Effects of visual search vs. auditory tasks on postural control in children with autism spectrum disorder

Balance and motor skills differences between children and teenagers with autism spectrum disorder and neurotypically developing

This study examined the differences between children and adolescents with autism spectrum disorder (ASD) and neurotypically developing (NTD) in terms of balance, postural control, and motor skills. It also examined which motor skills are most affected and whether scores on different assessment tests in ASD children are correlated. A cross-sectional observational study with two research groups was conducted. Timed up and go test (TUG), short form of Bruininks-Oseretsky test of Motor Proficiency version 2 (SFBOT-2), and pediatric balance scale (PBS) were used. A total of 100 participants 50 with ASD and 50 with NTD engaged in the research. Statistically significant differences were obtained between control group and ASD group in TUG test and in SFBOT-2 standard score and total score (p-value = <0.01). A statistically significant difference (p-value = <0.01) was seen between ASD group's and control group's PBS scores. Poor correlation was noted between TUG and SFBOT-2, as well as between PBS and TUG. A moderate correlation was also found between SFBOT-2 and PBS. Children with ASD present difficulties in motor skills and in static and dynamic balance compared to children with NTD. Differences were observed in the motor skills of strength followed by manual dexterity, running speed and agility, fine motor precision, fine motor integration, and balance. The PBS item that showed the greatest difference between the ASD group and control group was maintaining monopodial support with hands on hips. Finally, poor to moderate correlations were obtained between the different tests with statistically significant differences.

Sex differences in motor learning flexibility are accompanied by sex differences in mushroom spine pruning of the mouse primary motor cortex during adolescence

Background

Although males excel at motor tasks requiring strength, females exhibit greater motor learning flexibility. Cognitive flexibility is associated with low baseline mushroom spine densities achieved by pruning which can be triggered by α4βδ GABAA receptors (GABARs); defective synaptic pruning impairs this process.

Methods

We investigated sex differences in adolescent pruning of mushroom spine pruning of layer 5 pyramidal cells of primary motor cortex (L5M1), a site essential for motor learning, using microscopic evaluation of Golgi stained sections. We assessed α4GABAR expression using immunohistochemical and electrophysiological techniques (whole cell patch clamp responses to 100 nM gaboxadol, selective for α4βδ GABARs). We then compared performance of groups with different post-pubertal mushroom spine densities on motor learning (constant speed) and learning flexibility (accelerating speed following constant speed) rotarod tasks.

Results

Mushroom spines in proximal L5M1 of female mice decreased >60% from PND35 (puberty onset) to PND56 (Pubertal: 2.23 ± 0.21 spines/10 μm; post-pubertal: 0.81 ± 0.14 spines/10 μm, P < 0.001); male mushroom spine density was unchanged. This was due to greater α4βδ GABAR expression in the female (P < 0.0001) because α4 -/- mice did not exhibit mushroom spine pruning. Although motor learning was similar for all groups, only female wild-type mice (low mushroom spine density) learned the accelerating rotarod task after the constant speed task (P = 0.006), a measure of motor learning flexibility.

Conclusions

These results suggest that optimal motor learning flexibility of female mice is associated with low baseline levels of post-pubertal mushroom spine density in L5M1 compared to male and female α4 -/- mice.

Effects of sensory integration training on balance function and executive function in children with autism spectrum disorder: evidence from Footscan and fNIRS

Introduction

This study investigates the efficacy of sensory integration training (SIT) in enhancing balance and executive functions in children with autism spectrum disorder (ASD), with the aim of highlighting its potential for organizing and processing sensory information in the brain.

Methods

Utilizing Footscan for biomechanical evidence and functional near-infrared spectroscopy (fNIRS) for neural activation, we engaged two participant groups: a control group (n = 9) and an experimental group (n = 9). Assessments involved the Sharpened Romberg Test (SRT) for balance under varied visual conditions and the Go/No-Go task for executive function.

Results

The SIT intervention significantly improved balance function, particularly in Visual Deprivation (VD) scenarios. Neurophysiological data revealed heightened activation in the right Inferior Frontal Gyrus (R-IFG) and right Middle Frontal Gyrus (R-MFG), suggesting enhanced executive function. The potential of R-IFG/MFG activation as a reliable biomarker for assessing executive function in ASD was identified.

Discussion

The study provides empirical evidence supporting SIT's effectiveness in enhancing balance and executive functions in children with ASD. The therapy not only improves sensory processing and motor skills but also appears to compensate for sensory deficits, particularly in vision, vestibular perception, and proprioception. Enhanced neural activation in specific PFC regions underscores SIT's role in improving cognitive aspects, including inhibitory control and cognitive flexibility. The multidisciplinary approach adopted for this research highlights the intricate interplay between sensory-motor functions and cognitive control in ASD, paving the way for integrated therapeutic strategies. Despite these advancements, the mechanisms through which SIT exerts these multifaceted effects require further exploration.

The effectiveness of dance movement therapy for individuals with Down syndrome: a pilot randomised controlled trial

BACKGROUND

Individuals with Down syndrome (DS) exhibit deficits in static and dynamic balance abilities and maladaptive functions. This study aimed to determine the effectiveness of dance movement therapy (DMT) group intervention in individuals with DS.

METHODS

The 31 participating individuals with DS, aged 5-29 years, were randomly divided into intervention (n = 16) and control (n = 15) groups. Posturography was used for static balance measurement, timed up and go test for dynamic balance measurement and the Achenbach System of Empirically Based Assessment (ASEBA) questionnaire for adaptive function and behavioural problem measurement in participants before and after the DMT interventions. The intervention group underwent 60-min DMT intervention once a week for 10 times, while the control group had usual daily activities.

RESULTS

The results revealed a statistically significant difference and large effect sizes in dynamic balance [(f(1, 29) = 4.52, P = 0.04, η_p   ² = 0.14)] in the intervention group compared with the control group. There were no statistically significant differences in static balance and ASEBA scores between the groups.

CONCLUSIONS

This study found that the DMT interventions helped to improve the dynamic balance in individuals with DS.

Combined Gait and Grasping in Autistic and Non-Autistic Youths

This study was designed to extend research on motor skill development in autism spectrum disorder using a dual-task skill. Nine autistic and 18 non-autistic youths walked without grasping or while reaching to grasp a small or large object. Step extremity ratio, percent time in double support, and normalized speed were quantified. We hypothesized that gait would differ between autistic and non-autistic youth and that differences would be moderated by the phase (approach and grasp) and the complexity of the task (walking and grasping versus walking alone). Although gait parameters were similar during the walking-only trials, the combined task resulted in slower speed and shorter steps in autistic youth, particularly during the grasp phase. These findings, while in a small sample, offer preliminary evidence that autistic youth who show typical gait during simple assessments of motor ability may have difficulties in more complex tasks that require the coordination of movements.

Feasibility of a virtual reality-based exercise intervention and low-cost motion tracking method for estimation of motor proficiency in youth with autism spectrum disorder

Background

Motor impairment is widely acknowledged as a core feature in children with autism spectrum disorder (ASD), which can affect adaptive behavior and increase severity of symptoms. Low-cost motion capture and virtual reality (VR) game technologies hold a great deal of promise for providing personalized approaches to motor intervention in ASD. The present study explored the feasibility, acceptability and potential efficacy of a custom-designed VR game-based intervention (GaitWayXR™) for improving gross motor skills in youth with ASD.

Methods

Ten children and adolescents (10–17 years) completed six, 20-min VR-based motor training sessions over 2 weeks while whole-body movement was tracked with a low-cost motion capture system. We developed a methodology for using motion tracking data to quantify whole-body movement in terms of efficiency, synchrony and symmetry. We then studied the relationships of the above quantities with standardized measures of motor skill and cognitive flexibility.

Results

Our results supported our presumption that the VR intervention is safe, with no adverse events and very few minor to moderate side-effects, while a large proportion of parents said they would use the VR game at home, the most prohibitive reasons for adopting the system for home therapy were cost and space. Although there was little evidence of any benefits of the GaitWayXR™ intervention in improving gross motor skills, we showed several positive correlations between the standardized measures of gross motor skills in ASD and our measures of efficiency, symmetry and synchrony from low-cost motion capture.

Conclusions

These findings, though preliminary and limited by small sample size, suggest that low-cost motion capture of children with ASD is feasible with movement exercises in a VR-based game environment. Based on these preliminary findings, we recommend conducting larger-scale studies with methods for improving adherence to VR gaming interventions over longer periods.

Effects of vision and cognitive load on anticipatory and compensatory postural control

This study assessed the effects of vision and cognitive load on anticipatory postural adjustments (APAs) and compensatory postural adjustments (CPAs) in response to an externally triggered postural perturbation. A ball-hitting test was repeated under different visual conditions (eyes open, EO; eyes closed, EC) and cognitive loads (no load, 3-subtraction task, time-limited 3-subtraction task). Data were collected separately for I) surface electromyography from the right side of the biceps brachii (BIC) and erector spinae (ES) to detect the latency and response intensity (RI); and II) displacement of the centre of pressure (ΔCOP) to detect the standard deviation (ΔCOP_SD) and maximum value (ΔCOP_max) in the anterior-posterior direction. Compared with the results under the EC condition, the ES latency was shorter and the RI of the BIC was lower under the EO condition. Accordingly, the ΔCOP_SD and ΔCOP_max were increased in the APAs phase and decreased in the CPAs phase. Cognitive load had no effect on APAs and CPAs or on ΔCOP in the APAs phase. However, ΔCOP_max was decreased in the CPAs phase during the EC condition. In conclusion, vision played an important role in APAs and CPAs for muscle activation and ΔCOP. Cognitive load had no effect on neuromuscular APAs or CPAs except when the postural perturbation occurred when visually unexpected.

Biofeedback-Based, Videogame Balance Training in Autism

The present study examined the effects of a visual-based biofeedback training on improving balance challenges in autism spectrum disorder (ASD). Twenty-nine youth with ASD (7-17 years) completed an intensive 6-week biofeedback-based videogame balance training. Participants exhibited training-related balance improvements that significantly accounted for postural-sway improvements outside of training. Participants perceived the training as beneficial and enjoyable. Significant moderators of training included milder stereotyped and ritualistic behaviors and better starting balance. Neither IQ nor BMI moderated training. These results suggest that biofeedback-based balance training is associated with balance improvements in youth with ASD, most robustly in those with less severe repetitive behaviors and better starting balance. The training was perceived as motivating, further suggesting its efficacy and likelihood of use.

A Cross Sectional Examination of the Relation Between Depression and Frequency of Leisure Time Physical Exercise among the Elderly in Jinan, China

Depression has become a major global public health problem. Many studies have shown the positive effects of physical exercise on depression. However, few studies have examined the relationship between frequency of leisure time physical exercise and depression without considering the time and intensity of exercise among middle-aged and elderly people of urban communities in northern China. We conducted a cross-sectional survey that included 1604 participants among urban residents aged 50 years or older in China to evaluate how the frequency of physical exercise was related to depression. Our study showed that the prevalence of depression in the urban community of Jinan is 16.52%. For physical exercise, the odds ratios (ORs) and 95% confidence intervals (CIs) for 1~2 times per week, 3~4 times per week and ≥5 times per week were 1.137 (0.661, 1.953), 0.516 (0.304, 0.875) and 0.548 (0.392, 0.768) respectively, with adjustment for age, gender, marital status, BMI, hypertension, previously diagnosed type 2 diabetes, triglyceride, total cholesterol, soy food intake, milk food intake, vegetable and fruit intake and meat intake. We concluded that physically exercising three times a week is associated with a low prevalence of depression.

Cerebellar involvement in autism and ADHD

The cerebellum has long been known for its importance in motor learning and coordination. However, increasing evidence supports a role for the cerebellum in cognition and emotion. Consistent with a role in cognitive functions, the cerebellum has emerged as one of the key brain regions affected in nonmotor disorders, including autism spectrum disorder and attention deficit-hyperactivity disorder. Here, we discuss behavioral, postmortem, genetic, and neuroimaging studies in humans in order to understand the cerebellar contributions to the pathogenesis of both disorders. We also review relevant animal model findings.

Postural Control and Emotion in Children with Autism Spectrum Disorders

Autism Spectrum Disorders subjects (ASD) are well known to have deficits in social interaction. We recorded simultaneously eye movements and postural sway during exploration of emotional faces in children with ASD and typically developing children (TD). We analyzed several postural and ocular parameters. The results showed that all postural parameters were significantly greater in children with ASD; ASD made significantly fewer saccades and had shorter fixation time than TD, particularly in the eyes, and especially for unpleasant emotions. These results suggest that poor postural control of ASD and their impaired visual strategies could be due to a lack of interest in social cognition, causing a delay in the development of the cortical areas, and thus could have an effect on their postural control.

From movement kinematics to social cognition: the case of autism

The way in which we move influences our ability to perceive, interpret and predict the actions of others. Thus movements play an important role in social cognition. This review article will appraise the literature concerning movement kinematics and motor control in individuals with autism, and will argue that movement differences between typical and autistic individuals may contribute to bilateral difficulties in reciprocal social cognition.

Low Back Pain in Athletes Is Associated with General and Sport Specific Risk Factors: A Comprehensive Review of Longitudinal Studies

We aimed to examine systematically the available evidence on risk factors of low back pain (LBP) in athletes. We performed search without language restriction in PubMed, Ovid, Google Scholar, Scopus, and CINAHL. Longitudinal studies that examined possible risk factors of LBP in athletes were included in this systematic review. Based on methodological quality of studies, a best-evidence synthesis was conducted. Seven longitudinal studies were included, four of which had high methodological quality. Results showed that previous LBP, decreased lumbar flexion, and decreased lumbar extension are positively associated with LBP. There was moderate evidence for hip flexor tightness and high body weight as a risk factor. We found insufficient evidence for association between forward bending, previous injury, and amount of training per week, active years, age, and sex with LBP. In conclusion this study would provide a list of risk factors for LBP in athletes, though it showed a strong evidence for only a few including decrease lumbar flexion or extension, previous LBP, and high body weight. This review indicated a high heterogeneity of study characteristics including assessed risk factors and statistical techniques might limit the quality of evidence.

Does Ramadan Fasting Adversely Affect Cognitive Function in Young Females?

We examined the effects of Ramadan fasting on cognitive function in 17 female athletes. Data were obtained from participants of two fasting (n = 9) and nonfasting (n = 8) groups at three periods of the study (before Ramadan, at the third week in Ramadan, and after Ramadan). Digit span test (DST) and Stroop color test were employed to assess short-term memory and inhibition/cognitive flexibility at each time point. There were no significant changes for DST and Stroop task 1 in both groups, whereas Stroop task 2 and task 3 showed significant improvements in Ramadan condition (p < 0.05). Interference indices did not change significantly across the study except in post-Ramadan period of fasting group (p < 0.05). Group × week interaction was significant only for error numbers (p < 0.05). Athletes in nonfasting showed a significant decrease in number of errors in Ramadan compared to baseline (p < 0.05). The results suggest that Ramadan fasting may not adversely affect cognitive function in female athletes.

Attentional and sensory contributions to postural sway in children with autism spectrum disorder

Postural control is known to depend on sensory and cognitive factors. Little is known about how children with autism spectrum disorder (ASD) regulate static balance, and to what extent vision and cognition contribute to the regulation of balance in this group. We compared a group of children with mild ASD and a group of age- and gender-matched controls on various postural tasks, standing on a Wii Balance Board. We tested a sensory disturbance (closing the eyes) and a cognitive disturbance (word memorization) on the control of quiet standing. Analysis of center-of-pressure excursions revealed moderate effects of cognitive load, but clear effects of vision. We found a greater destabilizing effect of closing the eyes (greater postural excursions in the medio-lateral direction) for the ASD group than for controls. No group differences were found on word recall and on a standardized balance test (Movement Assessment Battery for Children; M-ABC2). We suggest that the postural effects reflect tighter coupling between vision and motor adjustments in ASD than in controls, which is consistent with recent suggestions of greater reliance on vision in this group.

Children with Autism Spectrum Disorder and Patterns of Participation in Daily Physical and Play Activities

Autism spectrum disorder (ASD) indicates several neurodevelopmental impairments which may end in impairments in motor or physical activities. Daily physical activity involvement was investigated in a total of 83 children (52 boys and 31 girls) with ASD aged 6–15 years. Results indicated that only 10 (12%) of children with ASD were physically active. Children were predominantly engaged in solitary play rather than social play activities. Gender, family income, and household structure were found to be associated with activity scores. Financial burden and lack of opportunities were noted as the leading barriers to physical activities. In conclusion, findings indicated a low rate of physical activity participation in children with ASD that is closely associated with sociodemographic variables.

Depression and Exercise: A Clinical Review and Management Guideline

CONTEXT

There is an increasing interest to detect how exercise affects depression symptoms. Although recent findings confirm the positive effect of exercise on depression, there is no clear guideline regarding advice on exercise for patients with depression. The following review aims at presenting the contemporary literature regarding the nature of depression, exercise, the underlying mechanisms and the management of an exercise program in individuals with depression.

EVIDENCE ACQUISITION

We searched electronic databases including Cochrane Library, PubMed, ISI web of knowledge and PsychInfo (from January 2000 to October 2014). We reviewed the systematic reviews, meta-analyses, and large-scale randomized control trials on effects of exercise on depression.

RESULTS

Recent evidence has emerged on characteristics of effective exercise programs and those patients with depression that will most benefit from the exercise programs. However due to the methodological weaknesses and inconsistencies of studies, conclusions must be made with caution.

CONCLUSIONS

We have provided a number of recommendations for clinicians and researchers who plan to use exercise protocols in depression.

Biological motion perception is affected by age and cognitive style in children aged 8-15

The current paper aims to address the question of how biological motion perception in different social contexts is influenced by age or also affected by cognitive styles. We examined developmental changes of biological motion perception among 141 school children aged 8-15 using point-light displays in monadic and dyadic social contexts. Furthermore, the cognitive styles of participants were investigated using empathizing-systemizing questionnaires. Results showed that the age and empathizing ability strongly predicted improvement in action perception in both contexts. However the systemizing ability was an independent predictor of performance only in monadic contexts. Furthermore, accuracy of action perception increased significantly from 46.4% (SD = 16.1) in monadic to 62.5% (SD = 11.5) in dyadic social contexts. This study can help to identify the roles of social context in biological motion perception and shows that children with different cognitive styles may present different biological motion perception.

Postural control impairments in individuals with autism spectrum disorder: a critical review of current literature

CONTEXT

Motor impairments in individuals with autism spectrum disorder (ASD) have been frequently reported. In this review, we narrow our focus on postural control impairments to summarize current literature for patterns, underlying mechanisms, and determinants of posture in this population.

EVIDENCE ACQUISITION

A literature search was conducted through Medline, ISI web of Knowledge, Scopus and Google Scholar to include studies between 1992 and February 2013.

RESULTS

Individuals with ASD have problems in maintaining postural control in infancy that well persists into later years. However, the patterns and underlying mechanisms are still unclear.

CONCLUSIONS

Examining postural control as an endophenotype or early diagnostic marker of autism is a conceptual premise which should be considered in future investigations. At the end of the review, methodological recommendations on the assessment of postural control have also been provided.