The Role of an Attention Demanding Activity for Priming Motor Learning
Condition: Basic Motor Learning Problem
Study type: Interventional

Summary: 
      The purpose of this study is to determine if priming attention prior to practicing a motor
      task will have an effect on the ability to acquire and learn that motor task. The
      investigators hypothesize that the acquisition and learning of a motor task will improve if
      attention is primed prior to practicing that motor task when compared to a group who does not
      receive the prime.
    

Detailed description: 
      This proposed study is a randomized trial on the effects of using an attention demanding
      prime prior to practicing a previously untrained motor task in a population of young and
      healthy individuals. Therefore, The investigators will randomize a group into a motor
      learning paradigm. The experimental group will prime with an activity that requires high
      attention demands . The control group will perform an activity that is matched for practice
      amount but requires less attention demands. Both groups will perform this activity
      immediately prior to practicing a previously untrained motor task. The objectives of our aims
      will be to compare the experimental group to the control group to determine the effects of
      the attention demanding prime on the amount, rate, and transfer of acquisition and learning
      of the motor task.

      On day one of the study, participants will be consented. Demographic information,
      participant's hand dominance (self-report), and level of arousal will then be documented.
      Level of arousal will be assessed by using the Stanford Sleepiness Scale. Each participant
      will then perform baseline measures on the previously untrained motor task, a functional task
      that simulates feeding, and two other motor task that will not be practiced which will be
      used to determine transfer of the practiced task. One task will be a card sorting task, which
      shares similar spatio-temporal characteristics to the simulated feeding task. The other
      transfer task will be a buttoning task which has dissimilar spatio-temporal characteristics
      when compared to the simulated feeding task. Baseline measurements will consists of two
      trials for each motor task and trial order will be randomized between all tasks. Each
      participant will then be randomized into either the experimental group or the control group
      using a block randomization technique. Participants randomized to the experimental group will
      perform the attention demanding task, a variant of the Simon Task, and will be told to
      emphasize accuracy over speed in order to prime for attention. Participants randomized to the
      control group will perform a similar task; however will be told to emphasize speed over
      accuracy; thereby creating a sham prime. Following completion of the cognitive tasks, both
      groups will immediately begin practicing 50 trials of the simulated feeding task. Following
      completion of practice on the simulated feeding task, participants will again perform 2
      trials of both the card sorting task and the buttoning task to determine transfer of the
      unpracticed task. Participants will then return on day 2 and will perform 2 trials of the
      simulated feeding task to assess for short term retention. Participants will again return on
      day 8 and will complete two trials of each motor task (simulated feeding task, card sorting
      task, and buttoning task) to determine delayed retention and transfer.

      The Attention Demanding Activity: The attention demanding activity will be a variant of the
      Simon Task, a choice reaction time task. In this task, participants will be instructed to
      respond as quickly and accurately as possible, pushing one of two buttons corresponding to
      the direction of arrows presented visually on a computer screen, ignoring the spatial
      location of the arrows. Arrows will be presented in one of two conditions: congruent and
      incongruent. Each arrow will be preceded by a fixation cross presented for 250 milliseconds
      in the center of the display followed by a blank screen for 100 milliseconds. The arrow will
      then be presented until the participant responds or 250 milliseconds or 750 milliseconds
      elapse depending on the group. In the congruent conditions, arrows will appear on the same
      side of the space as the direction they are facing (e.g. a right facing arrow on the right
      side of the space). In the incongruent condition, arrows will be presented on the opposite
      side of the space as the direction they are facing (e.g. a right facing arrow on the left
      side of the space). There will be a high proportion of congruent trials (75%; 480 trials) to
      incongruent trials (25%; 160 trials). In addition to verbal instructions, response deadlines
      will be in place. In order to ensure that the experimental group focuses on accuracy over
      speed, the deadlines throughout their activity will be 750 milliseconds. The control group
      will only have 250 milliseconds to respond to the on-screen stimulus which will ensure a
      focus on speed over accuracy. If a deadline is not met on a given trial, a message will
      appear to the participant as "Deadline Missed. Faster!" Every 15 trials, this was evaluated,
      and if more than 33% of deadlines are missed, a message will appear indicating that the
      participants are missing too many deadlines and that it is imperative that the deadlines be
      met, even if errors result.

      The previously untrained motor task: The investigators have chosen to use a functional upper
      extremity motor task that simulates feeding. This task requires participants to spoon beans
      (kidney, raw) from a central, proximal "start" cup to 3 distal "target" cups as fast as
      possible. The cups (9.5 centimeters in diameter) will be secured to a board with 3 cups
      secured radially at 45 degrees, 90 degrees, and 135 degrees around the start cup at a
      distance of 16 centimeters. The start cup will be oriented along the participant's midline
      and 15 centimeters in front of the seated participant. One repetition of the motor task will
      consist of spooning 2 beans at once from the start cup to a target cup with the non-dominant
      hand, with one trial equaling 15 repetitions. During each trial, participants will move first
      to the ipsilateral target cup, next to the center target cup, and then to the contralateral
      cup, relative to the hand used (right vs. left). This sequence will be repeated five times to
      complete the trial. The participant will begin each trial with their non-dominant hand to the
      side of the spoon. Each trial will begin as the administrator gives a verbal cue "go" and
      will end when the spoon is returned to the starting position (5 centimeters lateral to the
      start cup). The time it takes to complete the 15 repetitions ("trial time") will be the
      measure of performance, with faster times indicating better performance. All trials will be
      timed to the nearest 100th of a second via stopwatch. Participants will be given no explicit
      feedback (i.e. knowledge of performance or results) after each trial. They will also not be
      encouraged or coached to use a specific pattern of upper extremity kinematics during
      training.

      Transfer task that has similar spatio-temporal characteristics: This task will be a card
      sorting task. This task requires participants to place a standard playing card from a
      central, proximal "start" box to three distal target boxes as fast as possible. The boxes (9
      centimeters X 9 centimeters) will be secured to a board with 3 boxes secured radially at 45
      degrees, 90 degrees, and 135 degrees around the start box at a distance of 16 centimeters.
      The start box will be oriented along the participant's midline and 15 centimeters in front of
      the seated participant with the cards face down. One repetition of the motor task will
      consist of placing one card at a time; face up, from the start box to a target box with the
      non-dominant hand with one trial equaling 15 repetitions. During each trial, participants
      will move first to the ipsilateral target box, next to the center target box, and then to the
      contralateral box, relative to the hand used (right vs. left). This sequence will be repeated
      ten times to complete the trial. The participant will begin each trial with their
      non-dominant hand to the side of the start box. Each trial will begin as the administrator
      gives a verbal cue "go" and will end when the participant places their hand back at the
      starting location after the last card is at rest in the target box. The time it takes to
      complete the 30 repetitions ("trial time") will be the measure of performance, with faster
      times indicating better performance. All trials will be timed to the nearest 100th of a
      second via stopwatch. Participants will be given no explicit feedback (i.e. knowledge of
      performance or results) after each trial. They will also not be encouraged or coached to use
      a specific pattern of upper extremity kinematics during training.

      Transfer task that has dissimilar spatio-temporal characteristics: This task will require
      fastening buttons sequentially. At the start of each trial, participants will begin buttoning
      the top of ten buttons (3 centimeters apart) that will be sewed 2 centimeters apart
      vertically on a piece of plain weave cotton fabric. Both pieces of the fabric will be secured
      to a wooden board with the placket centered in line with the subject's non-dominant shoulder.
      The button side of the fabric will be folded onto the board, while the buttonhole side of the
      fabric will be unfolded onto the table prior to each trial. Buttons will be fastened through
      horizontal buttonholes in a left over right order, relative to the participant. Participants
      will fasten all ten buttons sequentially and then will unfasten each button in the reverse
      order using their non-dominant hand. The time it takes to fasten and unfasten all 10 buttons
      will be the trial time or measure of performance, with faster times indicating better
      performance. All trials will be timed to the nearest 100th of a second via stopwatch.
      Participants will be given no explicit feedback (i.e. knowledge of performance or results)
      after each trial. They will also not be encouraged or coached to use a specific pattern of
      upper extremity kinematics during training. This task will be performed with the subject's
      non-dominate upper extremity.
    

Intervention name(s): Attentional prime; Sham prime
Intervention type(s): Behavioral; Behavioral
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Supportive Care
Keywords: motor learning; attention; priming; rehabilitation