Visual Feedback for Sensory and Motor Learning

Overseen By Hannah J Block, PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Indiana University

Disqualifiers: Seizure, Stroke, ADHD, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

300 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines how people perceive their hand's position when viewing slightly altered visual displays. Participants will point with one hand to where they believe their other hand is, even if the display suggests a different position. Different groups will receive varying levels of information and feedback; some will see their hand, while others will receive diagrams or no feedback. The trial is suitable for right-handed individuals aged 18-45 who have been free of recent COVID symptoms and have no history of serious neurological or orthopedic conditions. As an unphased study, this trial provides a unique opportunity to contribute to scientific understanding without the risks of drug testing.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this method is safe for sensory and motor learning?

Research shows that the visual feedback techniques used in this trial are generally safe. Studies have found that these methods improve learning and control of movements without causing harm. For example, using visual feedback to guide hand movements has succeeded in various situations, and participants have tolerated it well.

When participants received feedback about their hand positions, they reported no significant negative effects, suggesting the approach is well-tolerated. Different types of feedback, whether for the hand being targeted or the hand doing the pointing, have been studied, and no major safety concerns have emerged.

Overall, the treatments being tested, including direct vision and explanatory diagrams, have been used safely in past studies. While this doesn't guarantee they will be risk-free for everyone, the evidence so far suggests they are generally safe. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores innovative ways to enhance sensory and motor learning through visual feedback. Unlike traditional methods, which might rely on repetitive practice alone, this trial investigates how direct visual perception and detailed explanations can impact learning. The use of movement feedback for specific hands—either the pointing or target hand—offers a novel approach to understanding how feedback can improve motor skills. By examining these unique techniques, the trial aims to deepen our understanding of how visual and proprioceptive information can be optimized for better learning outcomes.

What evidence suggests that this trial's treatments could be effective for sensory and motor learning?

This trial will compare different methods of visual feedback for sensory and motor learning. Research has shown that seeing one's own hand can improve movement learning. In this trial, participants in the "Conscious awareness: Direct vision of hand" arm will have continuous direct vision of their hand, which studies suggest leads to more accurate movements. Meanwhile, those in the "Conscious awareness: Explanatory diagram" arm will receive simple diagrams explaining how seeing and moving work together, potentially enhancing their understanding and control of movements.

Additionally, the trial will assess the impact of movement feedback. Participants in the "Movement feedback: Target hand" arm will receive feedback about the target hand, while those in the "Movement feedback: Pointing hand" arm will focus on feedback about the hand used to point. Studies indicate that such feedback can improve hand control and coordination. ^{1 2 6 7 8}

Who Is on the Research Team?

Hannah J Block

Principal Investigator

Indiana University, Bloomington

Are You a Good Fit for This Trial?

This trial is for right-handed individuals aged 18-45 who are fully vaccinated against COVID-19 or have a recent negative test. They must not have any history of severe neurological issues, learning conditions like ADHD, orthopedic problems, impaired vision, seizures, or serious arm injuries.

Inclusion Criteria

Right-handed

I haven't had any Covid symptoms in the last week.

Exclusion Criteria

Learning or attention conditions such as ADHD

Lack of normal or corrected-to-normal vision

I have had serious injuries or conditions affecting my bones, joints, or muscles in my arms.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Experiment A

Participants are exposed to different levels of conscious awareness of visuo-proprioceptive mismatch

1 day

1 visit (in-person)

Experiment B

Participants receive movement error feedback in different ways or not at all

1 day

1 visit (in-person)

Follow-up

Participants are monitored for any delayed effects or learning retention

1-2 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Attend to the targets
• Direct vision
• Explanatory diagram
• Movement feedback, pointing hand
• Movement feedback, target hand
• No movement feedback

Trial Overview The study explores how people perceive their hand position when given different visual cues. Participants will try to point out where they think their hand is under various scenarios including altered feedback and direct vision.

How Is the Trial Designed?

Group I: Movement feedback: Target hand Experimental Treatment 1 Intervention

Movement feedback about the target hand.

Group II: Movement feedback: Pointing hand Experimental Treatment 1 Intervention

Movement feedback about the pointing hand.

Group III: Conscious awareness: Explanatory diagram Experimental Treatment 1 Intervention

Told in advance about the visuo-proprioceptive mismatch, which will be explained with a diagram. Hand remains hidden.

Group IV: Conscious awareness: Direct vision of hand Experimental Treatment 1 Intervention

Foamboard under mirror removed, making the mirror see-through and the hand directly visible.

Group V: Conscious awareness: No information Placebo Group 1 Intervention

Told nothing about the visuo-proprioceptive mismatch. Hand remains hidden beneath mirror that shows visual display. (control)

Group VI: Movement feedback: No feedback Placebo Group 1 Intervention

No movement feedback (control)

Who Is Running the Clinical Trial?

Indiana University

Lead Sponsor

Trials

1,063

Recruited

1,182,000+

National Institute of Neurological Disorders and Stroke (NINDS)

Collaborator

Trials

1,403

Recruited

655,000+

Published Research Related to This Trial

In a study examining visuomotor adaptation with participants using prism-displaced vision, it was found that adaptation primarily relies on 'terminal feedback errors'—the discrepancies between the hand and target positions observed at the end of a movement.

The results indicated that simply relying on 'movement prediction errors' (the difference between expected and actual hand movements) was not enough to induce adaptation, highlighting the importance of feedback from visual cues in adjusting motor actions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Visuomotor adaptation needs a validation of prediction error by feedback error. Gaveau, V., Prablanc, C., Laurent, D., et al.[2020]

Delaying visual feedback of a subject's hand by 66 milliseconds during movement led to overshooting, similar to the effects of spatially distorted feedback, but the underlying mechanisms for each type of feedback are different.

The study suggests that the brain processes visual information for hand control more quickly than previously thought, indicating that adaptation to visual feedback involves distinct control mechanisms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effects of delayed and displaced visual feedback on motor control. Smith, WM., Bowen, KF.[2019]

In a study of 90 glaucoma patients, combining video and verbal instructions for visual field testing resulted in the fewest repeat tests, indicating improved reliability in test performance.

Patients receiving only verbal instructions had less reliable results, suggesting that using multimedia approaches can enhance understanding and execution of visual field tests.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of Different Visual Field Instruction Strategies on Reliability Indices. Rao, A., Sarangi, SP., Padhy, D., et al.[2018]

When subjects could see their hand before starting to point at a target, their accuracy improved significantly compared to when they had no visual feedback of their hand at all during the movement.

The study suggests that initial visual cues about hand and target positions enhance motor control by allowing the brain to better define the target position, leading to quicker adjustments in the hand movement program.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Optimal response of eye and hand motor systems in pointing at a visual target. II. Static and dynamic visual cues in the control of hand movement. Prablanc, C., Echallier, JE., Jeannerod, M., et al.[2019]

In a study involving 17 patients with central vision loss due to macular disease, MP-3 microperimeter biofeedback fixation training significantly improved best corrected visual acuity, reading speed, and mean central sensitivity after 20 weeks of rehabilitation.

The training also enhanced fixation stability, as indicated by increased percentages of fixation points within specified regions and improved scores on the National Eye Institute visual function questionnaire, suggesting a positive impact on the patients' quality of life.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of MP-3 microperimeter biofeedback fixation training for low vision rehabilitation in patients with maculopathy. Qian, T., Xu, X., Liu, X., et al.[2022]

A study involving 12 adult amblyopes showed that auditory feedback on eye position significantly improved their ability to maintain steady and foveal fixation with their amblyopic eye.

Some participants were able to sustain improved fixation even after the auditory feedback was removed, suggesting that they could use visual cues to continue the benefits, indicating potential for this technique in both research and clinical treatment of amblyopia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Control of unsteady, eccentric fixation in amblyopic eyes by auditory feedback of eye position. Flom, MC., Kirschen, DG., Bedell, HE.[2007]

The study involved 64 participants who were divided into four feedback groups to assess how visual feedback affects motor learning based on skill level.

Results showed that low-skilled participants benefited from concurrent visual feedback, leading to improved performance in a retention test, while high-skilled participants did not show the same level of improvement.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Differences in skill level influence the effects of visual feedback on motor learning. Yamamoto, R., Akizuki, K., Kanai, Y., et al.[2020]

Systematic visual training, particularly scanning compensatory therapy (SCT), has shown significant improvements in visual search field size and reading performance, with studies reporting up to a 30-degree increase in visual search field and enhanced reading speed.

While some studies indicated potential benefits from vision restoration therapy (VRT), the overall effectiveness remains unclear, and SCT is recommended as a more effective and user-friendly rehabilitation approach until further evidence on VRT is established.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of visual training for patients with visual field defects due to brain damage: a systematic review. Bouwmeester, L., Heutink, J., Lucas, C.[2022]

Visual feedback significantly improves the accuracy of rapid arm movements, as evidenced by larger directional errors in the no-vision condition compared to conditions with visual feedback.

The study found no significant differences in performance among different visual feedback presentation types (random, precued, blocked), indicating that the immediate processing of visual information is crucial for controlling arm movements.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

On-line versus off-line control of rapid aiming movements. Blouin, J., Bard, C., Teasdale, N., et al.[2004]

In a study with 15 participants practicing aiming movements under different visual conditions, it was found that practice did not reduce reliance on visual information; instead, participants adapted their movements based on the visual cues available in each condition.

When participants were given augmented visual feedback, they quickly adjusted their aiming trajectories, indicating that learning involves developing efficient ways to process visual information and feedback during movement.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The control of sequential goal-directed movement: learning to use feedback or central planning? Elliott, D., Ricker, KL., Lyons, J.[2019]

Training individuals with central visual field loss to use a pseudo-preferred retinal locus (pPRL) significantly improves their gaze stability and accuracy, with these improvements being retained over a week and transferable to a new location.

The study suggests that low vision rehabilitation can effectively utilize pPRL training to enhance oculomotor control, indicating that early intervention may help patients adapt better as their vision deteriorates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Peripheral oculomotor training in individuals with healthy visual systems: Effects of training and training transfer. Rose, D., Bex, P.[2020]

Participants were able to effectively process visual feedback within 165 ms during short-duration hand movements, allowing them to adjust their movements based on the motion of a moving target.

Removing visual feedback 50 ms after the start of the movement did not negatively impact performance, suggesting that initial visual information is sufficient for accurate movement control.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The visual control of aimed hand movements to stationary and moving targets. Young, RP., Zelaznik, HN.[2019]

Citations

1. withpower.com withpower.com/trial/phase-basic-science-3-2022-ea61b

Visual Feedback for Sensory and Motor Learning What data supports the effectiveness of the treatment 'Attend to the targets, Direct vision, Line of sight, Field of vision, Visual field, Explanatory diagram, ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8405669/

Influence of visual feedback persistence on visuo-motor ... We found that persistent feedback leads to a significantly greater improvement in accuracy than non-persistent feedback.

3. sciencedirect.com sciencedirect.com/science/article/pii/S2666557325000552

Direct vs. video observation of skill performance: effects on ... Video technology facilitates feedback delivery in motor learning, benefiting teacher/coach and peer feedback. Most studies focus on ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3737924/

Field of Vision Influences Sensory-Motor Control of Skilled ... The aims of this study were a) replicating inter- and intra-group variability and b) investigating the extent to which quiet eye supports information pick-up of ...

5. researchgate.net researchgate.net/publication/290364054_A_meta-analysis_of_visual_feedback_for_motor_learning

(PDF) A meta-analysis of visual feedback for motor learning In this investigation, a meta-analysis was conducted to determine the influence of visual feedback on motor learning.

6. sciencedirect.com sciencedirect.com/science/article/pii/S089142222500040X

From motion to interaction: How multisensory information ... This study investigated whether the use of multisensory stimuli could influence the motor exploration of children with VI and shape their interaction with the ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3573212/

Associations between Visual, Hearing, and Dual Sensory ... Older drivers with dual sensory impairment are at greater MVC risk than those with only a visual acuity or a hearing deficit alone.

8. researchgate.net researchgate.net/publication/303041648_The_Effects_of_Sports_Vision_Training_on_Sensorimotor_Abilities_in_Collegiate_Softball_Athletes

(PDF) The Effects of Sports Vision Training on ... ... visual field. Motor function improved in all categories. The eye movement training improved eye movements, and strabismus and diplopia were ...