Objective:To examine whether prefrontal cortex activation measured by functional near‑infrared spectroscopy (fNIRS) during the St. Louis University Mental Status (SLUMS) exam differs by cognitive status and whether relative neural efficiency (RNE) can serve as a physiological marker of cognitive impairment. Methods:This exploratory study was conducted in 2024 at a senior center in a small Mid‑Atlantic U.S. city. Thirteen community‑dwelling adults aged 65-85 years completed the SLUMS while wearing an fNIRS sensor positioned over the prefrontal cortex. Participants were classified as having normal cognition (NOR), mild cognitive disorder (MCD), or dementia (DEM) based on SLUMS scores. ΔHbO served as the indicator of cognitive effort, and RNE was calculated by combining normalized SLUMS performance and oxygenation values. Group differences were tested using ANOVA with confirmatory nonparametric analyses. Results:RNE differed significantly among groups (F₂,₁₀ = 5.26, p = 0.0275). Post‑hoc comparisons showed lower RNE in the DEM group compared with the NOR group (p = 0.0224). Confirmatory Kruskal‑Wallis testing supported these findings (p = 0.0287), with a significant DEM-NOR difference on Dunn's test (p = 0.0311). Descriptive hemodynamic patterns indicated higher ΔHbO and ΔHbR variability in the DEM group across SLUMS question blocks. Conclusions:Older adults with dementia demonstrated reduced neural efficiency during SLUMS administration, suggesting greater cognitive effort relative to performance. These preliminary findings indicate that SLUMS items impose different cognitive workloads depending on impairment level. Policy Implications:Integrating physiological markers such as neural efficiency into cognitive screening may enhance early identification of impairment, support more targeted referral pathways, and inform public health planning for Delaware's aging population.

Educational games enhance learning experiences by integrating touchscreens, making interactions more engaging and intuitive for learners. However, the cognitive impacts of educational game input modalities, such as the hand and stylus technique, are not clear. We compared the experience of using hands vs. a stylus for touchscreens while educational gameplay by analyzing oxygenated hemoglobin collected by functional Near-Infrared Spectroscopy and self-reported measures. In addition, we measured the hand vs. the stylus modalities of the task and calculated the relative neural efficiency and relative neural involvement using the mental demand and the quiz score. Our findings show that the hand condition had a significantly lower neural involvement, yet higher neural efficiency than the stylus condition. This result suggests the requirement of less cognitive effort while using the hand. Additionally, the self reported measures show significant differences, and the results suggest that hand-based input is more intuitive, less cognitively demanding, and less frustrating. On the other hand, the use of a stylus required higher cognitive effort due to the cognitive balance of controlling the pen and answering questions. These findings highlight the importance of designing educational games that allow learners to engage with the system while minimizing cognitive effort.

Upper limb impairment significantly impacts daily activities and quality of life. Traditional robotic systems have been widely used in neurological rehabilitation applications. However, its adoption has been limited to laboratory and clinical settings due to cost constraints. Our study aimed to assess the feasibility and usability of a cost-effective virtual reality (VR) system for home-based upper limb training. We used a customized wearable sleeve sensor to assess the hand and elbow joint movements objectively. A pilot user study (n = 16) with healthy participants involved evaluating system usability, task load, and presence within two conditions of VR alone and VR combined with a customized inverse kinematics robot arm (KinArm). Results of statistical analysis using a two-way repeated measure (ANOVA) revealed no significant difference between conditions in task completion time. However, significant differences were observed in the normalized number of mistakes and recorded elbow joint angles between tasks. Our findings highlight the potential advantages of an immersive and multi-sensory approach towards performance assessment. This study explores avenues for the development of potentially cost-effective, tailored, and engaging environments for home-based therapy applications.

This study aimed to evaluate the correlation between nursing informatics(NI)competency and information literacy skills for evidence-based practice(EBP)among intensive care nurses.This cross-sectional study was conducted on 184 nurses working in intensive care units(ICUs).The study data were collected through demographic information,Nursing Informatics Competency Assessment Tool(NICAT),and information literacy skills for EBP questionnaires.The intensive care nurses received competent and low-moderate levels for the total scores of NI competency and information literacy skills,respectively.They received a moderate score for the use of different information resources but a low score for information searching skills,different search features,and knowledge about search operators,and only 31.5％ of the nurses selected the most appropriate statement.NI competency and related subscales had a significant direct bidirectional correlation with information literacy skills for EBP and its subscales(P＜0.05).Nurses require a high level of NI competency and information literacy for EBP to obtain up-to-date information and provide better care and decision-making.Health planners and policymakers should develop interventions to enhance NI competency and information literacy skills among nurses and motivate them to use EBP in clinical settings.

Detailed Assessment of Speed of Handwriting (DASH 17+) assessment provides information about the speed and legibility of handwriting. Handwriting difficulties in general and DASH17+ performance, in particular, are signs of neuromotor difficulties. Individualized interventions can be developed with a better understanding of both the biomechanical and neurological underpinnings of the task. We used a multimodal assessment strategy to deconstruct the product and process of handwriting measures in adults. A total of 23 neurotypical college age adults took part in the study. We combined the standardized norm-referenced test DASH17+ and explored the online process of handwriting using the MovAlyzeR software, and simultaneously explored prefrontal cortex activity, using functional near infrared spectroscopy (fNIRS), during the task execution. Our research indicated that underlying neural and kinematic mechanisms changed between tasks, within tasks, and even from one trial block to another that are not reflected in the DASH17+ performance assessment alone. Therefore, this multi-modal approach provides a promising method in clinical populations to further investigate any subtle change in handwriting.

Fidget spinners have been marketed as repetitive motion devices that improve attention and motor performance, and as such, they have become quite appealing to individuals with Attention Deficit Hyperactive Disorder (ADHD). To date, no studies have explored changes in brain activity that may occur due to fidgeting in ADHD. Our aim was to use functional Near-Infrared Spectroscopy (fNIRS) to examine the prefrontal cortex (PFC) during the performance of a standardized fine motor skills test after using a fidget spinner. Eight right-handed adults with ADHD and eight age and gender matched adults without ADHD (4F/4M, 4 control/4 fidget) performed the Purdue Pegboard Test (PPT) while their brain oxygenation was monitored using fNIRS. Relative neural efficiency (RNE) and involvement (RNI) were calculated and analyzed for all subtasks of PPT including the less cognitively demanding fine motor subtasks and more complex assembly tasks. The fidget spinner improved both task performance and RNE in the ADHD group but not the non-ADHD group for the less cognitively demanding subtasks. Our results indicate Fidget spinners may improve both relative neural efficiency and fine motor performance in adults with ADHD for less cognitively demanding tasks.

Gait impairment often limits physical activity and negatively impacts quality of life. EMG-Biofeedback (EMG-BFB), one of the more effective interventions for improving gait impairment, has been limited to laboratory use due to system costs and technical requirements, and has therefore not been tested on a larger scale. In our research, we aimed to develop and validate a cost-effective, commercially available EMG-BFB device for home- and community-based use. We began by repurposing mTrigger® (mTrigger LLC, Newark, DE, USA), a cost-effective, portable EMG-BFB device, for gait application. This included developing features in the cellphone app such as step feedback, success rate, muscle activity calibration, and cloud integration. Next, we tested the validity and reliability of the mTrigger device in healthy adults by comparing it to a laboratory-grade EMG system. While wearing both devices, 32 adults walked overground and on a treadmill at four speeds (0.3, 0.6, 0.9, and 1.2 m/s). Statistical analysis revealed good to excellent test–retest reliability (r > 0.89) and good to excellent agreement in the detection of steps (ICC > 0.85) at all speeds between two systems for treadmill walking. Our results indicated that mTrigger compared favorably to a laboratory-grade EMG system in the ability to assess muscular activity and to provide biofeedback during walking in healthy adults.

Despite increasing popularity, media attention, and commercial success of fidget spinners, scientific evidence on their effectiveness is scarce. The purpose of this study was to explore how fidget spinners affect fine motor performance and its neural correlates in the Prefrontal Cortex (PFC). Functional Near Infrared Spectroscopy (fNIRS) was used to examine the PFC activity while a group of healthy adult participants completed five different sub-tasks of the Purdue Pegboard Task (PPT). In this study, fidget spinners resulted in a significant decrease in ΔHbO compared to the controls during performance of the more cognitively demanding assembly subtask despite no differences in behavioral output. No other main effects for group existed in the other sub-tasks, although significant group by block interactions occurred in all four brain regions. This finding suggests that fidget spinners may reduce the cognitive load on LDLPFC during a cognitively challenging fine motor task.

To evaluate manual dexterity in clinical settings Purdue Pegboard test (PPT) is widely used and consists of four uni- and bi-manual sub-tests. The objective of this study is to deep dive into PPT and parse out the cognitive component of the subtests using functional Near Infrared Spectroscopy (fNIRS). The prefrontal cortex (PFC) of 16 participants was assessed using fNIRS technique while performing PPT. Repeated measures one-way ANOVA was performed on average ∆HbR and ∆HbO in PFC regions (left DLPFC, left vmPFC, right vmPFC, right DLPFC). A Bonferroni correction was used to account for multiple comparisons. Results from both outcome measures taken together showed that assembly sub-task uses significantly higher resources in the left PFC. The findings can be summarized as follows: PPT measures more than manual dexterity. Subtask complexity affects the cognitive demands in the PFC. The Assembly may be the most sensitive subtest to the changes in PFC activity.

In the current study, we used functional near-infrared spectroscopy (fNIRS) to compare prefrontal cortex (PFC) activity in adults as they performed two conditions of the Tower of Hanoi (ToH) disk-transfer task that have equivalent executive function (EF) but different motor requirements. This study explored cognitive workload, here defined as the cognitive effort utilized while problem-solving by performance output. The first condition included a two-dimensional (2D) computerized ToH where participants completed trials using a computer mouse. In contrast, our second condition used a traditional, three-dimensional (3D) ToH that must be manually manipulated. Our aim was to better understand the role of the PFC in these two conditions to detect if PFC activity increases as a function of motor planning. Twenty right-handed, neurotypical adults (10M/10F, x ¯ = 24.6, SD ± 2.8 years old) participated in two blocks (one per condition) of three 1-min trials where they were asked to solve as many puzzles as possible. These data were analyzed using a mixed effects ANOVA with participants nested within blocks for 2D vs. 3D conditions, presentation order (leading block), individual participants, and regions and additional follow-up statistics. Results showed that changes in oxygenated hemoglobin, ΔHbO, were significantly higher for 3D compared to 2D condition (p = 0.0211). Presentation order and condition interacted significantly (p = 0.0015). Notably, a strong correlation between performance and ΔHbO existed between blocks 1 and 2 (r = -0.69, r 2 = 0.473, p < 0.01) when the 3D condition was initially performed, in contrast to the 2D condition where no significant correlation was seen. Findings also showed a significant decrease in ΔHbO between the first and second block (p = 0.0015) while performance increased significantly for both 3D and 2D conditions (p < 0.005). We plan to use this information in the future to narrow the potential points of impairment on the perception-cognition-action continuum in certain developmental disabilities.

Event Abstract Back to Event Does oxygenation of prefrontal cortex change in a two versus three-dimensional Tower of Hanoi task? Kim M. Ceja1*, Elham Bakhshipour1, Reza Khoeilar1 and Nancy Getchell1* 1 University of Delaware, Kinesiology and Applied Physiology, United States Aims. In the current study, we used functional near infrared spectroscopy (fNIRS) to compare prefrontal cortex (PFC) activity in adults as they performed two Tower of Hanoi tasks that require equivalent executive function input but differ in motoric requirements. The Tower of Hanoi disk-transfer task is one in which the PFC should be active due to task-dependent problem solving. The first condition included a two-dimensional (2D) computer task where participants completed trials using minimal movement of a computer mouse. In contrast, our second condition used a traditional, three-dimensional (3D) TOH puzzle that must be manually manipulated in order to be solved. Our aim is to better understand the role of the prefrontal cortex in these two tasks to see if prefrontal cortex activity increases as a function of motor planning. We plan to use this information in the future to narrow the potential points of impairment on the perception-cognition-action continuum in certain developmental disabilities by comparing PFC activity between the two and three-dimensional tasks. Method. We evaluated changes in hemoglobin oxygenation during the Tower of Hanoi two and three-dimensional tasks in 13 adults (18-35 years old) with no recent history of head injuries. The Edinburgh Handedness Inventory was administered, and left-handed participants were excluded. An fNIRS band with 16 optodes was placed on top of the participants forehead to collect oxygenation data. Participants utilized a wooden TOH model with three pegholes and four graduated disks to perform the three-dimensional task and a custom-made software to perform the two-dimensional task in a PC (Figure 1). Participants attempted to solve TOH puzzles during three, one-minute intervals, and were presented with the same set of puzzles for both tasks. fNIRS data was collected using COBI Studio Software and analyzed using fNIRSoft Software. Light files were processed using finite impulse response digital filer (FIR filtering). Then, the refined data was converted to oxygenation graphs and was further processed using the “de-trending” setting to set the slope of the overall vector equal to zero. Changes in prefrontal hemodynamics were calculated using the oxygenated hemoglobin biomarker, ΔHbO. Optodes were grouped into four regions representing the left dorsal, left medial, right medial, and right dorsal prefrontal regions. Preliminary data were analyzed using two statistical analysis in JMP Version 13. Significance level was set as p < 0.05. Results. For the analysis of PFC regions, statistical differences existed between conditions in the left dorsal (p = .042) and left medial (p = .048) regions, with 3D > 2D ΔHbO in both cases. In the two-way mixed model ANOVA with participants random and 2Dv3D fixed, there were no main effects, but a significant interaction between participants and condition in three of four regions (p values ranging from .031 - .034), indicating that the effect of changing conditions varies for different individuals. Therefore, the effect of changing conditions had a large effect on some participants, but little effect on others. Conclusions. Our preliminary results suggest that the three-dimensional version of the Tower of Hanoi puzzle requires greater oxygenation in the left regions of the prefrontal cortex. At the same, the effect is not consistent across all participants, with some showing a much larger effect of condition than others. We plan to expand this research paradigm to children with or at-risk for developmental coordination disorder (DCD), a poorly understood developmental disability affecting up to 6% of the population, as a means to identify if coordination issues may be related in part to PFC deficits. Figure 1 Figure 2 Keywords: Executive Function, Tower of Hanoi, fNIRS, motor control, Motor planning Conference: 2nd International Neuroergonomics Conference, Philadelphia, PA, United States, 27 Jun - 29 Jun, 2018. Presentation Type: Poster Presentation Topic: Neuroergonomics Citation: Ceja KM, Bakhshipour E, Khoeilar R and Getchell N (2019). Does oxygenation of prefrontal cortex change in a two versus three-dimensional Tower of Hanoi task?. Conference Abstract: 2nd International Neuroergonomics Conference. doi: 10.3389/conf.fnhum.2018.227.00009 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 10 Apr 2018; Published Online: 27 Sep 2019. * Correspondence: Ms. Kim M Ceja, University of Delaware, Kinesiology and Applied Physiology, Newark, DE, 19716, United States, kimmc@udel.edu Dr. Nancy Getchell, University of Delaware, Kinesiology and Applied Physiology, Newark, DE, 19716, United States, getchell@udel.edu Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Kim M Ceja Elham Bakhshipour Reza Khoeilar Nancy Getchell Google Kim M Ceja Elham Bakhshipour Reza Khoeilar Nancy Getchell Google Scholar Kim M Ceja Elham Bakhshipour Reza Khoeilar Nancy Getchell PubMed Kim M Ceja Elham Bakhshipour Reza Khoeilar Nancy Getchell Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.