, the postural fluctuation phase and phase-amplitude coupling between postural fluctuation and EEG are sensitive indicators of the age-related decline in postural adjustments, reflecting less flexible motor state transitions and adaptive changes in error monitoring and visuospatial attention.

Abstract Background Analysis of tongue movement would benefit from a reference showcasing healthy tongue capability. We aimed to develop a reference of tongue capability and evaluated the role of visual feedback on the expression of movement. Methods Using a wireless tracking intraoral wearable device, we composed probability distributions of the tongue tip as subjects were asked to explore the entire sensing surface area. Half of the 32 subjects received live visual feedback of the location of the center of the tongue tip contact. Results We observed that the visual feedback group was 51.0% more consistent with each other in the position domain, explored 21.5% more sensing surface area, and was 50.7% more uniformly distributed. We found less consistent results when we evaluated velocity and acceleration. Conclusion Visual feedback best established a healthy capability reference which can be used for designing new interfaces, quantifying tongue ability, developing new diagnostic and rehabilitation techniques, and studying underlying mechanisms of tongue motor control.

Stroke rehabilitation faces challenges in attaining enduring improvements in hand motor function and is frequently constrained by interventional limitations. This research aims to present an innovative approach to the integration of cognitive engagement within visual feedback incorporated into fully immersive virtual reality (VR) based games to achieve enduring improvements. These innovative aspects of interaction provide more functional advantages beyond motivation to efficiently execute repeatedly hand motor tasks. The effectiveness of virtual reality games incorporated with innovative aspects has been investigated for improvements in hand motor functions. A randomized controlled trial was conducted, a total of (n=56) subacute stroke patients were assessed for eligibility and (n=52) patients fulfilled the inclusion criteria. (n=26) patients were assigned to the experimental group and (n=26) patients were assigned to the control group. VR intervention involves four VR based games, developed based on hand movements including flexion/extension, close/open, supination/pronation and pinch. All patients got therapy of 24 sessions, lasting 4 days/week for a total of 6 weeks. Five clinical outcome measures were Fugl- Meyer Assessment-Upper Extremity, Action Research Arm Test, Box and Block Test, Modified Barthel Index, and Stroke-Specific Quality of Life were assessed to evaluate patients’ performance. Results revealed that after therapy there was significant improvement between the groups (p

Background: Regular moderate–vigorous intensity exercise is recommended for adults as it can improve longevity and reduce health risks associated with a sedentary lifestyle. However, there are barriers to achieving intense exercise that may be addressed using virtual reality (VR) as a tool to promote exercise intensity and adherence, particularly through visual feedback and competition. The purpose of this work is to compare visual feedback and competition within fully immersive VR to enhance exercise intensity and user experience of exercise for young adults; and to describe and compare visual attention during each of the conditions. Methods: Young adults (21–34 years old) bicycled in three 5 min VR conditions (visual feedback, self-competition, and competition against others). Exercise intensity (cycling cadence and % of maximum heart rate) and visual attention (derived from a wearable eye tracking sensor) were measured continuously. User experience was measured by an intrinsic motivation questionnaire, perceived effort, and participant preference. A repeated-measures ANOVA with paired t-test post hoc tests was conducted to detect differences between conditions. Results: Participants exercised at a higher intensity and had higher intrinsic motivation in the two competitive conditions compared to visual feedback. Further, participants preferred the competitive conditions and only reached a vigorous exercise intensity during self-competition. Visual exploration was higher in visual feedback compared to self-competition. Conclusions: For young adults bicycling in VR, competition promoted higher exercise intensity and motivation compared to visual feedback.

Purpose: No study has addressed the effect of patient-reported outcomes as a visual feedback tool during telerehabilitation. This study aimed to investigate the effect of a visual feedback-based monitoring application PhysioAnalyst on pain, pain catastrophizing, physical functions, quality of life, usability, satisfaction, and exercise adherence in individuals with chronic low back pain (CLBP). Methods: A single-blind, randomized controlled trial was conducted with 44 CLBP patients. Participants were randomized into two groups: the tele-assessment feedback group (TAFG) (n = 22) and the control group (CG) (n = 22). Participants were assessed before the intervention, at the 4th week and after the intervention. Individuals were assessed using the Visual Analog Scale (VAS), Nottingham Health Profile (NHP), Pain Catastrophizing Scale (PCS), Oswestry Disability Index (ODI), Telehealth Usability Questionnaire (TUQ), Telemedicine Satisfaction Questionnaire (TSQ), and Exercise Adaptation Rating Scale (EARS) via PhysioAnalyst. Individuals in the TAFG group received graph-based visual feedback on assessment data in week 4. Results: The improvement in VAS, NHP, ODI, TUQ, TSQ, and EARS of individuals in TAFG was statistically significant (p < 0.05). Only ODI and PCS scores in CG showed significant improvement (p < 0.05). After the graphics-based visual feedback presented to the TAFG, the VAS, NHP-Emotional, NHP-Sleep, NHP-Total, PCS, TUQ, TSQ, ODI, and EARS scores gained more than CG (p < 0.05). Conclusion: The results confirmed the additional contribution of telerehabilitation's graphics-based visual feedback in pain, pain catastrophizing, disability, quality of life, and exercise participation. Since the importance of continuity in long-term rehabilitation in patients with CLBP is comprehended, feedback to increase patient motivation can be added to telerehabilitation applications. [ABSTRACT FROM AUTHOR]

Learning to write relies on the effective integration of sensory feedback and a transition from motor control based on written tracings to motor control based on expert writing movements. This study aimed to test whether the photographic technique of light painting (LP) would facilitate this transition. To achieve this, we conducted two experiments using different LP setups. LP involves moving a light source in a dark environment while taking a long-exposure photograph. LP entails both a real-time reduction of product-related visual information and a post-trial addition of process-related visual information. In the first experiment, we conducted a pre-test, training, and post-test in which 16 adults wrote four new characters with the non-dominant hand. During the training sessions, participants stood and wrote in a vertical frame (1 × 1.2 m) two characters in the control condition (with a marker on the vertical support) and two characters in the LP condition (with a flashlight in the air). In the test phases, participants were seated at a table and copied the four characters into a square (4 cm * 4 cm) on a fixed sheet of graphics paper. As in-air writing strongly differs from classical handwriting situations, we performed a second LP experiment. The aim was to implement LP training in a condition closer to writing. Sixteen new participants followed the same protocol but sat at a table and wrote in a horizontal square (20 cm * 20 cm). In both experiments, participants who trained with the LP method wrote faster and with less pressure than those trained in the control condition. We also observed an improvement in spatial accuracy in Experiment 2, whatever the training condition. LP seemed to have led participants to focus on the writing process, probably because it modified the nature and timing of the visual information used for writing. LP may be a promising technique for remediating writing difficulties. [ABSTRACT FROM AUTHOR]

We recently showed that subjects can learn motion state-dependent changes to motor output (temporal force patterns) based on explicit visual feedback of the equivalent force field (i.e., without the physical perturbation). Here, we examined the spatiotemporal properties of this learning compared with learning based on physical perturbations. There were two human subject groups and two experimental paradigms. One group (n = 40) experienced physical perturbations (i.e., a velocity-dependent force field, vFF), whereas the second (n = 40) was given explicit visual feedback (EVF) of the force-velocity relationship. In the latter, subjects moved in force channels and we provided visual feedback of the lateral force exerted during the movement, as well as the required force pattern based on movement velocity. In the first paradigm (spatial generalization), following vFF or EVF training, generalization of learning was tested by requiring subjects to move to 14 untrained target locations (0- to ±135-around the trained location). In the second paradigm (temporal stability), following training, we examined the decay of learning over eight delay periods (0 to 90 s). Results showed that learning based on EVF did not generalize to untrained directions, whereas the generalization for the vFF was significant for targets - 45-away. In addition, the decay of learning for the EVF group was significantly faster than the FF group (a time constant of 2.72 ± 1.74 s vs. 12.53 ± 11.83 s). Collectively, our results suggest that recalibrating motor output based on explicit motion state information, in contrast to physical disturbances, uses learning mechanisms with limited spatiotemporal properties. [ABSTRACT FROM AUTHOR]

Forward Head Posture (FHP) is when the head leans forward due to factors such as heavy backpacks or poor computer ergonomics. FHP can lead to neck strain and discomfort as well as potential long-term issues such as arthritis. Treatment options include specialized exercises, orthopedic devices, manual therapy, physical exercises, and visual feedback techniques, along with guidance from specialists in physical medicine and rehabilitation. In this study, a visual feedback-based approach was used to address FHP in female students. The study spanned ten days and included a visual feedback group and a control group. The results showed significant improvements in maximum head angle deviation in the visual feedback group compared to the control group; however, there was no significant change in the DFA number, indicating stability in policy control by the central nervous system. The study demonstrated that visual feedback sessions led to immediate benefits, with participants progressively acquiring skills involving the maintenance of proper head positioning. The test results indicated that the neck angle decreased to less than 15 degrees, indicating a return to a normal state. The versatility of the developed affordable and easy-to-use device and the potential for using smartphone motion sensors for similar visual feedback systems are discussed in this paper as well. The study suggests the promising potential of visual feedback in healthcare, including remote monitoring and smartphone-based solutions. [ABSTRACT FROM AUTHOR]

Background: Analysis of tongue movement would benefit from a reference showcasing healthy tongue capability. We aimed to develop a reference of tongue capability and evaluated the role of visual feedback on the expression of movement. Methods: Using a wireless tracking intraoral wearable device, we composed probability distributions of the tongue tip as subjects were asked to explore the entire sensing surface area. Half of the 32 subjects received live visual feedback of the location of the center of the tongue tip contact. Results: We observed that the visual feedback group was 51.0% more consistent with each other in the position domain, explored 21.5% more sensing surface area, and was 50.7% more uniformly distributed. We found less consistent results when we evaluated velocity and acceleration. Conclusion: Visual feedback best established a healthy capability reference which can be used for designing new interfaces, quantifying tongue ability, developing new diagnostic and rehabilitation techniques, and studying underlying mechanisms of tongue motor control. [ABSTRACT FROM AUTHOR]