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Fetal movement detection: comparison of the Toitu actograph with ultrasound from 20 weeks gestation.

OBJECTIVE: This study evaluates the validity of Doppler-detected fetal movement by a commercially available monitor and investigates whether characteristics of maternal body habitus and the intrauterine environment affect its performance. METHODS: Fetal movement was evaluated in normal pregnancies using both ultrasound visualization and a fetal actocardiograph (Toitu MT320; Tofa Medical Inc., Malvern, PA). Data were collected for 32 min on 34 fetuses stratified by gestational age (20-25 weeks; 28-32 weeks; 35-39 weeks). Fetal and maternal characteristics were recorded. Comparisons between ultrasound-detected trunk and limb movements and actograph records were conducted based both on 10-s time intervals and on detection of individual movements. RESULTS: Time-based comparisons indicated agreement between ultrasound and actograph 94.7% of the time; this association rose to 98% when movements of less than 1 s duration were excluded. Individual movements observed on ultrasound were detected by the actograph 91% of the time, and 97% of the time when brief, isolated movements were excluded. The overall kappa value for agreement was 0.88. The actograph was reliable in detecting periods of quiescence as well as activity. These findings did not vary by gestational age. The number of movements detected by the actograph, but not the single-transducer ultrasound, significantly increased over gestation. Maternal age, parity, weight, height, or body mass index were not consistently associated with actograph validity. Characteristics of the uterine environment, including placenta location, fetal presentation, and amniotic fluid volume also did not affect results. CONCLUSIONS: The Toitu actograph accurately detects fetal movement and quiescence from as early as 20 weeks gestation and has utility in both clinical and research settings. Actographs are most useful for providing objective and quantifiable measures of fetal activity level, including number and duration of movements, while visualization through ultrasound is necessary for studies of movement quality, source, or mechanics.

Analysis of Variance↗

Hyperkinetic movement disorders misdiagnosed as tics in Gilles de la Tourette syndrome.

OBJECTIVE: To describe the gamut of movements misdiagnosed as tic exacerbations in Gilles de la Tourette syndrome (GTS) in a referral tertiary-care center. BACKGROUND: Movements seen in GTS can be classified as: (a) tics; (b) movements related to conditions associated with GTS, specifically obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), and antisocial behaviors; and (c) movements secondary to treatment. METHODS: We reviewed a videotape database and patient records from a tertiary treatment center for GTS and collected GTS cases referred for disease exacerbation who had both tics and non-tic movements thought by the referring physician, the patient, and the family to be an exacerbation of tics. RESULTS: Of 373 GTS cases, 12 had movement disorders secondary to treatment, and six had non-tic movements related to conditions commonly associated with GTS. In the former group, there were 7 patients with acute akathisia, 3 with acute dystonia, 1 with tardive chorea, 1 with withdrawal emergent chorea, and 5 with tardive dystonia. Six had movement disorders related to non-tic conditions commonly associated with GTS: four patients had movements associated with OCD, one with ADHD and antisocial behavior, respectively. CONCLUSION: There is a broad spectrum of movements in GTS that are not tics but can be misdiagnosed as tics. Clinical awareness of these movements is paramount to proper diagnosis and pharmacologic intervention.

Adolescent↗

Influence of maternal carbohydrate intake on fetal movements at 14 to 16 weeks of gestation.

OBJECTIVE: Ultrasonographic assessment of fetal movements at 14 to 16 weeks of gestation before and after maternal oral intake of carbohydrate. DESIGN: Thirty consecutive healthy pregnant women between 14 and 16 weeks of gestation were scanned transvaginally. Real-time ultrasound recordings of 20 min duration were performed in the fasting state and after an oral intake of 110 g of glucose. The number of fetal movements, body and limb movements and breathing movements were evaluated. Fetal movements were quantified using a digital chronometer, and the percentage of time spent moving and the rate of movements per minute were then calculated. Data was statistically analyzed using the simple and Wilcoxon paired t-test. RESULTS: Absolute number of fetal movements, body movements, rotation movements, time spent moving and rate of movements per minute showed a statistically significant increase after maternal intake of carbohydrate (p < 0.0001). CONCLUSIONS: Maternal oral intake of 110 g of carbohydrate significantly increases fetal movements at 14 to 16 weeks of gestation, thus allowing better ultrasonographic viewing of the fetus.

Adult↗

Examination of movement in patients with long-lasting musculoskeletal pain: reliability and validity.

BACKGROUND AND PURPOSE: An examination method based on psychosomatic physiotherapy, with 24 standardized tests related to general aspects of mobility, flexibility and the ability to relax, is used in some pain and rehabilitation clinics in Scandinavia in order to document where--and to what degree--patients have aberrations within the domain 'movement'. The measurement properties of the movement tests have, however, not been investigated in patients with long-lasting musculoskeletal pain. The aims of the present study were, therefore, to investigate inter-tester reliability and validity (construct, discriminative and concurrent validity) related to movement. METHOD: The study design was cross-sectional. Reliability was examined by three physiotherapists examining 19 people. Construct validity was studied by means of structural equation modelling (SEM). Discriminative validity was examined by comparing movement data from 247 patients with long-lasting musculoskeletal pain, and 104 healthy subjects. The patient sample was categorized according to localized or widespread pain, and movement scores compared between the groups. Most patients filled in a psychological screening questionnaire (MMPI-2), plus information about pain intensity and function, and concurrent validity of the movement measures were examined by correlation. RESULTS: SEM results indicated a modified movement scale, consisting of 16 items in four subscales. Both the original and modified versions showed good reliability, and scores differed significantly between healthy subjects and patients, and between patients with localized versus widespread pain. A relationship was found between the movement tests and psychological characteristics, but mainly in patients with widespread pain. Significant relationships were found between the ability to relax and pain, and between all aspects of movement and function. CONCLUSIONS: Movement may be reliably and validly assessed with composite scores from 4 x 4 items. The method may be useful as a global screening instrument in order to examine where, and to what extent, patients with long-lasting pain problems have movement aberrations; findings to be addressed in treatment.

Adult↗

Comparative phenotypic resolution of spontaneous, D2-like and D1-like agonist-induced orofacial movement topographies in congenic mutants with dopamine D2 vs. D3 receptor "knockout".

Using a novel system, the role of D2-like dopamine receptors in distinct topographies of orofacial movement was assessed in mutant mice with congenic D2 vs. D3 receptor knockout, and compared with findings in D1A mutants. Under spontaneous conditions, D2 mutants evidenced increased vertical jaw movements and unaltered horizontal jaw movements, with reductions in tongue protrusions and incisor chattering; in D3 mutants, only incisor chattering was reduced. Given previous evidence that D1A mutants show reduced horizontal but not vertical jaw movements, this indicates that apparent oppositional D1-like:D2-like interactions in the regulation of composited jaw movements may in fact reflect the independent actions of D2 receptors to inhibit vertical jaw movements and of D1A receptors to facilitate horizontal jaw movements. Effects of the D2-like agonist RU 24213 to exert greater reduction in horizontal than in vertical jaw movements were not altered prominently in either D2 or D3 mutants. The D1-like agonists A 68930 and SK&F 83959 induced vertical jaw movements, tongue protrusions, and incisor chattering; induction of tongue protrusions by A 68930 was reduced in D2 mutants. D2 receptors exert topographically specific regulation of orofacial movements in a manner distinct from their D1A counterparts, while D3 receptors exert only minor regulation of such movements.

Animals↗

A dynamic theory of coordination of discrete movement.

The concepts of pattern dynamics and their adaptation through behavioral information, developed in the context of rhythmic movement coordination, are generalized to describe discrete movements of single components and the coordination of multiple components in discrete movement. In a first step we consider only one spatial component and study the temporal order inherent in discrete movement in terms of stable, reproducible space-time relationships. The coordination of discrete movement is captured in terms of relative timing. Using an exactly solvable nonlinear oscillator as a mathematical model, we show how the timing properties of discrete movement can be described by these pattern dynamics and discuss the relation of the pattern variables to observable end-effector movement. By coupling several such component dynamics in a fashion analogous to models of rhythmic movement coordination we capture the coordination of discrete movements of two components. We find the tendency to synchronize the component movements as the discrete analogon of in-phase locking and study its breakdown when the components become too different in their dynamic properties. The concept of temporal stability leads to the prediction that remote compensatory responses occur such as the restore synchronization when one component is perturbed. This prediction can be used to test the theory. We find that the discrete analogon to antiphase locking in rhythmic movement is a tendency to move sequentially, a finding that can also be subjected to empirical test.

Cybernetics↗

Stability properties of human reaching movements.

Through an experimental study of the stability properties of the human neuromuscular system while it performs simple point-to-point arm movements, this paper evaluates the concepts of equilibrium and virtual trajectories as a means of executing movement of the arm. Human subjects grasped the instrumented handle of a two-link robot manipulandum and performed specified point-to-point planar arm trajectories. Computer-controlled brakes were used to subtly change the movements by constraining the trajectory along an arc of radius equal to the length of one link of the manipulandum. Target points were arranged to lie along the arc so that the subject could complete the movement even when constrained. These situations were tested: (1) unconstrained throughout the movement, (2) constrained through the entire movement, and (3) initially constrained and then released during movement. Experimental results showed that the constraint evoked significant forces strongly oriented so as to restore the hand to the unconstrained hand path. In addition, when released from the constraint, these forces caused a strong tendency to return the hand to the unconstrained path before the end of the movement was reached. Such strong positional stability properties of the arm reinforce the notion that a moving attractor point dominates the dynamics of the arm during movement. Additionally, bounds on the shape of the virtual trajectory were found which indicate that the equilibrium point remains close to the actual movement produced. These results, showing that a controlled equilibrium point may be used for planning and coordinating multijoint movements, are consistent with an equilibrium point hypothesis.

Adult↗

Selective perturbation of visual input during prehension movements. 1. The effects of changing object position.

Prehension involves processing information in two hypothesized visuomotor channels: one for extrinsic object properties (e.g., the spatial location of objects) and one for intrinsic objects properties (e.g., shape and size). The present study asked how the two motor components that correspond to these channels (transport and grasp, respectively) are related. One way to address this question is to create a situation where unexpected changes occur at the input level of one of the visuomotor channels, and to observe how the movement reorganizes. If transport and grasp are independent components, then changing the object location, for example, should affect only the transport, not the grasp component. Subjects were requested to reach, grasp and lift as accurately as possible one of three dowels using the distal pads of the thumb and index finger. On certain trials, upon movement initiation towards the middle dowel, the dowel was made to instantaneously change its location to one of the two other positions, requiring the subject to reorient the hand to the new dowel location. Results consisted of comparing the movement characteristics of the transport and grasp components of these perturbed movements with appropriate control movements. Kinematics of the wrist trajectory showed fast adjustments, within 100 ms, to the change of dowel position. This duration seems to correspond to the minimum delay required within the visuomotor system for visual and/or proprioceptive reafferents to influence the ongoing movement. In addition, these delays are much shorter than has been found for conditions where object location changes before movement initiation (approximately 300 ms). The faster times may relate to the dynamic character of the deviant limb position signals, with the only constraint being the physiological delays for visual and kinaesthetic signals to influence the movement. A spatiotemporal variability analysis of the movement trajectories for non-perturbed trials showed variability to be greatest during the acceleration part of the movement, interpreted as due to control by a relatively inaccurate directional coding mechanism. Control during the deceleration phase, marked by low trajectory variability, was seen to be due to a sensorimotor process, using motor output signals, and resulting in an optimized trajectory supporting a successful grasp. Analysis of the grasp component of prehension showed that perturbing object location influenced the movement of the fingers suggesting a kinematic coupling of the two components. However, forthcoming work shows that, when object size changes, and location remains constant, there is a clear temporal dissociation of the two components of prehension.(ABSTRACT TRUNCATED AT 400 WORDS)

Fingers↗

The effects of changing movement velocity and complexity on response preparation: evidence from latency, kinematic, and EMG measures.

If movement control is afforded through the advance planning, or preprogramming, of upcoming actions, then one of the behavioral outcomes should be an increase in reaction time (RT) as the movement becomes more complex. In some situations, however, RT does not increase across levels of complexity, rather it remains invariant. In these cases, on-line preparation is typically inferred. That is, the sequence is said to be prepared in parts throughout the movement, as opposed to entirely beforehand. Given that there is some planning occurring during the sequence, then evidence of this process should be apparent within the movement itself. Three such dependent variables appear to provide such evidence. Specifically, the number of times the underlying accelerations cross the zero line within the movement, the number of 'significant deviations' within the acceleration trace, and the length of time for which the muscles are active (as measured by EMG) in relation to the duration of the movement. In the present experiment, then, these variables were measured in addition to the time required to prepare and initiate a movement performed under conditions conducive to either preprogramming or online preparation. Specifically, the movements were either completed as fast as possible, or at a considerably slower, more controlled speed. Each of the dependent variables displayed evidence of preprogramming in the movements completed at the fast velocity, and on-line preparation in the slower paced movements. Thus, in the slow condition, subjects appeared to rely more heavily on on-line prepared adjustments to produce an accurate outcome. The convergence attained between the various dependent measures lends power to the conclusions regarding hypothesized modes of control within the different speeds of movement.

Arm↗

Single cell studies of the primate putamen. II. Relations to direction of movement and pattern of muscular activity.

The major goal of this study was to determine whether the activity of single cells in the primate putamen was better related to the direction of limb movement or to the underlying pattern of muscular activity. In addition, the neural responses to load application were studied in order to determine whether the same neurons were also responsive to somatosensory stimuli. Two rhesus monkeys were trained to perform a visuomotor arm tracking task which required elbow flexion/extension movements with assisting and opposing loads in order to dissociate the direction of elbow movement from the pattern of muscular activity required for the movement. Neurons in the putamen were selected for study only if they were related both to the task and to arm movements outside the task. Most (96%) of the cells studied responded to load application: 36% of these showed short-latency (less than 50 ms), "sensory" responses. Forty-four percent of neurons had significant relations to the level of static load as the animal held the arm stationary against the steady loads: in general, static load effects were relatively weak. During the elbow flexion/extension movements in the task, 76% of cells had significant relations to the direction of movement, and 52% of neurons had significant dynamic relations to the level of load. Half of all neurons studied were primarily related to the direction of movement independent of the load. Only thirteen percent of cells in the putamen had a pattern of activity similar to that of muscles. These results indicate that neuronal activity in the putamen is predominantly related to the direction of limb movement rather than to the activity of particular muscles and that the basal ganglia may play a role in the specification of parameters of movement independent of the activity of specific muscles. These results also indicate that the basal ganglia receive proprioceptive input which may be used in the control of ongoing movement.

Animals↗

Cerebellar unit responses of the mossy fibre system to passive movements in the decerebrate cat. I. Responses to static parameters.

1) Experiments were designed to detect how static parameters of natural, passive hand movements are encoded and integrated within the cerebellar cortex. For this purpose unit activity was recorded extracellularly from presumed mossy fibres (MF), presumed granule cells (GrC) and from Purkinje cells (PC) discharging with simple spikes (SS) and complex spikes (CS). With respect to the PC, our interest was focussed primarily on the SS activity. The recordings were performed in the intermediate part of the cerebellar anterior lobe of decerebrate cats. The animal's forepaw was passively moved around the wrist joint by an electronically controlled device. The movements were exactly reproducible so that peristimulus time histograms of the unit activity could be constructed. 2) At the input level (MF) and at the first level of integration within the cerebellar cortex (GrC), patterns with similar discharge characteristics were found. Such patterns could, to a limited extent, also be detected at the cerebellar output (SS of PC). However, in most cases of SS discharge, patterns were found with weak correlation between the tonic activity and static parameters of the movements. 3) Absolute paw position, amplitude, and duration of movements were found to be related over wide ranges to the activities of MF and GrC. Absolute position is directly encoded by tonic discharge during the low or high holding phases. Beside this, units were found without a correlation between the tonic discharge and the position of the nonmoving paw. However, in these units it was sometimes observed that the information about the momentary position or the information about the mean position was sometimes conveyed exclusively during the proceeding upward or downward movement. Thus, information about static parameters was transmitted only at times when a dynamic parameter (such as velocity) occurred. This type of position information encoding is termed "indirect mode of transmission". 4) A specific relationship between SS unit activity of PC and the absolute position of the forepaw or amplitude of the movement could be found primarily by using multiple ramps instead of single ramp movements. This was observed even if both types of ramp movements had the same velocity, individual amplitude, and tested range. However, on multiple ramp movements the paw generally remained for a shorter period at a specific position level as compared to the single ramp movements. 5) Apart from this timing phenomenon, a late movement response was observed, which results in a specific type of position information encoding on multiple ramp functions.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

Physical principles for economies of skilled movements.

This paper presents some elementary principles regarding constraints on movements, which may be useful in modeling and interpreting motor control strategies for skilled movements. Movements which are optimum with respect to various objectives, or "costs", are analyzed and compared. The specific costs considered are related to movement time, distance, peak velocity, energy, peak acceleration, and rate of change of acceleration (jerk). The velocity patterns for the various minimum cost movements are compared with each other and with some skilled movement patterns. The concept of performance trade-offs between competing objectives is used to interpret the distance-time relationships observed in skilled movements. Examples of arm movements during violin bowing and jaw movements during speech are used to show how skilled movements are influenced by considerations of physical economy, or "ease", of movement. Minimum-cost solutions for the various costs, which include the effect of frictional forces, are given in Appendices.

Arm↗

Visual stability with goal-directed eye and arm movements toward a target displaced during saccadic suppression.

This experiment tested whether the perceived stability of the environment is altered when there is a combination of eye and visually open-loop hand movements toward a target displaced during the eye movements, i.e., during saccadic suppression. Visual-target eccentricity randomly decreased or increased during eye movements and subjects reported whether they perceived a target displacement or not, and if so, the direction of the displacement. Three experimental conditions, involving different combinations of eye and arm movements, were tested: (a) eye movements only; (b) simultaneous eye and rapid arm movements toward the target; and (c) simultaneous eye and arm movements with a restraint blocking the arm as soon as the hand left the starting position. The perceptual threshold of target displacements resulting in an increased target eccentricity was greater when subjects combined eye and arm movements toward the target object, specially for the no-restraint condition. Subjects corrected most of their arm trajectory toward the displaced target despite the short movement times (average MT = 189 ms). After the movements, the null error feedback of the hand's final position presumably overlapped the retino-oculomotor signal error and could be responsible for the deficient perception of target displacements. Thus, subjects interpreted the terminal hand positions as being within the range of the endpoint variability associated with the production of rapid arm movements rather than as a change of the environment. These results suggest that a natural strategy adopted for processing spatial information, especially in a competing situation, could favour a constancy tendency avoiding systematic perception of a change of environment for any noise or variability at the central or peripheral levels.

Adult↗

Imagined and actual arm movements have similar durations when performed under different conditions of direction and mass.

Several experiments have suggested that similar physiological substrates are involved in movement execution and motor imagery, and that the same laws of movement control apply to both processes. Using a mental chronometry paradigm, we examined the effects of movement direction and added mass on the duration of actual and imagined movements. Six subjects executed or imagined arm movements in the sagittal and horizontal plane, in three different loading conditions: without added mass, and with an added mass of 1 and 1.5 kg. The duration of both actual and imagined movements was measured by an electronic stopwatch. The actual movements were significantly increased in duration as a function of mass, for both movement directions. However, direction per se had no effect on duration. The duration of imagined movements was very similar to that of actual movements whatever the subject and mass and direction condition. These results show that both inertial and gravitational constraints are accurately incorporated in the timing of the motor imagery process, which appears therefore to be functionally very close to the process of planning and performing the actual movement.

Adult↗

Cerebellar subjects show impaired coupling of reach and grasp movements.

We examined how cerebellar deficits in isolated reaching or grasping movements contribute to abnormalities in a combined reach and grasp movement, and whether people with cerebellar damage show abnormalities in the spatiotemporal relationships of reach and grasp movements. We studied subjects with cerebellar damage and matched controls as they performed a combined reach and grasp, an isolated reach, and an isolated grasp. These movements were performed under slow-accurate and fast speed conditions. Subjects were also tested for their ability to correctly estimate the target size based on visual information. We measured the three-dimensional position of the index finger, thumb and wrist joint during all tasks. Results showed that cerebellar subjects overestimated the target size to a greater extent than did controls. During movement testing, cerebellar subjects were impaired on isolated reach and isolated grasp. However, they did not worsen parameters of reach or grasp movements during the combined reach and grasp. Instead there were distinct deficits in the coupling of the reach and grasp movement. Compared with controls, cerebellar subjects showed abnormalities in the sequence of the reach and grasp movement and highly variable timing of peak grip aperture. In the slow-accurate condition, cerebellar subjects decomposed the reach and grasp movement into separate reach then grasp components, and produced multiple peaks in grip aperture. In the fast condition, cerebellar subjects did not decompose, produced a single peak grip aperture, and dropped the target more often. These results indicate that cerebellar damage can cause a specific breakdown in the coupling of reach and grasp movements. The cerebellum may be involved in combining reach and grasp movements into a single motor program.

Adult↗

End posture selection in manual positioning: evidence for feedforward modeling based on a movement choice method.

Although it is well known that the postures adopted at the ends of movements depend on where one starts and how one moves, it is not yet clear whether those differing end postures are selected before movements begin. Two experiments were designed to test the hypothesis that end postures for positioning movements are chosen before movements commence. The experiments were further designed to check whether movements are internally simulated before overt movements occur and end-postures are still being selected. To address these questions we used a movement choice method. Participants were presented with two possible end postures and were asked to choose between them by moving to the one that seemed easier to adopt. End-posture choices were affected by starting positions and also by the movements that would have to be made, as affected by having obstacles in the way. The results suggest that participants relied on feedforward modeling of prospective movements as they selected end postures prior to overt movement production. The fact that the movement choice method could confirm this suggests that the method holds considerable promise as a tool for investigating motor planning.

Analysis of Variance↗

Neuronal activity in primary motor cortex differs when monkeys perform somatosensory and visually guided wrist movements.

This study was designed to investigate how activity patterns of primary motor cortical (MI) neurons change when monkeys perform the same movements guided by somatosensory and/or visual cues. Two adult male rhesus monkeys were trained to make wrist extensions and flexions after holding a steady position during an instructed delay period lasting 0.5-2.0 s. Monkeys held against a 0.07 Nm load that opposed flexion movements. Wrist movements were guided by vibratory cues (VIB-trials), visual cues (VIS-trials), or both in combination (COM-trials). Extracellular recordings of 188 MI neurons were made during all three paradigms. Individual neurons were counted twice, once for each movement direction, yielding 376 cases. All neurons had significant task-related activity (TRA) changes relative to delay period activity during at least one of the three paradigms. TRA was analyzed to determine if it was different as a function of the sensory cue(s) that initiated movement and that specified movement endpoints. Cases were grouped by whether the TRA changes were greater in VIB- or VIS-trials; this defined their "bias". One hundred and eighteen cases (31.4%) had greater TRA changes in VIB-trials (Vb-neurons), whereas 185 (49.2%) showed greater TRA changes in VIS-trials (Vs-neurons). The remaining 73 cases (19.4%) had similar TRA changes in VIB- and VIS-trials (Nb-neurons). For Vb- and Vs-neurons, earlier TRA onsets and greater TRA changes were observed in the trials for which these neurons were biased. During the COM-trials, the TRA was intermediate. During the trials for which the activity was not biased, the TRA was the least. For Nb-neurons, no significant TRA differences were observed across paradigms. TRA changes of MI neurons may represent movement planning-related inputs from other central, presumably cortical, sources as well as contribute to motor outflow from the cortex. These data suggest that Vb- and Vs-neurons are affected differently by somatosensory- and visually related central inputs, resulting in different TRAs, even for essentially identical movements. Such differences may depend not only on the type of sensory information that initiates movement but also whether that information specifies movement endpoints or might interfere with movement monitoring.

Animals↗

Perceptual coupling in rhythmic movement coordination: stable perception leads to stable action.

Rhythmic movement coordination exhibits characteristic patterns of stability, specifically that movements at 0 degrees mean relative phase are maximally stable, 180 degrees is stable but less so than 0 degrees, and other coordinations are unstable without training. Recent research has demonstrated a role for perception in creating this pattern; perceptual variability judgments covary with movement variability results. This suggests that the movement results could be due in part to differential perceptual resolution of the target movement coordinations. The current study used a paradigm that enabled simultaneous access to both perception (between-trial) and movement (within-trial) stability measures. A visually specified 0 degrees target mean relative phase enabled participants to produce stable movements when the movements were at a non-0 degrees relationship to the target being tracked. Strong relationships were found between within-trial stability (the traditional movement measure) and between-trial stability (the traditional perceptual judgment measure), suggestive of a role for perception in producing coordination stability phenomena. The stabilization was incomplete, however, indicating that visual perception was not the sole determinant of movement stability. Rhythmic movement coordination is intrinsically a perception/action system.

Adolescent↗