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

Trial Summary

What is the purpose of this trial?

How participants perceive the position of their own hand in various contexts will be examined. This will include changing the visual display to suggest the hand is in a slightly different position, and asking participants to indicate where they think it is by pointing with their other hand.

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 data supports the effectiveness of the treatment 'Attend to the targets, Direct vision, Line of sight, Field of vision, Visual field, Explanatory diagram, Movement feedback, pointing hand, Motor learning feedback, Sensory feedback technique, Movement feedback, target hand, No movement feedback'?

Research shows that training with visual feedback can improve eye movement control and visual field performance, as seen in studies where individuals with visual impairments or simulated vision loss showed significant improvements in gaze stability and accuracy. Additionally, visual training has been effective in enhancing visual search strategies and reading speed in patients with visual field defects. ^{1 2 3 4 5}

Is visual feedback for sensory and motor learning safe for humans?

The research suggests that visual feedback techniques, such as those used in motor learning and adaptation studies, are generally safe for humans. These studies focus on how visual feedback affects movement accuracy and adaptation, without reporting any adverse safety concerns. ^{6 7 8 9 10}

How does the treatment 'Visual Feedback for Sensory and Motor Learning' differ from other treatments for motor learning?

This treatment is unique because it uses visual feedback to enhance motor learning by allowing individuals to see their movements and adjust in real-time, which can improve accuracy and adaptation compared to treatments that do not provide such immediate visual cues. ^{6 7 8 11 12}

Research Team

Hannah J Block

Principal Investigator

Indiana University, Bloomington

Eligibility Criteria

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 am between 18 and 45 years old.

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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]

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 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]

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]

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]

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]

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]

References

1. England pubmed.ncbi.nlm.nih.gov

Peripheral oculomotor training in individuals with healthy visual systems: Effects of training and training transfer. [2020]

2. England pubmed.ncbi.nlm.nih.gov

The effect of visual training for patients with visual field defects due to brain damage: a systematic review. [2022]

3. England pubmed.ncbi.nlm.nih.gov

Efficacy of MP-3 microperimeter biofeedback fixation training for low vision rehabilitation in patients with maculopathy. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Control of unsteady, eccentric fixation in amblyopic eyes by auditory feedback of eye position. [2007]

5. England pubmed.ncbi.nlm.nih.gov

Impact of Different Visual Field Instruction Strategies on Reliability Indices. [2018]

6. Germany 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. [2019]

7. Switzerland pubmed.ncbi.nlm.nih.gov

Visuomotor adaptation needs a validation of prediction error by feedback error. [2020]

8. United States pubmed.ncbi.nlm.nih.gov

The effects of delayed and displaced visual feedback on motor control. [2019]

9. United States pubmed.ncbi.nlm.nih.gov

On-line versus off-line control of rapid aiming movements. [2004]

10. Netherlands pubmed.ncbi.nlm.nih.gov

The visual control of aimed hand movements to stationary and moving targets. [2019]

11. United States pubmed.ncbi.nlm.nih.gov

The control of sequential goal-directed movement: learning to use feedback or central planning? [2019]

12. Japan pubmed.ncbi.nlm.nih.gov

Differences in skill level influence the effects of visual feedback on motor learning. [2020]