OBJECTIVE: The purpose of this study was to investigate whether practicing a complex self-care occupation in a contextually relevant environment would enhance the learning and transfer of skill. METHOD: The design consisted of an acquisition phase, a rest period, and a transfer phase. Fifty-six women were recruited for this study and randomly assigned to one of three groups:(a) a contextually relevant (CR) group that practiced tying a necktie knot onto a mannequin,(b) a non-contextually relevant (NCR) group that practiced tying the same type of knot with a rope onto a wooden pole, and (c) a control group that did not practice at all during the acquisition phase. Participants in all three groups tied a necktie onto themselves during the transfer phase. Dependent variables were movement time, movement units, and the quality of the necktie knot. RESULTS: No difference in the rate of performance change was found during the acquisition phase between the CR and NCR groups. The difference among the CR, NCR, and control groups' initial transfer phase performance was near significance for movement time and movement units. A significant difference in the rate of performance change was found among the three groups in movement time and movement units during the transfer phase but not in the quality of necktie knot measures. CONCLUSION: The degree of similarity during the acquisition of a dressing skill may influence the rate of performance improvement in a similar dressing skill during a transfer phase. Until further research has been established, generalization of these results to special populations should be done conservatively.

We have previously identified two auxin-binding polypeptides in plasma membrane (PM) preparations from zucchini (Cucurbita pepo L.)(Hicks et al. 1989, Proc. Natl. Acad. Sci. USA 86, 4948-4952). These polypeptides have molecular weights of 40 kDa and 42 kDa and label specifically with the photoaffinity auxin analog 5-N3-7-3H-IAA (azido-IAA). Azido-IAA permits both the covalent and radioactive tagging of auxin-binding proteins and has allowed us to characterize further the 40-kDa and 42-kDa polypeptides, including the nature of their attachment to the PM, their relationship to each other, and their potential function. The azido-IAA-labeled polypeptides remain in the pelleted membrane fraction following high-salt and detergent washes, which indicates a tight and possibly integral association with the PM. Two-dimensional electrophoresis of partially purified azido-IAA-labeled protein demonstrates that, in addition to the major isoforms of the 40-kDa and 42-kDa polypeptides, which possess isoelectric points (pIs) of 8.2 and 7.2, respectively, several less abundant isoforms that display unique pIs are apparent at both molecular masses. Tryptic and chymotryptic digestion of the auxin-binding proteins indicates that the 40-kDa and 42-kDa polypeptides are closely related or are modifications of the same polypeptide. Phase extraction with the nonionic detergent Triton X-114 results in partitioning of the azido-IAA-labeled polypeptides into the aqueous (hydrophilic) phase. This apparently paradoxical behavior is also exhibited by certain integral membrane proteins that aggregate to form channels. The results of gel filtration indicate that the auxin-binding proteins do indeed aggregate strongly and that the polypeptides associate to form a dimer or multimeric complex in vivo. These characteristics are consistent with the hypothesis that the 40-kDa and 42-kDa polypeptides are subunits of a multimeric integral membrane protein which has an auxin-binding site, and which may possess transporter or channel function.

The level of minimal residual disease (MRD) early in treatment of acute lymphoblastic leukemia (ALL) strongly predicts the risk of marrow relapse. As a variety of methods of varying complexity have been separately used for detecting and quantifying MRD, we compared the prognostic utility of three methods measurement of blast percentage on day 14 of treatment, detection of monoclonality on day 14 or day 35, and measurement of MRD by PCR-based limiting dilution analysis on day 14 or day 35. The study group comprised 38 children aged 1-15 with Philadelphia-negative B-lineage ALL who were uniformly treated and followed until relapse or for a minimum of 5 years. We also studied some of the technical factors which influence the ability to detect MRD. Measurement of blast percentage on day 14 by an expert morphologist, detection of monoclonality on day 35, and PCR-based measurement of MRD levels on days 14 and 35 all showed significant ability to divide patients into prognostic groups. Measurement of blast percentage on day 14 by routine morphology or detection of monoclonality on day 14 were not useful. The quality of DNA samples varied greatly, as determined by amplifiability in the PCR. However, virtually all amplifiable leukemic targets in a sample were detectable which suggests that the level of detection achieved by limiting dilution analysis is essentially determined by the amount of DNA which it is practicable to study. We conclude that quantification of MRD at the end of induction provides the full range of prognostic information for marrow relapse but is complex; detection of monoclonality on day 35 is simple and has good positive predictive value; and quantification of MRD on day 14 merits further study. PCR-based methods for measurement of MRD levels should incorporate a correction for variation in DNA amplifiability.

Many patients with acute lymphoblastic leukemia (ALL) are not cured by current therapy because of the development of drug resistance. It is not clear when resistance develops during the growth of the leukemic clone and whether resistant cells are already present at diagnosis or develop later during treatment. Twenty-two uniformly treated children with ALL were studied throughout induction treatment. The size of the leukemic clone in blood and marrow was estimated by limiting dilution PCR analysis, using the rearranged immunoglobulin heavy chain gene as a molecular marker. The decline in the number of leukemic cells was biphasic in virtually all patients. For both marrow and blood, the logarithmic mean of the number of leukemic cells fell by approximately four orders of magnitude during the first 2 weeks, one order of magnitude during the third week, and not at all during the last two weeks of induction treatment. For marrow, the median of the fraction of leukemic cells in each patient that survived per week of treatment was 0.008 for the first 2 weeks, 0.12 for the third week, and 1.4 for the last 2 weeks; for blood, the corresponding figures were 0.003, 0.14, and 0.69, respectively. In individual patients, the results for marrow and blood showed good correlation. The biphasic decline of leukemic cell number suggests that most leukemic cells were sensitive to treatment and were rapidly killed, leaving behind a minor but substantial population of drug-resistant cells. The most likely explanation for this phenomenon is that these resistant cells were already present at diagnosis, their resistance having originated from genetic or epigenetic mutations during prior growth of the leukemic clone.

Cross-education of strength is much greater when the dominant arm is trained in right-handed individuals. This asymmetry of strength transfer in the upper limbs is similar to what has been shown for skill transfer between limbs. The discussion focuses on the connection between transfer of strength and skills and the potential for cross-education to be used during recovery from unilateral injury.

An experiment was designed to determine if the addition of a load altered the effector transfer profile observed in earlier experiments using multi-element movement sequences. The acquisition task required participants to move a horizontal lever (with 0.567kg load) to 16 sequentially projected targets. One group practiced the movement sequence with their right (dominant) limb and another group practiced with their left (non-dominant) limb. Approximately 24h after completion of the acquisition session both groups were administered test blocks (0kg, 0.567kg, and 1.134kg) using their practiced and unpracticed limbs. Decreased and increased loads had minimal effect on test performance. The results indicated that the group trained with their left limb were able to perform the right limb tests as well as the group that trained with the right limb. However, the group that trained with their right limb were significantly slower performing the tests with the left limb than the group that practiced with their left limb. Importantly, the left acquisition limb group maintained the pattern of element durations used during practice on the various tests including transfer to the dominant limb. However, the pattern of element durations for the right acquisition limb group on the left limb transfer tests was altered such that the production of only the fastest produced elements were disrupted. These results suggest that one of the reasons for poor sequence performance when transferring from the right to left is because the sequence structure developed during acquisition and used on the tests lacked access to the appropriate commands or the controller lacked the ability to implement codes that effectively manage the movement dynamics.

Although executive functions can be improved by training, little is known about the extent to which these training-related benefits can be transferred to other tasks, or whether this transfer can be modulated by the type of training. This study investigated lifespan changes in near transfer of task-switching training to structurally similar tasks and its modulation by verbal self-instructions and variable training, as well as far transfer to structurally dissimilar 'executive' tasks and fluid intelligence. Three age groups (8-10; 18-26; 62-76 years of age) were examined in a pretest-training-posttest design. We found near transfer of task-switching training in all age groups, especially in children and older adults. Near transfer was enhanced in adults and impaired in children when training tasks were variable. We also found substantial far transfer to other executive tasks and fluid intelligence in all age groups, pointing to the transfer of relatively general executive control abilities after training.

Part I of this study examined the effect of two 9-week instructional climates (low autonomy [LA] and mastery motivational climate [MMC]) on object-control (OC) skill development in preschoolers (N = 117). Participants were randomly assigned to an LA, MMC, or comparison group. OC skills were assessed at pretest, posttest, and retention test with the Test of Gross Motor Development-2nd Edition. A significant Treatment x Time interaction (p <.001) was present, supporting the effectiveness of both OC instructional climates in improving OC skills over time, while the comparison group resulted in no changes. The authors conclude that developmentally and instructionally appropriate climates are beneficial to OC skill learning, along with the need for "planned" movement experiences in motor learning environments.

The study examined whether attentional demands of a concurrent cognitive task during balance training affect the acquisition, retention and transfer of a postural control skill. Single-leg balance was evaluated in 64 volunteers (mean age 24.0years, SD 3.10years) while performing either a cognitive task requiring little attention (forward counting) or a highly demanding cognitive task (arithmetic manipulation) following three days of training. Skill retention was evaluated two days following the cessation of training, and transfer was determined by changes in the untrained extremity. Three training sessions induced decreases in mean sway velocity and amplitude variability. Skill retention was enhanced in the group trained under conditions with greater attentional demands, suggesting that diverting attention away from the postural task and allowing learning to involve more automatic processes may enhance the learning of such tasks. Practice induced similar changes in the trained and untrained extremities following both training protocols.

Recent studies on intermanual transfer of reaching movements suggest that this transfer is conducted over an "extrinsic" coordinate system. We hypothesize that training reaching movements in a force field with both hands at the same time, in the same position (bimanual grip) will be more beneficial in promoting transfer of the learned skill to the dominant hand than training the unimpaired limb on the same movements in the same force field since the representation of the movement should be invariant of the limb. However, unlike intermanual transfer, bimanual transfer has the potential to involve infinite number of actuator combinations, or joint configurations, interfering with consistent transfer. The efficacy of this method of transfer has implications for people with hemiparesis since the less-affected arm could potentially "instruct" the more-affected arm how to move. Here, we report on an experiment that evaluates and compares the skill transfer between limbs in a reaching task: 1) intermanual transfer (from the nondominant to the dominant hand) and 2) bimanual transfer (from a bimanual grip to the dominant hand) with healthy subjects. We used two methods from which to judge the transfer: performance in the presence of the force field or by errors made during "catch trials" when the forces were unexpectedly removed as subjects changed hands (known as after effects of adaptation). We found only a small amount of transfer (20% of that seen in the practiced limb) with both types of training, and surprisingly there was no significant difference in the movement accuracy between these two training methods. Moreover, the direction of the after effects supports the assertion that the nervous system generalizes these movements in an extrinsic coordinate system. Accordingly, the limb must experience the dynamics singularly in order to develop an internal model.

Practice of complex tasks can be scheduled in several ways: as whole-task practice or as practice of the individual skills composing the task in either a blocked or a random order. The authors used those 3 schedules to study 18 participants' learning of an orthopedic surgical task. They assessed learning by obtaining expert evaluation of performance and objective kinematic measures before, immediately after, and 1 week after practice (transfer test). During acquisition, the blocked group showed superior performance for simple skills but not for more complex skills. For the expert-based measures of performance, all groups improved from pretest to posttest and remained constant from posttest to transfer. Measures of the final product showed that the whole-practice group's outcomes were significantly better than those of the random group on transfer. All groups showed better efficiency of motions in the posttest than in the pretest. Those measures were also poorer on the transfer test than on the posttest. The present evidence does not support the contextual interference effect-hypothetically, because of the inherent cognitive effort effect associated with some of the component skills. The authors recommend that surgical tasks composed of several discrete skills be practiced as a whole. The results of this study demonstrate the importance of critically appraising basic theories in applied environments.

Resistance training can be defined as the act of repeated voluntary muscle contractions against a resistance greater than those normally encountered in activities of daily living. Training of this kind is known to increase strength via adaptations in both the muscular and nervous systems. While the physiology of muscular adaptations following resistance training is well understood, the nature of neural adaptations is less clear. One piece of indirect evidence to indicate that neural adaptations accompany resistance training comes from the phenomenon of 'cross education', which describes the strength gain in the opposite, untrained limb following unilateral resistance training. Since its discovery in 1894, subsequent studies have confirmed the existence of cross education in contexts involving voluntary, imagined and electrically stimulated contractions. The cross-education effect is specific to the contralateral homologous muscle but not restricted to particular muscle groups, ages or genders. A recent meta-analysis determined that the magnitude of cross education is approximate, equals7.8% of the initial strength of the untrained limb. While many features of cross education have been established, the underlying mechanisms are unknown.This article provides an overview of cross education and presents plausible hypotheses for its mechanisms. Two hypotheses are outlined that represent the most viable explanations for cross education. These hypotheses are distinct but not necessarily mutually exclusive. They are derived from evidence that high-force, unilateral, voluntary contractions can have an acute and potent effect on the efficacy of neural elements controlling the opposite limb. It is possible that with training, long-lasting adaptations may be induced in neural circuits mediating these crossed effects. The first hypothesis suggests that unilateral resistance training may activate neural circuits that chronically modify the efficacy of motor pathways that project to the opposite untrained limb. This may subsequently lead to an increased capacity to drive the untrained muscles and thus result in increased strength. A number of spinal and cortical circuits that exhibit the potential for this type of adaptation are considered. The second hypothesis suggests that unilateral resistance training induces adaptations in motor areas that are primarily involved in the control of movements of the trained limb. The opposite untrained limb may access these modified neural circuits during maximal voluntary contractions in ways that are analogous to motor learning. A better understanding of the mechanisms underlying cross education may potentially contribute to more effective use of resistance training protocols that exploit these cross-limb effects to improve the recovery of patients with movement disorders that predominantly affect one side of the body.

OBJECTIVE: Developing useful movement with the affected extremity in persons with cerebrovascular accidents (CVAs) is a common occupational therapy goal. The purpose of this study was to examine the effects of perceived risk in an occupational form on upper-extremity movement dynamics in persons who have had CVAs. METHOD: Twenty-eight persons (M = 69.6 years, SD = 15.6 years) with post-CVA participated in the randomly assigned, repeated measures counterbalanced study. In the higher risk condition, participants reached for and grasped a raw egg in an egg carton, transported it, and placed it in a bowl with other raw eggs. The same procedure was completed in the lower risk condition with weight-matched plastic eggs. Participants completed both conditions with their affected and unaffected upper extremities. Dependent variables included total movement time and movement units. RESULTS: The higher risk condition produced statistically significantly longer movement times (p < or =.001), but no difference in movement units (p >.05) compared to the lower risk condition. The affected extremity had significantly longer overall movement times (p < or =.001), but no difference in movement units (p >.05) compared to the unaffected extremity. CONCLUSION: When higher levels of perceived risk are present in an occupational form, slower movements are elicited among persons who have had a CVA. The occupational therapist can grade tasks from relatively lower risk to tasks with relatively higher risk to help patients achieve desired variability in their movement patterns. By doing this, the patient will be better prepared for everyday situations that vary widely in degree of risk.

Results from our earlier brain imaging studies regarding motor learning have shown different areas activated during naive and practiced performance. When right handed participants moved a pen either with the dominant or non-dominant hand continuously through a cut-out maze as quickly and accurately as possible, practice resulted in decreased brain activity in right premotor and parietal areas as well as left cerebellum, while increased activity was found in the supplementary motor area (SMA). These lateralized practiced-related changes in brain activation suggest effector-independent abstract coding of information. To test this hypothesis more extensively, intermanual transfer of learning was examined in 24 male and female participants (12 right- and 12 left-handed) using the same maze-learning task. It was hypothesized that if an abstract representation of the movement is learned and stored, intermanual transfer effects should be more pronounced when participants transferred to a same maze as opposed to a mirror image of the maze. Errors and velocity were measured during the following conditions: initial naive performance (Naive); after practice on the maze (Prac); during intermanual transfer to the same maze (Transfer Identical); and to the mirror maze (Transfer Mirror). Transfer direction was tested from the dominant to non-dominant hand and vice versa. No significant differences were found between right- and left-handed participants, males and females, and transfer directions. However, intermanual transfer of learning was significantly greater to the identical maze as opposed to the mirror maze. These results showed that learning was indeed taking place at an abstract effector independent level.