Matheus Maia Pacheco

Home-based rehabilitation after stroke is increasingly important, as pressure on hospital services rise and recovery occurs mostly at home. Enriching the home (Environmental Enrichment, EE) represents a potential strategy to support rehabilitation by providing continuous task- and context-specific stimulation that promotes functional recovery through frequent and exploratory use of the affected arm. Exploratory behaviour - self-initiated, varied and adaptive movements - is an important driver of motor learning and neuroplasticity. While strong evidence from animal research demonstrates the benefits of EE for functional recovery, translation to human home-based rehabilitation remains limited. This study will investigate the feasibility of the Pedagogy and Enriched Environment for Rehabilitation in the HOME after stroke (PEER-HOMEcare) intervention. PEER-HOMEcare translates EE by introducing meaningful, targeted and progressive home modifications to promote exploratory use of the affected arm during daily activities. In this prospective, single group, experimental study, 45 stroke survivors (≥ 18 years), within 6 months post-stroke across Norway, Sweden and Latvia will participate. Wearable sensors will be used to capture exploratory behaviour and activity patterns, giving objective insights to inform progressive modifications to the home. Primary outcomes of feasibility and acceptability will be assessed through questionnaires, logs and interviews. Intervention fidelity, participant adherence and adverse events will be evaluated. Secondary outcomes include changes in arm function, self-perceived activities of daily living and psychosocial outcomes. This study will provide important knowledge about the feasibility of an innovative EE approach for home-based rehabilitation, informing a future trial evaluating its clinical effectiveness. Trial registration in https://www.ClinicalTrials.gov on 06-04-2026, NCT07517120.

Conventional human movement science often considers body parts and processes separately as belonging to complementary but distinct domains (motor control, cognition). We break with this tradition by exploring how mechanical and cognitive demands jointly shape whole-body functional coordination in healthy young adults. Forty-eight participants performed postural control tasks under four conditions: stable surface without cognitive load, stable surface with the Trail Making Test (TMT) Part A, wobble board without TMT and wobble board with TMT. Whole-body coordination networks were derived from motion capture data of 21 retroreflective markers after controlling for the movement of the body’s centre of mass. Wobble board-induced mechanical instability shifted the whole-body coordination network from a modular structure to a more integrated and densely connected organization, as indicated by increased local transitivity, local efficiency, degree centrality, global efficiency, global transitivity and small-worldness. This transformation suggests enhanced local cohesion and global connectivity but coincided with reductions in modularity, characteristic path length and participation coefficient, reflecting a loss of distinct community structures and functional specialization. This shift may prioritize rapid global communication over modular control. However, performing TMT with a laser pointer moderated these changes, pulling within-body network relationships towards a less integrated and more specialized state and preserving functional segregation and adaptability. This research transforms our understanding of whole-body coordination by showing how both mechanical and cognitive task constraints alike reshape the structure of whole-body coordination networks, paving the way for breakthroughs in rehabilitation. Long reserved for studying brain function, network analytical methods applied to body movements are poised to bridge the brain–body divide, revealing how locally and globally porous the movement system is to mechanical and cognitive demands.

Despite several age-related processes impacting motor performance, older adults often retain the ability to implicitly adapt to sensory prediction errors. Here, we leverage the fact that implicit adaptation is not attenuated by aging to study the impact of aging on responses to motor errors. In other domains, such as reinforcement learning, aging has been shown to influence how task outcomes or rewards are processed and used to guide subsequent actions, with some studies emphasizing that older adults react more strongly to a miss than to a hit. We aimed to extend these reinforcement learning findings to the motor domain with two preregistered experiments testing whether missing the target leads to larger implicit adaptation in young and older adults to the same extent. In addition, we compared these results to one reinforcement learning task in the motor domain (Boolean feedback after reaching in the absence of visual feedback) and one in the cognitive domain (reward-based decision making). While we found age-related effects in the cognitive domain, we did not observe a consistent effect of age on the modulation of reaching direction or motor adaptation by task outcomes. These results suggest a domain-specific nature of age-related changes in sensitivity to task outcomes.

BACKGROUND: Coherent and ordered movement patterns emerge from the many available degrees-of-freedom and constraints channeling the interactions between them and the environment. AIM: We propose that task constraints have a different ontological status compared to the constraint categories of the environment and organism. METHODS: We argue that environmental and organismic constraints can be characterized as hard constraints as they are alternative descriptions of the dynamics (i.e., they describe the boundaries and characteristics of the system). Task constraints can, instead, be categorized as soft constraints–functions that influence the behavior toward task relevant solutions. Individuals search through the task space (function relating performance and movement parameters) encompassing rules and goal description but, only through learning, do the task constraints become actualized. Thus, in this manuscript, we discuss the ontology of task constraints elaborating how they should be discussed in the literature. CONCLUSION: This modified interpretation leads to an expansion of the concept into two frames (learner-based, experimenter-based) that has a series of consequences to future research on motor behavior.

The substantial variability in gross motor coordination (GMC) across populations underscores the need to establish context-specific reference values. This study aimed to (a) establish normative reference values for GMC performance in Brazilian children; (b) model the developmental dynamics by estimating pseudovelocity curves for each GMC test; and (c) conduct a comparative analysis of GMC performance of Brazilian children against established data from other international populations. A cohort of 2,212 children (1,133 boys), aged 5–10 years, was assessed using the Körperkoordinationstest für Kinder battery. Normative and pseudovelocity curves were generated using the Generalized Additive Models for Location, Scale, and Shape approach. International comparisons were conducted using published Körperkoordinationstest für Kinder data against normative findings. Körperkoordinationstest für Kinder data showed a consistent age-related improvement in GMC across both sexes, with boys generally performing better. Pseudovelocity curves indicated a progressive attenuation in the rate of coordination gain with increasing chronological age. Furthermore, the pseudovelocity curves indicated that the developmental peak in GMC gain generally occurred earlier in girls than in boys. An international comparative analysis showed lower GMC performance among Brazilian children, especially girls, across multiple subtests compared with international cohorts. This study offers a comprehensive set of normative and pseudovelocity data for GMC in Brazilian children, underscoring population-specific variations. These findings emphasize the need for context-specific reference data to identify developmental trajectories and motor delays accurately and to inform tailored interventions.

In low-income contexts, limited validity evidence hinders the selection of valid and reliable measures for assessing motor competence. This study evaluated the factorial structure and construct validity of the Motor Competence Assessment (MCA) in low-income Brazilian children and compared it with the Körperkoordinationstest für Kinder (KTK) and the supine-to-stand (STS) task. A cross-sectional study was conducted with 287 children (148 girls, 6.0–11.99 years) from three schools in a socioeconomically vulnerable municipality in northeast Brazil. Participants completed MCA and KTK tests and the STS task under standardized procedures. Confirmatory factor analysis tested one-, two-, and three-factor MCA models. Partial correlations, adjusted for age and sex, determined the concurrent validity among the measures. The two-factor model (combining stability and locomotor into one factor and manipulative into another) showed the most acceptable fit for the MCA. MCA subtests correlated strongly with KTK ( r = .59–.80), whereas correlations with STS were low to moderate ( r = −.23 to − .56), indicating partly distinct constructs. Overall, the MCA demonstrated valid measurement with a robust two-factor structure, capturing complementary facets of motor competence alongside the KTK and STS. These findings endorse its application in low-resource schools for screening and monitoring motor development, providing a practical tool for researchers and practitioners working with vulnerable populations.

The question of how to organize the practice for learning skills of a given sport is still unresolved. Despite the common belief that random practice is more beneficial for retention/transfer tests in motor learning than blocked practice, recent reviews demonstrate limitations in generalizing this effect for the sport context. Therefore, we investigated the effect of random and blocked practice schedules on learning the football kick. Seventy subjects aged 6–11 years were tested in five different kicking conditions varying whether the kick was (1) for maximum velocity of the ball, or whether the kick was for precision depending on the initial position of the ball; (2) stationary ball; (3) under kicker’s control; (4) with the ball at a constant speed; and (5) with the ball at varied speeds—as in a pass. For the practice phase, participants performed the four precision conditions under either block or random practice schedules. After seven practice sections, both groups improved similarly from pre- to posttests (120 hr after practice) in performance and overall movement pattern considering retention (Conditions 2–5) and transfer (Condition 1). Blocked and random practice conditions did not lead to distinct outcomes in learning the football kick.

The benefits of allowing learners to control when to receive knowledge of results (KR) compared to a yoked group has been recently challenged and postulated to be mild at best. A potential explanation for such dissident findings is that individuals differentially utilize the autonomy provided by the self-controlled condition, which, in its turn, affects the outcomes. Therefore, the present study investigated the effects of self-controlled KR on motor learning focusing on the frequency of KR requests when performing an anticipatory timing task. Self-controlled groups were created based on participants' KR frequency of request (High, Medium, and Low referring to fifth, third, and first quintile) and, then, Yoked groups were created self-control condition pairing the KR request of the Self-controlled groups. We also measured self-efficacy and processing time as means to verify potential correlates. The results supported the expected interaction. While no difference between self-controlled and yoked groups were found for low frequencies of KR, a moderate amount of KR request was related to better results for the self-controlled group. Nonetheless, the opposite trend was observed for high frequencies of KR; the yoked group was superior to the self-controlled group. The results of this study allow us to conclude that the choices made, and not just the possibility of choosing, seem to define the benefits of KR self-control in motor learning.