Learning to play golf for elderly people with subjective memory complaints: feasibility of a single-blinded randomized pilot trial.

BACKGROUND: Subjective Memory Complaints (SMC) in elderly people due to preclinical Alzheimer's Disease may be associated with dysregulation of the Kynurenine Pathway (KP), with an increase in neurotoxic metabolites that affect cognition. Golf is a challenging sport with high demands on motor, sensory, and cognitive abilities, which might bear the potential to attenuate the pathological changes of preclinical AD. This trial investigated the feasibility of learning to play golf for elderly with cognitive problems and its effects on cognitive functions and the KP. METHODS: In a 22-week single-blinded randomized controlled trial, elderly people with SMC were allocated to the golf (n = 25, 180 min training/week) or control group (n = 21). Primary outcomes were feasibility (golf exam, adherence, adverse events) and general cognitive function (Alzheimer's Disease Assessment Scale). Secondary outcomes include specific cognitive functions (Response Inhibition, Corsi Block Tapping Test, Trail Making Test), KP metabolites and physical performance (6-Minute-Walk-Test). Baseline-adjusted Analysis-of-Covariance was conducted for each outcome. RESULTS: 42 participants were analyzed. All participants that underwent the golf exam after the intervention passed it (20/23). Attendance rate of the golf intervention was 75 %. No adverse events or drop-outs related to the intervention occurred. A significant time*group interaction (p = 0.012, F = 7.050, Cohen's d = 0.89) was found for correct responses on the Response Inhibition task, but not for ADAS-Cog. Moreover, a significant time*group interaction for Quinolinic acid to Tryptophan ratios (p = 0.022, F = 5.769, Cohen's d = 0.84) in favor of the golf group was observed. An uncorrected negative correlation between attendance rate and delta Quinolinic acid to Kynurenic acid ratios in the golf group (p = 0.039, r=-0.443) was found as well. CONCLUSIONS: The findings indicate that learning golf is feasible and safe for elderly people with cognitive problems. Preliminary results suggest positive effects on attention and the KP. To explore the whole potential of golfing and its effect on cognitive decline, a larger cohort should be studied over a longer period with higher cardiovascular demands. TRIAL REGISTRATION: The trial was retrospectively registered (2nd July 2018) at the German Clinical Trials Register ( DRKS00014921 ).

Learning a skill with the expectation of teaching it impairs the skill's execution under psychological pressure.

When practicing a motor skill, learners who are expecting to teach it to another person exhibit superior gains in skill execution and declarative knowledge. Since skills acquired with large gains in declarative knowledge are highly susceptible to decrement under psychological pressure, it is possible the advantage of expecting to teach is lost when performing the learned skill under pressure. To test this hypothesis, we had 40 participants practice golf putting with the expectation of teaching (teach group) and 42 participants practice with the expectation of being tested (test group). The next day, all participants performed low- and high-pressure posttests. The teach group outperformed the test group under low pressure but not high pressure, where the teach group's performance declined to that of the test group. Further, the teach group reported using more declarative knowledge during the posttests than the test group, but declarative knowledge use did not mediate the performance decline from low- to high-pressure posttest. Taken together, results suggest expecting to teach benefits skill learning, but this advantage is lost when performing the skill under high pressure. However, whether skill breakdown under high pressure is caused by an increase in declarative knowledge use remains an open question. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

No Improvement on the Learning of Golf Putting By Older Persons With Self-Controlled Knowledge of Performance.

The aim of this study was to verify if older adults would benefit from a self-controlled schedule of knowledge of performance (KP) in the motor skill learning. The study's participants included 22 women and 18 men, with an average age of 68 years (SD = 2.95 years). These were divided into two groups: "Self," in which participants had control over when they received KP and "Yoked," in which participants received KP in a paired manner with the Self group. The learning task was golf putting. Results showed that the groups had similar scores for accuracy and consistency of performance. Results also showed that KP requests were more based on bad trials than good trials. It appears that the important variable for motor learning is not who controls the provision of feedback, but also the older adults' ability to use the information.

Using visual guidance to retrain an experienced golfer's gaze: A case study.

Eye movements are essential for both predictive and reactive control of complex motor skills such as the golf swing. We examined the use of a visually guided learning protocol to retrain an experienced golfer's point-of-gaze immediately prior to execution of the full golf swing; his swing, and his gaze behaviour, had become established over more than a decade of practice and competition. Performance and eye movement data were obtained, from baseline, through intervention, to retention, for a total of 159 shots struck at a target 200 yards away. Results show that, at baseline, not only was the golfer's point-of-gaze not at the intended/predicted location, at the top-rear of the ball, but there was also high trial-to-trial variability. A bespoke visual guidance protocol improved his gaze behaviour considerably, in terms of accuracy and consistency - and this was reflected in accuracy and consistency of his shots. Implications of oculomotor interventions for the relearning of established motor skills are discussed.

Expecting to teach enhances motor learning and information processing during practice.

Recent research has revealed that having learners study and practice a motor skill with the expectation of having to teach it enhances motor learning. However, the mechanisms underlying this effect remain unknown. We attempted to replicate this effect and elucidate the mechanisms underlying it. Thus, participants studied golf putting instructions and practiced putting either with the expectation of having to teach another participant how to putt or the expectation of being tested on their putting. During this acquisition phase, participants' motivation, anxiety, and information processing (the duration they took preparing each putt) were indexed as possible mechanisms underlying a motor learning effect. One day and seven days after the acquisition phase, learning was assessed by testing all participants on their golf putting. Results revealed that expecting to teach enhanced motor learning, replicating the original finding. Moreover, expecting to teach increased the duration participants took preparing each putt, which was correlated with superior motor learning. Thus, results suggest expecting to teach enhances motor learning by increasing information processing during practice.

The effects of golf training in patients with stroke: a pilot study.

BACKGROUND: Stroke is the most common neurological disease and the primary cause of lifelong disability in industrialized countries. Because of this it is important to investigate any kind of successful therapy. METHODS: From the 24 recruited stroke patients who were between 23 and 72 years old, 14 patients were separated either in a golf training group (EG), or a social communication meeting (CG). Both groups met for one hour sessions, twice a week, for ten weeks. All participants completed assessment tests before and after the experimental period: cognitive tests measuring attention (Go/No-Go task), visual-spatial memory (Block-Tapping test) and mental rotation performance (MRT); a balance test (Berg Balance Scale), and an emotional well-being test (CES-D-Scale). RESULTS: The results show that both groups improved in the CES Scale, the block-tapping test and the balance test. In addition, stroke patients who received a golf training showed a significant improvement in the MRT comparing to the control group (CG). CONCLUSION: It is indicated that golf training can improve visual imagery ability in stroke patients, even late after stroke.

Verbal-motor attention-focusing instructions influence kinematics and performance on a golf-putting task.

The authors examined how varying the content of verbal-motor instructions and requesting an internal versus external focus influenced the kinematics and outcome of a golf putting task. On Day 1, 30 novices performed 120 trials with the instruction to focus attention either on performing a pendulum-like movement (internal) or on the desired ball path (external). After 20 retention trials on Day 2, they performed 20 transfer trials with the opposite instruction. Group differences for retention and a group by block interaction showed that external instruction enhanced movement outcome. Kinematic data indicated that specific instruction content influenced outcomes by eliciting changes in movement execution. Switching from the external to the internal focus instruction resulted in a more pendulum-like movement.

Recovery of golfing ability in someone with an incomplete spinal cord injury: a case report.

PURPOSE: The purpose of this case report was to describe the elements needed to play golf, detail a rehabilitation program designed to teach someone with an incomplete spinal cord injury (SCI) to play golf and to document outcomes of such a program. METHODS: The participant was a 58-year-old male who sustained an incomplete C3-C6 SCI. The program was divided into three phases. Phase one (nine sessions) consisted of balance, strengthening and flexibility activities to prepare him to play golf. During phase two (12 sessions), he practiced his golf swing in a clinical setting and in phase three (seven sessions) focused on task-oriented training at a golf course. The ability to play golf, putting accuracy, driving distance, quality of swing, balance, physical functioning, walking capacity, muscle strength, endurance and quality of life were measured before and after the intervention. RESULTS: The participant was able to complete 9-holes of golf with assistance and demonstrated greater ability to drive the ball with better quality of swing. Improvements were observed in balance, physical functioning, walking capacity, endurance and quality of life but not in overall strength or putting accuracy. CONCLUSIONS: This individual was able to return to golf following an intense rehabilitation program even though he required an assistive device to walk. Implications for Rehabilitation Individuals with spinal cord injury often have impairments which make participation in leisure activities more difficult. Participation in leisure activities has been associated with better subjective well being and quality of life. Rehabilitation therapists should consider creating leisure goals with their patients.

Effort, performance, and motivation: insights from robot-assisted training of human golf putting and rat grip strength.

Robotic devices can modulate success rates and required effort levels during motor training, but it is unclear how this affects performance gains and motivation. Here we present results from training unimpaired humans in a virtual golf-putting task, and training spinal cord injured (SCI) rats in a grip strength task using robotically modulated success rates and effort levels. Robotic assistance in golf practice increased trainees feelings of competence, and, paradoxically, increased their sense effort, even though it had mixed effects on learning. Reducing effort during a grip strength training task led rats with SCI to practice the task more frequently. However, the more frequent practice of these rats did not cause them to exceed the strength gains achieved by rats that exercised less often at higher required effort levels. These results show that increasing success and decreasing effort with robots increases motivation, but has mixed effects on performance gains.

Layered stimulus response training improves motor imagery ability and movement execution.

This study aimed to test Lang's bioinformational theory by comparing the effects of layered stimulus and response training (LSRT) with imagery practice on improvements in imagery ability and performance of a motor skill (golf putting) in 24 novices (age, M = 20.13 years; SD = 1.65; 12 female) low in imagery ability. Participants were randomly assigned to a LSRT (introducing stimulus and response propositions to an image in a layered approach), motor imagery (MI) practice, or visual imagery (VI) practice group. Following baseline measures of MI ability and golf putting performance, the LSRT and MI practice groups imaged successfully performing the golf putting task 5 times each day for 4 days whereas the VI practice group imaged the ball rolling into the hole. Only the LSRT group experienced an improvement in kinesthetic MI ability, MI ability of more complex skills, and actual golf putting performance. Results support bioinformational theory by demonstrating that LSRT can facilitate visual and kinesthetic MI ability and reiterate the importance of imagery ability to ensure MI is an effective prime for movement execution.

Novice motor performance: better not to verbalize.

Offline verbalization about a new motor experience is often assumed to positively influence subsequent performance. Here, we evaluated this presumed positive influence and whether it originates from declarative or from procedural knowledge using the explicit/implicit motor-learning paradigm. To this end, 80 nongolfers learned to perform a golf-putting task with high error rates (i.e., explicit motor learning), and thus relied on declarative knowledge, or low error rates (i.e., implicit motor learning), and thus relied on procedural knowledge. Afterward, they either put their memories of the previous motor experience into words or completed an irrelevant verbal task. Finally, they performed the putting task again. Verbalization did not improve novice motor performance: Putting was impaired, overall, and especially so for high-error learners. We conclude that declarative knowledge is altered by verbalization, whereas procedural knowledge is not.

The effects of training and competition on achievement goals, motivational responses, and performance in a golf-putting task.

This study examined whether (a) training and competition influence achievement goals, effort, enjoyment, tension, and performance; (b) achievement goals mediate the effects of training and competition on effort, enjoyment, tension, and performance; and (c) the context influences the relationships between goals and effort, enjoyment, tension, and performance. Participants (32 males, 28 females; M age = 19.12 years) performed a golf-putting task in a training condition and a competition condition and completed measures of goal involvement, effort, enjoyment, and tension; putting performance was also measured. Both task and ego involvement varied across training and competition, and variation in ego involvement explained variation in effort and enjoyment between these conditions. Ego involvement positively predicted effort in training and performance in competition, and interacted positively with task involvement to predict effort and enjoyment in competition. Our findings suggest that the distinction between training and competition is a valuable one when examining individuals' achievement motivation.

Effect of different external attention of focus instruction on learning of golf putting skill.

The effect of different sources of external attentional focus on learning a motor skill was assessed in the present study. 30 students (12 men, 18 women) participated voluntarily and were divided, according to type of external focus, into target, club swing, and target-club swing groups. The task was a golf putting skill. The target focus group attended to the target (hole), the club swing focus group attended to the execution of the club's swing, and the target-club swing focus group attended to both. All participants performed 50 trials of the putting skill in the acquisition phase and 10 trials in the 24-hr. delayed retention phase. The dependent variable was the error in the putting skill measured as the distance from the hole to the ball after each strike. Results showed the target-club swing focus group had better scores in the acquisition and retention phases than the other groups. It was concluded that external focus instruction helped the learners to integrate target cue with action cue and is more effective in skill learning than other external-focus instructions. These results support the claims of ecological psychology theorists concerning the effects of external focus of attention.

Differences between experts and novices in kinematics and accuracy of golf putting.

In this study, golf-putting movements were examined under three goal distances (short, 1.7m; middle, 3.25m; long, 6m), two different putter weights (500g, 750g), and two levels of expertise (5 experts, 5 novices). The study's aim was to identify differences in kinematics and accuracy between expert and novice golfers. The results demonstrated that experts achieved higher accuracy with lower impact velocity than novices. In addition, while novices showed symmetrical movements, experts exhibited asymmetrical movements, which were achieved by modulating their movement time and amplitude differently from novices. These results demonstrated differences in relative timing, relative amplitude and velocity, but no difference in time-to-contact between novices and experts. The results reaffirmed the role of prior learning and supported the hypothesis of Manoel and Connolly (1995) that motor learning is a hierarchical process organized at both macroscopic and microscopic levels.

The role of physiology in the development of golf performance.

The attainment of consistent high performance in golf requires effective physical conditioning that is carefully designed and monitored in accordance with the on-course demands the player will encounter. Appreciating the role that physiology plays in the attainment of consistent performance, and how a player's physicality can inhibit performance progression, supports the notion that the application of physiology is fundamental for any player wishing to excel in golf. With cardiorespiratory, metabolic, hormonal, musculoskeletal and nutritional demands acting on the golfer within and between rounds, effective physical screening of a player will ensure physiological and anatomical deficiencies that may influence performance are highlighted. The application of appropriate golf-specific assessment methods will ensure that physical attributes that have a direct effect on golf performance can be measured reliably and accurately. With the physical development of golf performance being achieved through a process of conditioning with the purpose of inducing changes in structural and metabolic functions, training must focus on foundation whole-body fitness and golf-specific functional strength and flexibility activities. For long-term player improvement to be effective, comprehensive monitoring will ensure the player reaches an optimal physical state at predetermined times in the competitive season. Through continual assessment of a player's physical attributes, training effectiveness and suitability, and the associated adaptive responses, key physical factors that may impact most on performance success can be determined.

The architecture of the golfer's brain.

BACKGROUND: Several recent studies have shown practice-dependent structural alterations in humans. Cross-sectional studies of intensive practice of specific tasks suggest associated long-term structural adaptations. Playing golf at a high level of performance is one of the most demanding sporting activities. In this study, we report the relationship between a particular level of proficiency in playing golf (indicated by golf handicap level) and specific neuroanatomical features. PRINCIPAL FINDINGS: Using voxel-based morphometry (VBM) of grey (GM) and white matter (WM) volumes and fractional anisotropy (FA) measures of the fibre tracts, we identified differences between skilled (professional golfers and golfers with an handicap from 1-14) and less-skilled golfers (golfers with an handicap from 15-36 and non-golfer). Larger GM volumes were found in skilled golfers in a fronto-parietal network including premotor and parietal areas. Skilled golfers revealed smaller WM volume and FA values in the vicinity of the corticospinal tract at the level of the internal and external capsule and in the parietal operculum. However, there was no structural difference within the skilled and less-skilled golfer group. CONCLUSION: There is no linear relationship between the anatomical findings and handicap level, amount of practice, and practice hours per year. There was however a strong difference between highly-practiced golfers (at least 800-3,000 hours) and those who have practised less or non-golfers without any golfing practise, thus indicating a step-wise structural and not a linear change.

Relation of eye dominance with performance and subjective ratings in golf putting.

Previous research has discussed the interaction of hand preference, eye dominance, and sport performance. In this study, the relation of eye dominance with performance and subjective ratings in golf putting was investigated. 47 right-handed Japanese students from a college of physical education putted 10 balls to a drawn circle 3 m away, each under right-handed and left-handed stance conditions. Putting performance was measured by the number of successful putts. After putting in each condition, they rated subjective visibility and feelings of hitting. Analyses indicated that right-eyed subjects had significantly better performance using the right-handed stance than the left-handed stance, whereas left-eyed subjects showed the opposite. Most subjective ratings were more positive with right-handed stance for both right-eyed and left-eyed subjects. These findings suggest that eye dominance could have some influence on putting performance of Japanese novice golfers.

Expert golf instructors' student-teacher interaction patterns.

The purpose of this study was to identify the dominant instructional interaction patterns of expert golf instructors. Instructors (N = 22) were selected by the Ladies Professional Golf Association (LPGA) Teaching based on the following criteria: (a) 10 or more years of golf teaching experience, (b) LPGA certification, (c) awards received for the quality of their instruction, and (d) peer and student recognition for outstanding teaching. The instructors were videotaped teaching a 60-min lesson to a novice college-age woman with no previous golf experience. The tapes were then analyzed using both the Cheffers Adaptation of Flanders' Interaction Analysis System (CAFIAS) and a qualitative analysis. Based on the findings from descriptive statistics and correlation analyses of the CAFIAS data and qualitative data analysis, several trends were identified. First, the dominant instructional behavior of these teachers was providing information to the students using both explanations and demonstrations. Second, the prevailing instructional interaction pattern of the expert teachers included extensive explanations and demonstrations followed by directions. The student followed the directions by practicing skills and received praise for their achievements. Third, high rates of directions and praise from teachers prompted student practice. Fourth, engaging students in subject-related discussion was positively correlated with teachers' questions but negatively correlated with teachers' criticisms. Finally, teacher acceptance was positively correlated with student analytic behavior, while teachers' talk negatively correlated with students initiating discussions.

The efficacy of video feedback for learning the golf swing.

This study was designed to examine the efficacy of video instruction relative to that of verbal and self-guided instruction. Before training, 30 golfers were assigned at random to one of three groups: video, verbal or self-guided instruction. Video instruction was defined as a practice session in which the teacher was aided by the use of video. Verbal instruction was defined as practising with the teacher providing verbal feedback. Self-guided practice was defined as practising without the aid of a teacher. The participants had a pre-test, four 90 min practice sessions, an immediate post-test and a 2 week delayed post-test. During the pre-test and post-tests, all participants were required to strike 15 golf balls, with a 7-iron, from an artificial turf mat for distance and accuracy. The results showed that all groups were equal on the pre-test. On the first post-test, the two instruction groups performed worse than the self-guided group. However, on the second post-test, the two instruction groups performed better than the self-guided group, with the video group performing best. We interpret these results to mean that video analysis is an effective means of practice, but that the positive effects may take some time to develop.

Healthy swing: a golf rehabilitation model.

OBJECTIVE: To describe a rehabilitation model using a multidisciplinary team approach for the diagnosis and treatment of individuals with golf injuries or physically challenged persons desiring to play golf. DESIGN: A retrospective, descriptive study of a multidisciplinary golf rehabilitation program that included evaluation by a physiatrist, a physical therapist, and a Professional Golf Association golf professional. RESULTS: A total of 145 individuals were treated in this program between 1994 and 1997. The majority of subjects were amateur (95%), male golfers (80%), with a mean age of 55.7 yr (range, 14-80 yr). Golfing injuries of the lower back were the most common diagnosis and had a higher frequency in men than women (49% vs. 28%); women were more likely to have shoulder (28% vs. 10%) and elbow (13% vs. 9%) injuries than men. Interventions used included medical or surgical treatment (89%), physical rehabilitation, including exercises or diathermy (92%), and modification of golf swing technique (83%). Outcomes included a return to sports participation in 98% of subjects. All subjects with golf-induced injuries returned to sports participation, and one male and one female subject won state amateur golf championships. CONCLUSION: A comprehensive, multidisciplinary model for the evaluation and rehabilitation of golf injuries has been developed, using a team of healthcare professionals and a golf teaching professional. This approach may play a role in facilitating recovery and sports participation in injured golfers.