A Review on the Relationship Between Sound and Movement in Sports and Rehabilitation

Sonification of Golf Putting Gesture Reduces Swing Movement Variability in Novices

Purpose: To study whether novices can use sonification to enhance golf putting performance and swing movements. Method: Forty participants first performed a series of 2 m and 4 m putts, where swing velocities associated with successful trials were used to calculate their mean velocity profile (MVP). Participants were then divided into four groups with different auditory conditions: static pink noise unrelated to movement, auditory guidance based on personalized MVP, and two sonification strategies that mapped the real-time error between observed and MVP swings to modulate either the stereo display or roughness of the auditory guidance signal. Participants then performed a series of 2 m and 4 m putts with the auditory condition designated to their group. Results: In general our results showed significant correlations between swing movement variability and putting performance for all sonification groups. More specifically, in comparison to the group exposed to static pink noise, participants who were presented auditory guidance significantly reduced the deviation from their average swing movement. In addition, participants exposed to error-based sonification with stereo display modulation significantly lowered their variability in timing swing movements. These results provide further evidence of the benefits of sonification for novices performing complex motor skill tasks. Conclusions: More importantly, our findings suggest participants were able to better use online error-based sonification rather than auditory guidance to reduce variability in the execution and timing of their movements.

Sonification of combined action observation and motor imagery: Effects on corticospinal excitability

Action observation and motor imagery are valuable strategies for motor learning. Their simultaneous use (AOMI) increases neural activity, with related benefits for motor learning, compared to the two strategies alone. In this study, we explored how sonification influences AOMI. Twenty-five participants completed a practice block based on AOMI, motor imagery and physical execution of the same action. Participants were divided into two groups: An experimental group that practiced with sonification during AOMI (sAOMI), and a control group, which did not receive any extrinsic feedback. Corticospinal excitability at rest and during action observation and AOMI was assessed before and after practice, with and without sonification sound, to test the development of an audiomotor association. The practice block increased corticospinal excitability in all testing conditions, but sonification did not affect this. In addition, we found no differences in action observation and AOMI, irrespective of sonification. These results suggest that, at least for simple tasks, sonification of AOMI does not influence corticospinal excitability; In these conditions, sonification may have acted as a distractor. Future studies should further explore the relationship between task complexity, value of auditory information and action, to establish whether sAOMI is a valuable for motor learning.

Effects of auditory feedback on gait behavior, gaze patterns and outcome performance in long jumping

In the current study, we conducted two experiments to investigate the impact of concurrent, action-induced auditory feedback on gait patterns, gaze behavior and outcome performance in long jumping. In Experiment 1, we examined the effects of present vs. absent auditory feedback on gait, gaze and performance outcome measures. Results revealed a significant interaction effect between condition (present vs. absent auditory feedback) and phase (acceleration vs. zeroing-in phase) on participants' step lengths indicating that the absence (rather than the presence) of auditory feedback led to facilitatory effects in terms of a more prototypical gait pattern (i.e., shorter steps in the acceleration phase and longer steps in the zeroing-in phase). Similarly, the absent auditory feedback led to a higher gaze stability in terms of less switches between areas of interest (AOIs). However, there was no effect on jumped distance. In Experiment 2, we scrutinized the influence of concurrent vs. delayed auditory feedback on all three performance parameters. In contrast to concurrent feedback, delayed auditory feedback negatively affected all three measures: participants showed (i) dysfunctional deviations from their prototypical gait pattern (i.e., shorter steps across both phases of the run-up), (ii) less stable, maladaptive gaze patterns (i.e., more switches between AOIs) and (iii) poorer jumping performance (i.e., shorter jumped distances). Together, the two experiments provide clear evidence for the impact of concurrent, action-induced auditory feedback on the coordination of complex, rhythmical motor tasks such as the long jump.

Acoustic Feedback in Gait Rehabilitation-Pre-Post Effects in Patients With Unilateral Hip Arthroplasty

It is known that patients after unilateral hip arthroplasty still suffer from a deficient gait pattern compared to healthy individuals one year after surgery. Through the method of gait sonification, it may be possible to achieve a more efficient training and a more physiological gait pattern. Increased loads on the musculoskeletal system could thus be reduced and rehabilitation times shortened. In a previous investigation with this patient group, we found immediate gait pattern changes during training with dual mode acoustic feedback [real-time feedback (RTF) and instructive model sequences (IMS)]. To determine whether an effect persists without the immediate use of acoustic feedback, we analyze data from four times of testing. Following unilateral hip arthroplasty 22 patients participated in an intervention of ten gait training sessions of 20 min each. During gait training the sonification group (SG) (n = 11) received an acoustic feedback consisting of RTF and IMS compared to a control group (CG) (n = 11). Pre-test, intermediate test, post-test, and re-test were conducted using an inertial sensor-based motion analysis system. We found significant effects (α = 0.05) regarding step length and range of motion (RoM) of the hip joint. Step length of the affected leg increased in the SG from intermediate test to post-test but decreased in the CG [intermediate test: (SG) 0.63 m ± 0.12 m, (CG) 0.63 m ± 0.09 m; post-test: (SG) 0.66 m ± 0.11 m, (CG) 0.60 m ± 0.09 m]. However, from the post-test to the re-test a reverse development was observed [re-test: (SG) 0.63 m ± 0.10 m, (CG) 0.65 m ± 0.09 m]. Also, from post-test to re-test a decrease in the RoM of the unaffected hip for the SG but an increase for the CG could be observed [post-test: (SG) 44.10° ± 7.86°, (CG) 37.05° ± 7.21°; re-test: (SG) 41.73° ± 7.38°, (CG) 40.85° ± 9.28°]. Regarding further parameters, significant interactions in step duration as well as increases in stride length, gait speed, cadence, and a decrease in ground contact time from pre-test to re-test were observed for both groups. Clinical Trial Registration: https://www.drks.de/drks_web/, identifier DRKS00022570.

Effect of Dance on Balance, Mobility, and Activities of Daily Living in Adults With Cerebral Palsy: A Pilot Study

The age-related decline in motor function with respect to balance and mobility may hamper the activities of daily living, quality of life, and social participation. Despite the importance of managing secondary conditions leading to premature aging, the literature regarding appropriate physical activity for adults with cerebral palsy (CP) is still scarce. Dance forms have emerged as an effective physical activity that improves balance and mobility in individuals with neurological conditions and boosts social engagement. However, its effect on adults with CP has yet to be examined. This pilot study aimed to examine the long-term effect of dance on improving balance and mobility in adults with CP. This single-cohort study included 10 adults with CP. They attended two 90-min-long creative dance sessions per week for 12 weeks. The outcomes measured effects on balance, mobility, balance confidence, and level of functional independence. These measurements were obtained at pre-intervention, post-intervention, and the 3-month follow-up. Outcome data of pre- to post-intervention and pre-intervention to 3-month follow-up were analyzed and compared. Statistically significant differences were found in the pre- and post-intervention displacement of the center of pressure (CoP) in the eyes-opened (EO) condition, timed up and go test (TUG), and Berg Balance Scale (BBS), Dynamic Gait Index (DGI), and Korean-Activity of Balance Confidence (K-ABC) scores. Significant improvements were also observed for the CoP-EO, BBS, TUG, DGI, and K-ABC between the pre-intervention and 3-month follow-up assessments. However, there were no significant differences in the CoP in the eyes-closed condition and Korean modified Barthel Index score. Participants expressed enjoyment without any pain or fatigue. Our findings suggest that dance may have a positive impact in improving balance and mobility and may consequently contribute to healthy aging in adults with CP.

Does sonification of action simulation training impact corticospinal excitability and audiomotor plasticity?

Sonification is a sensory augmentation strategy whereby a sound is associated with, and modulated by, movement. Evidence suggests that sonification could be a viable strategy to maximize learning and rehabilitation. Recent studies investigated sonification of action observation, reporting beneficial effects, especially in Parkinson's disease. However, research on simulation training-a training regime based on action observation and motor imagery, in which actions are internally simulated, without physical execution-suggest that action observation alone is suboptimal, compared to the combined use of action observation and motor imagery. In this study, we explored the effects of sonified action observation and motor imagery on corticospinal excitability, as well as to evaluate the extent of practice-dependent plasticity induced by this training. Nineteen participants were recruited to complete a practice session based on combined and congruent action observation and motor imagery (AOMI) and physical imitation of the same action. Prior to the beginning, participants were randomly assigned to one of two groups, one group (nine participants) completed the practice block with sonified AOMI, while the other group (ten participants) completed the practice without extrinsic auditory information and served as control group. To investigate practice-induced plasticity, participants completed two auditory paired associative stimulation (aPAS) protocols, one completed after the practice block, and another one completed alone, without additional interventions, at least 7 days before the practice. After the practice block, both groups significantly increased their corticospinal excitability, but sonification did not exert additional benefits, compared to non-sonified conditions. In addition, aPAS significantly increased corticospinal excitability when completed alone, but when it was primed by a practice block, no modulatory effects on corticospinal excitability were found. It is possible that sonification of combined action observation and motor imagery may not be a useful strategy to improve corticospinal, but further studies are needed to explore its relationship with performance improvements. We also confirm the neuromodulatory effect of aPAS, but its interaction with audiomotor practice remain unclear.

Spontaneous Interpersonal Synchronization of Gait: A Systematic Review

Objective

To systematically review the existing evidence of spontaneous synchronization in human gait.

Data Sources

EBSCO, PubMed, Google Scholar, and PsycINFO were searched from inception to July 2020 using all possible combinations of (1) “spontaneous interpersonal synchronization” or “spontaneous interpersonal coordination” or “unintentional interpersonal synchronization” or “unintentional interpersonal coordination” and (2) “human movement” or “movement” or “walking” or “ambulation” or “gait.”

Study Selection

Studies had to focus on spontaneous synchronization in human gait, be published in a peer-reviewed journal, present original data (no review articles were included), and be written in English. The search yielded 137 results, and the inclusion criteria were met by 16 studies.

Data Extraction

Participant demographics, study purpose, setup, procedure, biomechanical measurement, coordination analytical technique, and findings were extracted. Our synthesis focused on the context in which this phenomenon has been studied, the role of sensory information in the emergence of spontaneous interpersonal synchronization in human gait, and the metrics used to quantify this behavior.

Data Synthesis

The included 16 articles ranged from 2007-2019 and used healthy, primarily young subjects to investigate the role of spontaneous interpersonal synchronization on gait behavior, with the majority using a side-by-side walking/running paradigm. All articles reported data supporting spontaneous interpersonal synchronization, with the strength of the synchronization depending on the sensory information available to the participants.

Conclusions

Walking alongside an intact locomotor system may provide an effective and biologically variable attractor signal for rehabilitation of gait behavior. Future research should focus on the utility of spontaneous interpersonal synchronization in clinical populations as a noninvasive method to enhance gait rehabilitation.

Concurrent Validity of Inertially Sensed Measures during Voluntary Body Sway in Silence and while Exposed to a Rhythmic Acoustic Stimulus: A Pilot Study

Introduction

The effect of rhythmic acoustic stimuli on body sway is of increasing interest due to their positive contribution when training or restoring the control of movement. Inertial sensors show promise as a portable, easier, and more affordable method compared to the force plate "gold standard" concerning the evaluation of postural sway. This study examined the concurrent validity of inertially sensed measures of voluntary body sway against those obtained with a force plate, in silence and while exposed to a rhythmic acoustic stimulus.

Methods

Temporal (sway duration and variability) and spatial (trajectory length, variability, range, velocity, and area) body sway variables were extracted using an inertial sensor (at L5) in synchronization with a force plate, during anteroposterior body sway in silence and while exposed to a rhythmic acoustic stimulus (n = 18 young women; two 70-s trials in each condition). Statistics included bivariate correlations between the inertially sensed and the force plate measures, separately, in silence and with a rhythmic acoustic stimulus, as well as for the effect of the rhythmic acoustic stimulus (percentage difference from silence) (p ≤ 0.05, SPSS v25.0).

Results

The inertially sensed measures demonstrated good-to-excellent concurrent validity for all temporal and almost all spatial variables, both in silence and with rhythmic acoustic stimulus (r > 0.75, p = 0.000), as well as for the rhythmic acoustic-stimulus effect (r > 0.75, p ≤ 0.05).

Conclusion

The inertially sensed measures of the voluntary anteroposterior body sway demonstrated an overall good-to-excellent concurrent validity against those obtained with the force plate "gold standard," both in the silence and the rhythmic acoustic stimulus conditions, as well as for the rhythmic acoustic-stimulus effect. The findings of this pilot study allow the recommendation of inertial sensing for the evaluation of postural control alterations when exposed to rhythmic acoustic stimuli, a condition of increasing interest due to the positive contribution of such stimuli when training or restoring the control of movement.

Effects of a Music-Based Rhythmic Auditory Stimulation on Gait and Balance in Subacute Stroke

Gait and balance impairments are common after stroke. This study aimed to evaluate the effect of a music-based rhythmic auditory stimulation (RAS) in combination with conventional physiotherapy on gait parameters and walking ability in subacute stroke. This single-blind, historical controlled trial, included 55 patients who had suffered a stroke within the three weeks prior to enrolment. Patients from 2018 (n = 27) were assigned as the historical control group whereas 2019 patients (n = 28) received music-based RAS three times a week. Both groups received 11 h of conventional physiotherapy per week during hospitalization. Primary outcomes were gait and balance parameters (Tinetti test and Timed Up&Go test) and walking ability (Functional Ambulation Category scale). Secondary outcomes were trunk control, assistive devices, functional independence (Functional Independence Measure, Barthel index), and stroke severity and disability (modified Rankin scale, National Institutes of Health Stroke Scale). Results: No between-group differences were identified for gait and balance parameters nor for secondary outcomes. Significant between-group differences were observed in the Functional Ambulation Category: the intervention group (Δmean ± SD; 3.43 ± 1.17) showed greater improvement (p = 0.002) than the control group (Δmean ± SD; 2.48 ± 1.09). Compared with conventional physiotherapy alone, our results suggest that the walking ability of subacute stroke patients might be improved with music-based RAS combined with conventional physiotherapy, but this treatment is not more effective than conventional physiotherapy in obtaining gait and balance gains.

The Role of Vision in Maintaining Stroke Synchronization in K2 Crew-Boat Kayaking

This study investigated the role of vision in maintaining stroke synchronization in crew-boat sprint kayaking. Sixteen sprint kayakers from a national team were paired into eight two-seater (K2) crews. Each crew paddled at high intensity with the back paddler's eyes open or closed in a randomized order. Using video analysis, stroke synchronization was quantified by the timing offsets between the front and back paddlers at four key positions of the stroke. All crews could paddle continuously without capsize or stopping under both visual conditions. In the absence of vision, neither 200-m performance time (p = 0.23, d = 0.47, small effect size) nor stroke rate (p = 0.41, d = 0.31, small effect size) was severely affected. There were no significant effects of vision on stroke synchronization offsets between the front and back paddlers across all key positions (all p > 0.05). Highly skilled paddlers likely relied on the kinesthetic perception to maintain the boat synchronization when visual information was not available.

Use of Acoustic Feedback to Change Gait Patterns: Implementation and Transfer to Motor Learning Theory—A Scoping Review

Changing gait parameters through acoustic feedback is a promising approach in gait therapy. The question remains to what extent, if any, the theories and concepts of motor learning have been taken into account for acoustic feedback systems development. Fifteen studies were identified for further analysis using a scoping review framework, among which seven had individuals with disordered gait as their population and eight incorporated healthy individuals. It was found that most studies used error feedback and did not test for long-term effects on gait parameters. It can be concluded that future studies should apply motor learning theories and concepts to the development of acoustic feedback devices for gait therapy.

Online sonification improves cycling performance through kinematic and muscular reorganisations

Based on a previous study that demonstrated the beneficial effects of sonification on cycling performance, this study investigated which kinematic and muscular activities were changed to pedal effectively. An online error-based sonification strategy was developed, such that, when negative torque was applied to the pedal, a squeak sound was produced in real-time in the corresponding headphone. Participants completed four 6-min cycling trials with resistance values associated with their first ventilatory threshold. Different auditory display conditions were used for each trial (Silent, Right, Left, Stereo), where sonification was only presented for 20 s at the start of minutes 1, 2, 3, and 4. Joint kinematics and right leg muscular activities of 10 muscles were simultaneously recorded. Our results showed participants were more effective at pedalling when presented sonification, which was consistent with previously reported findings. In comparison to the Silent condition, sonification significantly limited ankle and knee joint ranges of motion and reduced muscular activations. These findings suggest performance-based sonification significantly affected participants to reduce the complexity of the task by altering the coordination of the degrees of freedom. By making these significant changes to their patterns, participants improved their cycling performance despite lowering joint ranges of motion and muscular activations.

Patterns of enhancement in paretic shoulder kinematics after stroke with musical cueing

Musical cueing has been widely utilised in post-stroke motor rehabilitation; however, the kinematic evidence on the effects of musical cueing is sparse. Further, the element-specific effects of musical cueing on upper-limb movements have rarely been investigated. This study aimed to kinematically quantify the effects of no auditory, rhythmic auditory, and melodic auditory cueing on shoulder abduction, holding, and adduction in patients who had experienced hemiparetic stroke. Kinematic data were obtained using inertial measurement units embedded in wearable bands. During the holding phase, melodic auditory cueing significantly increased the minimum Euler angle and decreased the range of motion compared with the other types of cueing. Further, the root mean square error in the angle measurements was significantly smaller and the duration of movement execution was significantly shorter during the holding phase when melodic auditory cueing was provided than when the other types of cueing were used. These findings indicated the important role of melodic auditory cueing for enhancing movement positioning, variability, and endurance. This study provides the first kinematic evidence on the effects of melodic auditory cueing on kinematic enhancement, thus suggesting the potential use of pitch-related elements in psychomotor rehabilitation.

Acute Effects of Self-Selected Music Intervention on Golf Performance and Anxiety Level in Collegiate Golfers: A Crossover Study

Music has been reported as a positive intervention for improving psychophysiological conditions and exercise performance. However, the effects of music intervention on golf performance in association with psychophysiological responses have not been well examined in the literature. The purpose of the study was to investigate the acute effects of self-selected music intervention on golf swing and putting performance, heart rate (HR), HR variability (HRV), and anxiety. Twenty collegiate golfers voluntarily participated in this study (age = 20.2 ± 1.4 years, height = 171.7 ± 8.0 cm, body weight = 69.5 ± 14.6 kg, golf experience = 7.5 ± 2.1 years). A cross-over and within-subject design was used in this study. Participants performed a non-music trial (T1), pre-exercise music trial (T2), and simultaneous music trial (T3) in a randomized order with 48–72 h apart. The participants were attached to a HR monitor to record the HR and HRV during the measurement. The golf swing and putting performance was assessed by using the Golfzon golf simulator system. The state-trait anxiety inventory-state questionnaire (STAI-S) was used to evaluate anxiety state. All measurements were taken during baseline (phase one) and after resting or music intervention (phase two). Repeated measurement of analysis of variance (ANOVA) and Cohen’s effect size (ES) were used for statistical analyses. The results show no significant differences in golf swing and putting performance (p > 0.05). However, significant decrease in STAI-S score was found in T2 (p = 0.047, ES = 0.32). A significant increase in the standard deviation of normal R-R interval (SDNN), low-frequency power spectrum (LF), standard deviation of along the line-of-identity (SD2) in T2 and T3 were observed (p < 0.05). In conclusion, a single pre-exercise or simultaneous self-selected music intervention contributes minor effects to golf performance in collegiate golfers. The positive benefits of self-selected music intervention on the psychological condition and cardia-related modulation while practicing golf is warranted.

A Music-Based Digital Therapeutic: Proof-of-Concept Automation of a Progressive and Individualized Rhythm-Based Walking Training Program After Stroke

BACKGROUND

The rhythm of music can entrain neurons in motor cortex by way of direct connections between auditory and motor brain regions.

OBJECTIVE

We sought to automate an individualized and progressive music-based, walking rehabilitation program using real-time sensor data in combination with decision algorithms.

METHODS

A music-based digital therapeutic was developed to maintain high sound quality while modulating, in real-time, the tempo (ie, beats per minute, or bpm) of music based on a user's ability to entrain to the tempo and progress to faster walking cadences in-sync with the progression of the tempo. Eleven individuals with chronic hemiparesis completed one automated 30-minute training visit. Seven returned for 2 additional visits. Safety, feasibility, and rehabilitative potential (ie, changes in walking speed relative to clinically meaningful change scores) were evaluated.

RESULTS

A single, fully automated training visit resulted in increased usual (∆ 0.085 ± 0.027 m/s, P = .011) and fast (∆ 0.093 ± 0.032 m/s, P = .016) walking speeds. The 7 participants who completed additional training visits increased their usual walking speed by 0.12 ± 0.03 m/s after only 3 days of training. Changes in walking speed were highly related to changes in walking cadence (R² > 0.70). No trips or falls were noted during training, all users reported that the device helped them walk faster, and 70% indicated that they would use it most or all of the time at home.

CONCLUSIONS

In this proof-of-concept study, we show that a sensor-automated, progressive, and individualized rhythmic locomotor training program can be implemented safely and effectively to train walking speed after stroke. Music-based digital therapeutics have the potential to facilitate salient, community-based rehabilitation.

A Perspective on Implementing Movement Sonification to Influence Movement (and Eventually Cognitive) Creativity

Creativity represents an important feature in a variety of daily-life and domain-specific contexts. Recent evidence indicates that physical movement serves as a key resource for exploring and generating task-relevant creative ideas, supporting the embodied perspective on creative cognition. An intuitive link between movement and creative cognition is movement creativity. The process of exploring the movement solutions an environment offers (i.e., affordances) and exploiting novel, functional, and creative movements may translate to and improve how individuals explore and generate novel ideas. Opening perception to the variety of affordances (“conventional” and novel) an environment offers drives creative movement. Teachers and coaches can promote this process by designing a learning environment that invites performers to consider and utilize novel movement solutions. In this article, we present a rationale for using movement sonification to promote creative movement. Movement sonification consists of mapping a movement parameter into sound, with a sound being triggered or changing according to how movement unfolds. We argue that movement sonification can facilitate the emergence of creative movement via enhancing perception of currently performed movements and invite performers to utilize novel affordances, and emphasizing information for regulating subsequent creative actions. We exemplify this concept in a creative dance intervention for children during physical education classes. In conclusion, we contend that learning to explore original dance sequences using movement sonification may provide a meaningful link between creative movement and creative cognition. Children may use their minds and bodies as tools for creative thinking and exploration, such as shaping letters with their bodies.

Audio Feedback for Device-Supported Balance Training: Parameter Mapping and Influencing Factors

Recent studies suggest that real-time auditory feedback is an effective method to facilitate motor learning. The evaluation of the parameter mapping (sound-to-movement mapping) is a crucial, yet frequently neglected step in the development of audio feedback. We therefore conducted two experiments to evaluate audio parameters with target finding exercises designed for balance training. In the first experiment with ten participants, five different audio parameters were evaluated on the X-axis (mediolateral movement). Following that, in a larger experiment with twenty participants in a two-dimensional plane (mediolateral and anterior-posterior movement), a basic and synthetic audio model was compared to a more complex audio model with musical characteristics. Participants were able to orient themselves and find the targets with the audio models. In the one-dimensional condition of experiment one, percussion sounds and synthetic sound wavering were the overall most effective audio parameters. In experiment two, the synthetic model was more effective and better evaluated by the participants. In general, basic sounds were more helpful than complex (musical) sound models. Musical abilities and age were correlated with certain exercise scores. Audio feedback is a promising approach for balance training and should be evaluated with patients. Preliminary evaluation of the respective parameter mapping is highly advisable.

Cellists' sound quality is shaped by their primary postural behavior

During the last 20 years, the role of musicians’ body movements has emerged as a central question in instrument practice: Why do musicians make so many postural movements, for instance, with their torsos and heads, while playing musical instruments? The musical significance of such ancillary gestures is still an enigma and therefore remains a major pedagogical challenge, since one does not know if these movements should be considered essential embodied skills that improve musical expressivity. Although previous studies established clear connections between musicians’ body movements and musical structures (particularly for clarinet, piano or violin performances), no evidence of direct relationships between body movements and the quality of the produced timbre has ever been found. In this study, focusing on the area of bowed-string instruments, we address the problem by showing that cellists use a set of primary postural directions to develop fluid kinematic bow features (velocity, acceleration) that prevent the production of poor quality (i.e., harsh, shrill, whistling) sounds. By comparing the body-related angles between normal and posturally constrained playing situations, our results reveal that the chest rotation and vertical inclination made by cellists act as coordinative support for the kinematics of the bowing gesture. These findings support the experimental works of Alexander, especially those that showed the role of head movements with respect to the upper torso (the so-called primary control) in ensuring the smooth transmission of fine motor control in musicians all the way to the produced sound. More generally, our research highlights the importance of focusing on this fundamental postural sense to improve the quality of human activities across different domains (music, dance, sports, rehabilitation, working positions, etc.).

Sex Differences in Maintaining the Requested Handgrip Force Enhanced by Auditory or Visual Feedback

Thus far, the differences in effect of auditory or visual feedback in motor learning have presented results derived from mixed groups and sex differences have not been considered. However, perception and processing of auditory stimuli and performance of visual motor tasks appear to be sex-related. The purpose of this study was to investigate the learning of the simple motor task of maintaining a requested handgrip force in separate male and female groups. A total of 31 volunteers (15 males, 16 females) were randomly assigned to one of four experimental groups with defined sex and training conditions (audio or visual feedback). Participants performed training sessions over a period of six days, for which auditory or visual feedback was provided, and the effectiveness of both types of signals was compared. The evident learning effect was found in all groups, and the main effect of sex was significant among visual groups in favor of the males (p < 0.05). On the other hand, the main effect of feedback conditions was found to be significant among females, beneficially in the case of auditory displays (p < 0.05). The results lead to the conclusion that an equal number of males and females in mixed experimental groups may be supportive to obtain reliable results. Moreover, in motor-learning studies conducted on females only, a design including auditory feedback would be more suitable.

Rhythmic Auditory Stimulation as an Adjuvant Therapy Improved Post-stroke Motor Functions of the Upper Extremity: A Randomized Controlled Pilot Study

OBJECTIVES

To explore whether rhythmic auditory stimulation (RAS) could improve motor functions of post-stroke hemiparetic upper extremity.

DESIGN

A prospective, randomized controlled, assessor-blinded pilot study.

METHODS

Thirty stroke patients were randomly distributed into the RAS group (n = 15) and the control group (n = 15). Both groups received regular therapies. The RAS group received additional 30 min of RAS training, while the control group received additional 30 min of regular therapies for 5 days per week for 4 weeks. The Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Wolf Motor Function Test (WMFT), and Barthel Index (BI) were used. The co-activation interval and co-contraction index were calculated from surface electromyography (sEMG) recordings on the affected biceps and triceps during elbow flexion and extension. Assessments were performed before and after the treatments.

RESULTS

Significant improvements in motor functions were observed within both groups (p < 0.05 in the FMA-UE, WMFT, and BI, respectively), as well as between groups after the treatments (higher scores in the RAS group, all p < 0.05 except for p = 0.052 in the FMA-UE; group × time interaction, all p < 0.05). Statistical significance was found in the co-activation interval between groups after the treatments (lower in the RAS group; p = 0.022 during elbow extension; p = 0.001 during elbow flexion; group × time interaction, p < 0.05 only during elbow extension). No statistical significance was found in the co-contraction index between groups; an inversed pattern of changes was observed between groups supported by relatively higher increments in the triceps recruitments to the biceps.

CONCLUSION

Using RAS in task-oriented exercises was effective in moderating co-contraction, facilitating task-oriented movements of the hemiparetic upper extremity, and improving ADLs among those who had emerging isolated joint movements. The effects were evident on sEMG possibly by adjusting the balance of recruitments between the agonist and the antagonist.

CLINICAL TRIAL REGISTRATION

The study was registered at the Chinese Clinical Trial Registry (No. 1900026665).

Incidental or Intentional? Different Brain Responses to One's Own Action Sounds in Hurdling vs. Tap Dancing

Most human actions produce concomitant sounds. Action sounds can be either part of the action goal (GAS, goal-related action sounds), as for instance in tap dancing, or a mere by-product of the action (BAS, by-product action sounds), as for instance in hurdling. It is currently unclear whether these two types of action sounds-incidental or intentional-differ in their neural representation and whether the impact on the performance evaluation of an action diverges between the two. We here examined whether during the observation of tap dancing compared to hurdling, auditory information is a more important factor for positive action quality ratings. Moreover, we tested whether observation of tap dancing vs. hurdling led to stronger attenuation in primary auditory cortex, and a stronger mismatch signal when sounds do not match our expectations. We recorded individual point-light videos of newly trained participants performing tap dancing and hurdling. In the subsequent functional magnetic resonance imaging (fMRI) session, participants were presented with the videos that displayed their own actions, including corresponding action sounds, and were asked to rate the quality of their performance. Videos were either in their original form or scrambled regarding the visual modality, the auditory modality, or both. As hypothesized, behavioral results showed significantly lower rating scores in the GAS condition compared to the BAS condition when the auditory modality was scrambled. Functional MRI contrasts between BAS and GAS actions revealed higher activation of primary auditory cortex in the BAS condition, speaking in favor of stronger attenuation in GAS, as well as stronger activation of posterior superior temporal gyri and the supplementary motor area in GAS. Results suggest that the processing of self-generated action sounds depends on whether we have the intention to produce a sound with our action or not, and action sounds may be more prone to be used as sensory feedback when they are part of the explicit action goal. Our findings contribute to a better understanding of the function of action sounds for learning and controlling sound-producing actions.

Do You Transfer Your Skills? From Sports to Health Management in Cancer Patients

Skill transfer is a process where personal cognitive and behavioral abilities are applied to contexts that are different from the one in which they were originally learned. Literature demonstrates that skill transferability is possible: for example, people can apply skills learned in sports to other life-domains (such as school, work, or health management) with the aim to improve individual characteristics and reach personal goals. To do this, several factors, such as positive communication, adequate context, a person-centered perspective, and specific strategies, are necessary. On the basis of this, the aim of this contribution is explore the relationship between sports and health management skills to enhance the coach/athlete as well as the patient/physician relationships. Useful strategies for skill transfer from sports to cancer management are shown.

Modulation of ellipses drawing by sonification

Most studies on the regulation of speed and trajectory during ellipse drawing have used visual feedback. We used online auditory feedback (sonification) to induce implicit movement changes independently from vision. The sound was produced by filtering a pink noise with a band-pass filter proportional to movement speed. The first experiment was performed in 2D. Healthy participants were asked to repetitively draw ellipses during 45 s trials whilst maintaining a constant sonification pattern (involving pitch variations during the cycle). Perturbations were produced by modifying the slope of the mapping without informing the participants. All participants adapted spontaneously their speed: they went faster if the slope decreased and slower if it increased. Higher velocities were achieved by increasing both the frequency of the movements and the perimeter of the ellipses, but slower velocities were achieved mainly by decreasing the perimeter of the ellipses. The shape and the orientation of the ellipses were not significantly altered. The analysis of the speed-curvature power law parameters showed consistent modulations of the speed gain factor, while the exponent remained stable. The second experiment was performed in 3D and showed similar results, except that the main orientation of the ellipse also varied with the changes in speed. In conclusion, this study demonstrated implicit modulation of movement speed by sonification and robust stability of the ellipse geometry. Participants appeared to limit the decrease in movement frequency during slowing down to maintain a rhythmic and not discrete motor regimen.

Home-Based Gait Training Using Rhythmic Auditory Cues in Alzheimer's Disease: Feasibility and Outcomes

Background/Purpose: Although gait disorders occur early in the course of Alzheimer's disease (AD) and increase the risk of falling, methods to improve walking in the home setting are poorly understood. This study aimed to determine the feasibility of a home-based gait training program using rhythmic auditory cues for individuals living with mild to moderately severe AD.

Methods: Participants had probable AD with no other major conditions affecting locomotion. The intervention consisted of eight progressively modified 45-min gait training sessions delivered during home visits over 4 weeks. Experienced physiotherapists provided the therapy that incorporated rhythmic music cues for a range of locomotor tasks and ambulatory activities. On the days when the physiotherapist did not attend, participants independently performed a seated music listening activity. Walking speed, cadence, stride length, double limb support duration, and gait variability (coefficient of variation) were measured using an 8-m GAITRite® computerized walkway immediately before and after the physiotherapy intervention. Participant satisfaction was also assessed using a purpose-designed questionnaire.

Results: Eleven (median age, 77.0 years; median ACE III score, 66/100; 3 females and 8 males) community-dwelling adults living with AD participated. Wilcoxon signed rank tests revealed statistically significant increases in gait speed following the home-based physiotherapy intervention (baseline = 117.5 cm/s, post-intervention = 129.9 cm/s, z = −2.40, p < 0.05). Stride length also improved (baseline = 121.8 cm, post-intervention = 135.6 cm, z = −2.67, p < 0.05). There was no significant change in gait variability. The program was found to be feasible and safe, with no attrition. Participant satisfaction with the home-based music-cued gait training was high, and there were no adverse events.

Conclusion: A progressively modified gait training program using rhythmic auditory cues delivered at home was feasible, safe, and enjoyable. Music-cued gait training can help to reduce the rate of decline in gait stride length and speed in some individuals living with AD.

Trial Registration:http://www.anzctr.org.au/Default.aspx, ACTRN12616000851460.

Universal Trial Number: U1111-1184-5735.

Effects of auditory feedback on movements with two-segment sequence and eye-hand coordination: Using a short auditory contact cue

During sequential reaches to multiple targets, eye and hand movements are highly coordinated, and the gaze is anchored to each target until the reaching hand makes contact to each of them. Such contact events are monitored by multimodal (visual, proprioceptive) sensory systems, and one function of the gaze anchoring to each target is verification of successful target contact (reach completion). The present study focused on this verification function and examined how planning and control of eye and hand movements during two-segment eye-hand movements are affected by augmented auditory feedback of reach completion. Young adults made a reach to the first target with a saccade, and then made another saccade to the second target in blocked trials. An auditory target-contact cue condition delivered four short sounds during the initial reach, and the last sound was synchronized with target contact, whereas a control condition lacked the last target-contact sound. The results showed that saccadic reaction time increased with the target-contact cue, especially when the reaching accuracy demand was high. The reach also became slower with lower peak velocity and longer time to peak velocity with that cue, suggesting that the limb-motor system lower the preplanned speed of the reach in a top-down fashion for a better preparation toward reach completion. However, no auditory effects were found for the timing of gaze shift to the second target. These results were different from those seen in previous studies, indicating that the effects of the additional auditory contact feedback differ depending on behavioral tasks and cue characteristics.

The Influence of Auditory Cues on Bodily and Movement Perception

The sounds that result from our movement and that mark the outcome of our actions typically convey useful information concerning the state of our body and its movement, as well as providing pertinent information about the stimuli with which we are interacting. Here we review the rapidly growing literature investigating the influence of non-veridical auditory cues (i.e., inaccurate in terms of their context, timing, and/or spectral distribution) on multisensory body and action perception, and on motor behavior. Inaccurate auditory cues provide a unique opportunity to study cross-modal processes: the ability to detect the impact of each sense when they provide a slightly different message is greater. Additionally, given that similar cross-modal processes likely occur regardless of the accuracy or inaccuracy of sensory input, studying incongruent interactions are likely to also help us predict interactions between congruent inputs. The available research convincingly demonstrates that perceptions of the body, of movement, and of surface contact features (e.g., roughness) are influenced by the addition of non-veridical auditory cues. Moreover, auditory cues impact both motor behavior and emotional valence, the latter showing that sounds that are highly incongruent with the performed movement induce feelings of unpleasantness (perhaps associated with lower processing fluency). Such findings are relevant to the design of auditory cues associated with product interaction, and the use of auditory cues in sport performance and therapeutic situations given the impact on motor behavior.

Auditory Coding of Reaching Space

Reaching movements are usually initiated by visual events and controlled visually and kinesthetically. Lately, studies have focused on the possible benefit of auditory information for localization tasks, and also for movement control. This explorative study aimed to investigate if it is possible to code reaching space purely by auditory information. Therefore, the precision of reaching movements to merely acoustically coded target positions was analyzed. We studied the efficacy of acoustically effect-based and of additional acoustically performance-based instruction and feedback and the role of visual movement control. Twenty-four participants executed reaching movements to merely acoustically presented, invisible target positions in three mutually perpendicular planes in front of them. Effector-endpoint trajectories were tracked using inertial sensors. Kinematic data regarding the three spatial dimensions and the movement velocity were sonified. Thus, acoustic instruction and real-time feedback of the movement trajectories and the target position of the hand were provided. The subjects were able to align their reaching movements to the merely acoustically instructed targets. Reaching space can be coded merely acoustically, additional visual movement control does not enhance reaching performance. On the basis of these results, a remarkable benefit of kinematic movement acoustics for the neuromotor rehabilitation of everyday motor skills can be assumed.

Sound matters: The impact of auditory deprivation on movement precision in rowing

Purpose of the study was to quantify the importance of auditory feedback for movement precision in elevated rowing task difficulty with elite athletes under normal and masked hearing conditions. It was hypothesized that rowing with masked hearing would reduce the precision of movement, particularly at the non-usual/less-preferred stroke frequencies (SF). Self-reported questionnaires helped to understand the difficulty of the task. Twenty rowers completed 2 × 1000 m-distance-blocks, each separated into 4 × 250 m, with increasing SF 18, 20, 22 24 strokes/minute once with normal and once with masked hearing. Precision was determined as the deviation between the SF target and the SF actually performed (DSF). Athletes' subjective perception was requested before and after the experiment. A 2 (hearing condition) × 4 (SF 18, 20, 22, 24) repeated measures ANOVA showed systematically larger DSF during masked hearing for all SFs compared to the DSF in the normal hearing condition (p < .01). Further, the highest DSFs were found for SF 18 and 24 in both hearing conditions (no interaction effect). The athletes' perception of the relevance of natural movement sounds for their rowing performance changed when evaluated before and after the experiment. Rowing without hearing was evaluated as mentally more demanding than physically. The results confirmed our initial assumptions and showed the relevance of natural auditory information for movement precision in rowing practice, even at a high level of expertise.

Real-time feedback by wearables in running: Current approaches, challenges and suggestions for improvements

Injuries and lack of motivation are common reasons for discontinuation of running. Real-time feedback from wearables can reduce discontinuation by reducing injury risk and improving performance and motivation. There are however several limitations and challenges with current real-time feedback approaches. We discuss these limitations and challenges and provide a framework to optimise real-time feedback for reducing injury risk and improving performance and motivation. We first discuss the reasons why individuals run and propose that feedback targeted to these reasons can improve motivation and compliance. Secondly, we review the association of running technique and running workload with injuries and performance and we elaborate how real-time feedback on running technique and workload can be applied to reduce injury risk and improve performance and motivation. We also review different feedback modalities and motor learning feedback strategies and their application to real-time feedback. Briefly, the most effective feedback modality and frequency differ between variables and individuals, but a combination of modalities and mixture of real-time and delayed feedback is most effective. Moreover, feedback promoting perceived competence, autonomy and an external focus can improve motivation, learning and performance. Although the focus is on wearables, the challenges and practical applications are also relevant for laboratory-based gait retraining.

New Perspectives on Music in Rehabilitation of Executive and Attention Functions

Modern music therapy, starting around the middle of the twentieth century was primarily conceived to promote emotional well-being and to facilitate social group association and integration. Therefore, it was rooted mostly in social science concepts. More recently, music as therapy began to move decidedly toward perspectives of neuroscience. This has been facilitated by the advent of neuroimaging techniques that help uncover the therapeutic mechanisms for non-musical goals in the brain processes underlying music perception, cognition, and production. In this paper, we focus on executive function (EF) and attentional processes (AP) that are central for cognitive rehabilitation efforts. To this end, we summarize existing behavioral as well as neuroimaging and neurophysiological studies in musicians, non-musicians, and clinical populations. Musical improvisation and instrumental playing may have some potential for EF/AP stimulation and neurorehabilitation. However, more neuroimaging studies are needed to investigate the neural mechanisms for the active musical performance. Furthermore, more randomized clinical trials combined with neuroimaging techniques are warranted to demonstrate the specific efficacy and neuroplasticity induced by music-based interventions.

Pressing Crowd Noise Impairs the Ability of Anxious Basketball Referees to Discriminate Fouls

The decision-making processes of referees in sports are affected by many factors, including the pressure of spectators. While the home/visitor bias has been previously investigated, the role of crowd noise has been less studied. In the present study, we investigated how the crowd noise (calm vs. pressing) influence the decisions of basketball referees, when examining videos of potential fouls. In doing so, we also considered the level of competitive anxiety of referees (low vs. high anxiety), as factor potentially interacting with the pressure exerted by the spectators. A 2 × 2 ANOVA (Crowd noise x Anxiety) revealed a significant interaction [F _(1,28) = 7.33; p < 0.05; η p 2 = 0.21; power = 0.74], with the highly anxious referees showing poorer performances in the pressing crowd condition [t ₍₁₄₎ = 2.24; p < 0.05; d = 0.64]. The results indicate that the crowd noise does not seem to affect the referees' decisions, unless we consider the anxiety. The present findings suggest that the decisions of referees with high anxiety might be more easily influenced by external factors like crowd noise. Based on these results, referees' federations should consider the possibility to develop training protocols dedicated to highly anxious referees, to avoid their decisions from being biased by spectators' pressure.

Optimizing Performative Skills in Social Interaction: Insights From Embodied Cognition, Music Education, and Sport Psychology

Embodied approaches to cognition conceive of mental life as emerging from the ongoing relationship between neural and extra-neural resources. The latter include, first and foremost, our entire body, but also the activity patterns enacted within a contingent milieu, cultural norms, social factors, and the features of the environment that can be used to enhance our cognitive capacities (e.g., tools, devices, etc.). Recent work in music education and sport psychology has applied general principles of embodiment to a number of social contexts relevant to their respective fields. In particular, both disciplines have contributed fascinating perspectives to our understanding of how skills are acquired and developed in groups; how musicians, athletes, teachers, and coaches experience their interactions; and how empathy and social action participate in shaping effective performance. In this paper, we aim to provide additional grounding for this research by comparing and further developing original themes emerging from this cross-disciplinary literature and empirical works on how performative skills are acquired and optimized. In doing so, our discussion will focus on: (1) the feeling of being together, as meaningfully enacted in collective musical and sport events; (2) the capacity to skillfully adapt to the contextual demands arising from the social environment; and (3) the development of distributed forms of bodily memory. These categories will be discussed from the perspective of embodied cognitive science and with regard to their relevance for music education and sport psychology. It is argued that because they play a key role in the acquisition and development of relevant skills, they can offer important tools to help teachers and coaches develop novel strategies to enhance learning and foster new conceptual and practical research in the domains of music and sport.

The sound of speed: How grunting affects opponents' anticipation in tennis

Grunting in tennis is a widespread phenomenon and whether it influences opponents’ predictions of ball trajectory—and if so, why—is subject of ongoing debate. Two alternative hypotheses have been proposed to explain why grunting may impede opponents’ predictions, referred to as the distraction account (i.e., grunts capture attentional resources necessary for anticipation) and the multisensory integration account (i.e., auditory information from the grunt systematically influences ball trajectory prediction typically assumed to rely on visual information). To put these competing hypotheses to test, in the current study we presented tennis players with a series of temporally occluded video clips of tennis rallies featuring experimentally amplified, attenuated, or muted grunting sounds. Participants were asked to predict the ball landing position. Results indicated that higher grunt intensities yielded judgments of longer ball trajectories whereas radial prediction errors were not affected. These results are clearly at odds with the distraction account of grunting, predicting increased prediction errors after higher intensity grunts. In contrast, our findings provide strong support for the multisensory integration account by demonstrating that grunt intensity systematically influences judgments of ball trajectory.