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The relationship of movement time to hand-foot laterality patternsDorota Olex-Zarychta a; Joachim Raczek a

a Academy of Physical Education, Katowice, Poland

First Published on: 31 May 2008

To cite this Article Olex-Zarychta, Dorota and Raczek, Joachim(2008)'The relationship of movement time to hand-foot lateralitypatterns',Laterality: Asymmetries of Body, Brain and Cognition,13:5,439 — 455To link to this Article: DOI: 10.1080/13576500802134623URL: http://dx.doi.org/10.1080/13576500802134623

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The relationship of movement time to hand!footlaterality patterns

Dorota Olex-Zarychta and Joachim Raczek

Academy of Physical Education, Katowice, Poland

Asymmetries in movement times of the hands in 60 healthy participants withdifferent patterns of hand!foot dominance were investigated. Handedness andfootedness were assessed by means of questionnaires and verified by simple motortasks. Psychomotor performance was evaluated by the use of selected tests from thecomputerised Vienna Test System (VST, Vienna, Austria). Movement time (MT)was assessed separately for dominant and non-dominant hands in a unimanualsimple reaction task. Participants performed significantly better with their preferredhand, and differences in performance between right- and left-handers were notsignificant, neither was there a main effect of foot dominance on MT of the hands.However there was a significant effect of laterality pattern in hand!foot combina-tion on hands MT: participants with cross-lateral dominance patterns of hands andfeet performed significantly better than those with congruent hand!foot dom-inance. No significant interaction with sex was found. These results provideevidence for a lack of independence of hand and foot dominance in motorperformance, suggesting the functional significance of limb laterality pattern in themotor control system. The results support the hypothesis that the quality of humanhand movements may be influenced not only by central information processing(hemispheric specialisation) but also by other structures and processes of motorcontrol, such as central pattern generators (CPGs) and biomechanical factors.

The problem of differences in performance in manual aiming movementsbetween preferred and non-preferred hands was introduced over a centuryago. In 1899, P. S. Woodworth published the results of an experimental seriesfocusing on differences in speed and accuracy of hands (Woodworth, 1899).He posed the fundamental question about the source of asymmetry in upperlimb performance, suggesting its relation to motor control systems. Todaythere is still no clear answer to that question (see Elliot & Heath, 1999, forreview). Much research has focused on movement asymmetry and relatedtopics*handedness, footedness, brain laterality, and characteristics of

Address correspondence to: Dorota Olex-Zarychta, Department of Human Motor Behaviour,

Academy of Physical Education, Ul. Mikolowska 72a, 40 ! 065 Katowice, Poland. E-mail:

[email protected]

LATERALITY, 2008, 13 (5), 439!455

# 2008 Psychology Press, an imprint of the Taylor & Francis Group, an Informa business

http://www.psypress.com/laterality DOI: 10.1080/13576500802134623

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motor performance in the limbs*but the aetiology of motor performanceasymmetry in human is still unclear (Agnew, Zeffiro, & Eden, 2004;Denckla, 1973; Flowers, 1975; Francis & Spiriduso, 2000; Lage et al.,2007; McManus, 2002; Olex, 2000; Peters, 1991; Springer & Deutsch 2004).Asymmetry in neuromotor performance is assumed to be linked to brainlaterality connected with hemispheric specialisation (Gasser, Rousson,Caflish, & Largo, 2005; Springer & Deutsch, 2004). The greater involvementof the contralateral hemisphere while performing various motor tasks hasbeen shown in some experiments with positron emission tomography (PET)and functional magnetic resonance imaging (fMRI) (Agnew et al., 2004;Babiloni et al., 2003; Haaland, Elsinger, Mayer, Durgerian, & Rao, 2004). Asthe task becomes more complex, the brain activation becomes more bilateral(Lage et al., 2007). It has been suggested that different neurophysiologicalprocesses are involved in phylogenetically old motor behaviours (likerhythmic movements) and discrete movements like grasping or reaching(Schaal, Sternad, Osu, & Kawato, 2004).

MOTOR PERFORMANCE AND HANDEDNESS

Asymmetry in manual motor actions is assumed to be linked withhandedness. Better results of the dominant (preferred) hand have beenfound in repetitive and alternating motor tasks (Denckla, 1973) as well as intapping (Carlier, Dumont, Beau, & Michel, 1993). Lateral differences inmotor performance are reported to be task specific and most visible inskilled task performance (Plamondon & Alimi, 1997). Many findingssupported the hypothesis of no correlation between limb functionalpreference in motor actions and muscle strength or muscle fatigue indifferent tasks, which strongly suggests independency of limb preference andforce parameters of performance. The dominant hand is not always thestronger one and strength is not an indicator of hand proficiency in precisionperformance (Elliot & Heath, 1999; Kauranen, Siira, & Vanharanta, 1999;Olex-Mierzejewska & Raczek, 2001; Walter & Swinnen, 1990; Zijdewind &Bosch, 1990). Motor asymmetry is reported to be very distinct in tasksrequiring speed, accuracy, and fast reaction time. Right-handed participantstypically complete manual aiming movements more rapidly and moreaccurately when aiming with their right (dominant) hand (Annett, 1992;Elliot & Heath, 1999; Hore, Watts, Tweed, & Miller, 1998; Kabbash,MacKenzie, & Buxton, 1993; Peters, 1991, Plamondon & Alimi, 1997; Tan &Kutlu, 1991). More precise performance with the dominant hand was alsofound in left-handers. Peters and Ivanoff (1999) found that right-handedpeople performed faster with their right hand (as expected), and left-handedpeople had similar speed of movement in both hands. The dominant hand

440 OLEX-ZARYCHTA AND RACZEK


advantage was also shown in some rhythm-adapting tasks of variousfrequencies of signals (Jancke et al., 2000; Olex, 2000) and visuomotorreaction time (Riolo-Quinn, 1991). Some findings confirmed the left-handedparticipants’ better results in this aspect of performance (Teixeira, Gaspar-etto, & Sugie, 1999). Taking into consideration that the right hemispherecontrols the left hand, and the left hemisphere controls the right hand,researchers assumed that the left hand should show faster reaction times intasks involving spatial relationships (such as pointing at a target). The resultsof Boulinquez and Bartelemy (2000) and Bartelemy and Boulinquez (2001and 2002) supported that idea. Bryden (2002) observed only right-handedpeople and found that task difficulty did not affect the reaction timedifference between the left and right hands. Reaction time (RT) for bimanualsymmetrical movements is reported to be shorter than for unimanual andbimanual non-symmetrical tasks in children (Barral, Debu, & Rival, 2006).In movement time (MT) the advantage of dominant hand performance wasobserved, with no differences between men and women. MT is also reportedto increase progressively with ageing (Nicoletti et al., 2005). Gender-relateddifferences in asymmetry of aiming with the dominant and non-dominanthand have been reported. In tasks requiring both speed and precision womentend to trade-off speed for accuracy: in some experiments they slowedmovement to achieve the required level of precision (Barral & Debu, 2004).In right-handed participants the dominant hand advantage in accuracy wasobserved only in men, while in women no differences in terminal accuracy ofhand performance were observed. In left-handed females the decrease inpreferred hand accuracy was observed as hand speed increased (Tan, 1993).In left-handed men the dominant hand accuracy did not depend on speed.The majority of experiments reported faster reaction times in males thanfemales, which was distinct even after training (Adam et al., 1999; Dane &Erzurumluoglu, 2003; Der & Deary, 2006; Noble, Baker, & Jones, 1964;Welford, 1980).

MOTOR PERFORMANCE AND FOOTEDNESS

Asymmetry in lower extremities and foot performance even in walking hasbeen found as a normal phenomenon (Maupas, Paysant, Martinet, & Andre,1999). However, the feet are reported to be weakly asymmetric inperformance. Some authors explained this phenomenon by the fact thatbipedal activities typical for humans (walking, standing) are abundant(Gasser et al., 2005). The pattern of foot preference is assumed to have anobvious relevance for sports such as football (Carey et al., 2001). Footpreference is defined as the ability of a limb to execute a manipulative ormobilising action while the other, non-dominant one provides stabilising

MOVEMENT TIME AND HAND-FOOT LATERALITY 441


support, i.e., during kicking a ball (Gabbard & Hart, 1996; Gabbard & Iteya,1996). A strong relationship between preferred foot and motor performancein unilateral and bilateral tasks has been found (Hart & Gabbard, 1998). Themajority of the population prefer the right foot in motor performance*more than 75% (Carey et al., 2001). Some findings supported the hypothesisthat footedness may be a better predictor of brain lateralisation thanhandedness, i.e., language function lateralisation (Elias & Bryden, 1998).Footedness is assumed to be less influenced by some dextral social pressuresthan handedness, which probably makes it a sensitive index of hemisphericspecialisation (Chapman, Chapman, & Allen, 1997) The motor control offoot performance is still unclear (Foundas, Hong, Leonard, & Heilman,1998). It has been suggested that motor performance of the upper limbs isinfluenced only by central information processing, while the effect for thelower limbs is also influenced by peripheral motor control (Kato & Asami,1998).

MOTOR PERFORMANCE AND LATERALITY PATTERN INHAND!FOOT COMBINATION

Associations between hand and foot preference behaviour have beeninvestigated in different aspects of human performance. The four mainlaterality patterns in the limbs are typically identified: two congruentpatterns RH/RF, LH/LF (right hand/right foot, left hand/left foot) andtwo cross-lateral ones RH/LF, LH/RF (right hand/left foot, left hand/ rightfoot), (Day & MacNeilage, 1996; Elias & Bryden, 1998; Gabbard, 1992;Olex, 2000). Gabbard (1992) also introduced some mixed patterns (i.e., righthand/mixed foot), taking into consideration ambidexterity in participants’limbs. The proportion of crossed hand!foot preference is reported to behigher in men than women (7.4% vs 2.5%), and higher in left-handers thanright-handers (16.3% vs 4.1%). The overall frequency of crossed preferencesbetween hand and foot was shown as 5% (Dargent-Pare, Agostini, Mesbah,& Dellatolas, 1992).

The relationship of lower limb dominance to handedness is reported to besignificantly different in right- and left-handers, and more consistent forright-handed participants. In an experiment conducted by Beling, right-handed participants showed greater consistency of lower limb use fordifficult unilateral motor tasks (Beling, Wolfe, Allen, & Boyle, 1998). Inrhythm capability, a significant effect of hand!foot laterality pattern wasfound in unilateral hand performance with the preferred hand, but not inbilateral tasks (Olex, 2000). Maupas et al. (1999) suggested no relation ofasymmetry in lower limb performance to handedness or other lateraldominance. It is well established in the literature that on most tasks the



degree of asymmetry expression in motor performance is attributed toseveral factors: task complexity, hand training, participant’s gender and age,and processing characteristics of the motor control systems (i.e., whether themovement is produced to sensory or central input), (Francis & Spiriduso,2000; McManus, 2002; Plamondon & Alimi, 1997; Provins, 1997). Takinginto consideration previous findings, motor control research could takeadvantage of limb laterality pattern analysis in motor performance studies.

In this study we investigated asymmetries in movement time of handperformance in men and women with different limb laterality patterns. Themain objective was to find the effect on hand MT of limb laterality pattern.Our results are expected to contribute to the discussion on motor control ofhuman voluntary movements.

A number of investigators have postulated that physiological asymmetriesor genetic mechanisms account for manifestation of side preference andperformance in humans (Annett, 1992, McManus, 2002, Springer &Deutsch, 2004). At present it cannot be rejected that laterality in motorperformance, in connection with the neural mechanisms of motor control, isattached to signal processing and transmission in the nervous system. Theseprocesses have great significance in rapid aimed movements (Kandel,Schwartz, & Jessel, 1991). According to contemporary research, the innerstructure of rapid movement coordination could be determined by neuro-sensory factors connected not only with central steering mechanisms (i.e.,hemispheric specialisation) but also with the influence of some peripheralfactors (effectors network activity, signal transmission in peripheral nerves)and their interactions, in relation to environmental factors. We hope ourresults support the following hypothesis: Differences exist in neuralmechanisms of movement control among different laterality patterns.Asymmetry of motor performance could be connected with asymmetry ofmotor control not only on the central but also on the peripheral level. Weassume that quality of movements is in special relation with limb lateralitypattern, and some neuromuscular factors influence the effect of performanceasymmetry in the limbs. Any effect of foot dominance on hand performance,and/or significant differences in motor performance among various lateralitypatterns, could be new evidence for lack of independence of hand and foot inmotor control of rapid aimed movements. It would suggest that quality ofhuman movements (i.e., spinal cord reflexes, rhythmic motor patterns,voluntary movements) can be the effect of more complicated interactionsinvolving different motor control levels: the central motor control structuresand processes (hemispheric specialisation), central pattern generators oflimb performance (CPGs), and also peripheral motor control factors.According to this hypothesis, limb laterality pattern could be the indirectpredictor of not only cerebral laterality but also laterality of other motorcontrol mechanisms.



METHOD

Participants

A total of 60 healthy young adults took part in the experiment. The groupconsisted of 29 women and 31 men in the age range 21!23 (M"21.8),divided into four sub-groups according to criteria of limb laterality patterns:two congruent domination pattern groups (LH/LF, n"17; RH/RF, n"15),and two cross-lateral domination pattern groups (LH/RF, n"13; RH/LF,n"15). The experimental group was chosen from 200 students who werevolunteers tested for hand and foot dominance (see Procedure below).Students presenting no signs of ambidexterity in their limbs took part in thelaboratory tests. All participants gave informed consent for their involve-ment in the experiment and were naive as to the purpose of the research.

Procedure

The hand and foot dominance of each participant was established by meansof a questionnaire (selection from the Edinburgh Handedness Inventory;Oldfield, 1971), with adaptation for foot dominance (some added questionsconnected with precise sporting foot performance, e.g., hurdles; allparticipants were PE students involved with different forms of sport activity)verified by simple motor tasks. Self-reported handedness and footedness(treated as additional information) were also recorded. The level ofpsychomotor performance of each participant was evaluated by the use ofselected tests from the computerised Vienna Test System (Raczek, Waskie-wicz, & Juras, 1997). In Europe the VTS is a one of the most widespreadbatteries of computer-aided tests of diagnosis in the field of the neuropsy-chological and physiological basis of movement. This diagnostic tool hasbeen described and verified with regard to validity and reliability, and itsusefulness has been presented in earlier publications (Raczek, Mynarski, &Ljach, 1998; Raczek et al., 1997). The VTS (dr G.Schuhfried GmbH,Modling, Austria) consists of computer-supplemented tests constructed todiagnose the neurophysiological basis of human movement. It consists of themain system (PC, interface, managing system ! MENUE, and operationsystem ! RSX) and peripheral panels (configurable and adjustable), usingwhich the test can be performed. The peripheral device used in thisexperiment was the battery of Reaaktiongerat (RG) tests. The RG enablesassessment of reaction to visual and auditory stimuli. Testing procedure inthis experiment included a simple reaction parametric block. There was arow of five coloured lights on the board panel as well as two buttons belowthe lights: a ‘‘stand-by’’ button and a ‘‘reaction button’’ 10 cm away fromeach other vertically. The participant was sitting by the panel. Movement



time (MT) was measured for the right and left hand of each participant byrecording the time between releasing the stand-by button and pressing thereaction button when the visual stimulus appeared (yellow light). The 10randomised visual stimuli were given in about 6 minutes, and the participantwas instructed to react as quickly as possible each time. The dominant handwas tested first. The variables included hand movement time, recorded inmilliseconds (ms).

Statistical analysis

An analysis of movement time (MT) was carried out separately fordominant and non-dominant hand. The statistics included arithmeticmean (M), standard deviation (SD), and mean squared deviation (QD) asa qualitative indicator of the MT results’ homogeneity in research groups. Avariance analysis (ANOVA) was used as a main statistical method to finddifferences in hand MT among participants presenting different limblaterality patterns.

The time needed for the motor task should depend on handedness(whether the dominant or the non-dominant hand is used), but in the light ofour hypothesis should also depend on the limb laterality pattern. It wasdesirable to have one statistical model incorporating not only the effect ofsingle predictors but also the effect of combinations of predictors. In ourexperiment an almost equal number of women and men took part (29women and 31 men) so we decided to take gender into consideration in thestatistical design despite the smaller statistical power in this aspect. A linearmixed model ANOVA was used, incorporating the main effects of handdominance (HD), foot dominance (FD), and gender as well as theirinteractions. The selected model contained the three main effects, and thethree two-way interactions (HD*FD, gender*HD, gender*FD). The onethree-way interaction was also recorded (gender*HD*FD). The Bonferronimethod in post-hoc testing was also used in more detailed analysis of MTdifferences in groups with different laterality patterns. All statistics werecalculated by means of the Statistica software 7.1. by Statsoft.

RESULTS

Handedness effect

A difference in MT in performance with dominant and non-dominant handwas found. Participants generally performed better with the preferred hand,with a mean MT of 114.71929.62 (mean9SD), and handedness showed asignificant main effect on hand performance, F(2, 57)"4.09, p".023. Left-



handed participants performed slightly better with the dominant hand thandid right-handed participants (110.93924.2 ms and 118. 50931.6 ms) butwith no statistical effect. In what was a rather astonishing result, the minordifferences between results obtained with the dominant and non-dominanthand were found in right-handers (Figure 1).

Footedness effect

No main effect of footedness on hand MTwas found (p".36). However, theanalysis of mean squared deviation (QD) of left and right hand performance(treated as an qualitative indicator of the results’ homogeneity in researchgroups) indicated that left-footed participants were significantly morehomogeneous in hand MT than right-footed participants, F(2, 55)"5.972,p".003 (see Figure 3).

Laterality pattern effect

The statistical analysis indicated that the model of hand!foot lateralitypattern was an important interaction influencing the level of handperformance, which required fast simple movement time. The mixed-model ANOVA analysis showed significant differences in MT amonggroups of participants with different laterality patterns, F(2, 55)"5.964,p".004. Participants presenting the cross-lateral limb domination patterns(RH/LF, LH/RF) performed better than those with congruent dominationpatterns. The model of right-side-congruent limb dominance (RH/RF) inour study was related to the slowest movement time in the research group,for right hand (dominant) as well as left hand performance. Furtherstatistical analysis using the Bonferroni method, shown in Figure 2,confirmed differences in performance between samples of right-handedparticipants (groups of RH/RF and RH/LF), as statistically significantresults for left hand performance at the level of .01 (p".004) and forright hand MT at the level of .05 (p".034). In left-handers no sta-tistical effect between cross-lateral and congruent laterality patterns wasfound.

This seems to confirm the greater homogeneity of non-right-handers inmotor functions suggested previously in the literature (Peters & Ivanoff,1999); however, previous studies did not take the footedness effect intoconsideration. Our results may be due to the effect of greater homogeneity ofleft-handed persons in everyday motor performance, which may reflectstrong social pressure as far as hand performance is concerned (it would beinteresting to check this effect on precise foot performance).



Gender effect

The next step of our analysis was to compare hand MT results betweenmales and females presenting different limb laterality patterns. Generally,male participants had an advantage in MT for both right and left hand, and

right hand MT left hand MT

right handed left handed

hand dominance

108

110

112

114

116

118

120

122

124m

ovem

ent t

ime

(ms)

Figure 1. Mean movement time and hand dominance in participants.



minor differences in performance of the dominant and non-dominant handwere observed in the group of men, but all with no statistical support. Nosignificant gender effect on MT results in groups of participants withdifferent limb laterality patterns was found (p".19).

DISCUSSION

Handedness effect

The value of MT tests in hand dominance assessment has been introducedpreviously in the literature (Nicoletti et al., 2005; Plamondon & Alimi,1997). Our results generally confirm the dominant hand advantage in thisaspect of hand performance. The minor differences in performance of thedominant and non-dominant hand observed in the group of menindicated the strongest lateralisation of women in motor functions, whichwas suggested previously by Peters (1991). The results of this experimentdo not support Boulinquez and Bartelemy’s idea of superiority of the lefthand in reaction time, which contradicts the theory of contralateralhemispheric influence as an exclusive motor control mechanism ofhand movements (Bartelemy & Boulinquez, 2001, 2002; Boulinquez &

MT RH MT LH

RH/RF LH/LF RH/LF LH/LF

laterality pattern

80

90

100

110

120

130

140

150

160

mov

emen

t tim

e (m

s)

Figure 2. Mean values90.95 confidence intervals of movement time (MT) in four laterality patterns.



Bartelemy, 2000). In our study right-handed participants presented greaterhomogeneity of results obtained with the dominant and non-dominanthand, which is in contrast to other findings suggesting that left-handers

QD RQD L

RH/RF LH/LF RH/LF LH/RF

laterality pattern

5

10

15

20

25

30

35

40

45

50

Figure 3. Mean squared deviations of right (QD R) and left hand (QD L) movement time9confidence intervals in relation to limb laterality pattern.



show weaker lateral preferences in motor tasks (Oldfield, 1971; Peters &Ivanoff, 1999). Taking into consideration the complex aetiology ofhandedness, it is supposed that the structure of this phenomenon isvery sensitive to the sample structure and depends on participant selection(Doyen & Carlier, 2002). In our experiment we did not measure intra-group differences in performance, taking into consideration the meanvalues of each group of participants. Left-handers are reported to be avery heterogeneous group, especially in non-preferred hand performance(Doyen & Carlier, 2002).

Footedness effect

In our experiment footedness did not show a main effect on handperformance quality. We only found left-footed participants to be morehomogeneous in motor performance than right-footed ones, with noinfluence of sole foot dominance on the values of MT in handperformance. Footedness has been suggested in some previous experimentsto be an important factor predicting the level of motor preparation, notmuch influenced by dextral social pressures, which makes it a sensitiveindex of hemispheric specialisation (Chapman et al., 1997; Elias &Bryden, 1998; Elias, Bryden, & Bulman-Fleming, 1998) however, themotor control of foot performance is still unclear (Foundas et al., 1998).Our results on hand MT demonstrate the more complex character ofthe motor preparation system in humans, where footedness does notplay a major role in hand performance but has an influence on the resultof motor action, as part of the inner structure of the motor controlsystem.

Laterality pattern effect

This research provides insight into the relationship between hand motorperformance and limb laterality pattern. Our results demonstrate how thelevel of MT not only reflects hand dominance, but also seems to be stronglyinfluenced by the limb laterality pattern. In our study the cross-lateralpattern of hand!foot dominance was related to a higher level of hand MT, incomparison to participants with a congruent hand!foot dominance pattern.The pattern of right-side-congruent limb dominance (RH/RF) was con-nected with the slowest MT in the research group, for both left and righthand performance. Our results confirm those obtained by Beling et al.(1998), suggesting the existence of a relationship of lower limb dominancewith handedness in right- and left-handers. Significant differences in motorperformance among various laterality patterns lead to the question of why



the lack of independence of hand and foot in motor control of rapid aimedmovements occurs.

Within the current context, our findings partly contradict models andtheories based on hand performance lateral asymmetries as an effect ofexclusively central motor control. It has been suggested so far that motorperformance of the upper limbs is influenced only by central informationprocessing, while the effect for the lower limbs is influenced only byperipheral motor control (Kato & Asami, 1998). Asymmetry in neuro-motor performance is assumed to be linked with brain laterality connectedwith hemispheric specialisation (Gasser et al., 2005; Springer & Deutsch,2004). However, studies in the area of motor control have consistentlygenerated contradictory results on the correlation between left hemispherelaterality and right hand leading when comparing left and right handreaction times in relation to hand dominance (Barthelemy & Boulinguez,2001, 2002; Carson, Chua, Elliot, & Goodman, 1990).

However, other mediating factors may contribute to hand performance.According to our hypothesis one distinct possibility is that quality ofdiscrete limb movement in humans is the effect of interactions on differentmotor control levels, where the central motor control structures andprocesses (hemispheric specialisation), locomotor centres of limb perfor-mance (CPGs), and also peripheral motor control factors may be involvedsimultaneously. We assume that the whole movement-producing systemreceives inputs not only from higher cortical areas (brain hemispheres) andpossibly other structures within the central nervous system, but also fromperipheral sensors (in particular, visual receptors, vestibular receptors, andproprioreceptors). The complexity of motor laterality can be the effect ofasymmetries of neuromuscular activity and movement generation processes(the aetiology of such asymmetries is a different problem*genetic and/orenvironmental factors can be involved). The effect of laterality pattern onhand performance could be influenced by afferent and efferent signals inthe neural system, where lateral limb preferences play a modifying role inmotor programming and execution. Our hypothesis brings support to someother findings suggesting the role of peripheral factors in rapid movementsperformed with the hands (Jaric, 2000; Schaal et al., 2004). This effectconfirms the urgent need for research on upper and lower limb laterality inlight of differences in neurological mechanisms involved in motor control,as suggested by Peters (1990, 1991). Although the simplicity of psycho-motor performance tests makes them an attractive means of assessingmotor laterality, a more involved research process is likely necessary toconfirm or reject our hypothesis. Limb performance measures should beassociated with brain-imaging techniques and more sophisticated neuro-physiologic examination of motor and sensory functions of peripheralnerves. Viewing laterality in motor performance as an effect of a motor



control ‘‘internet’’ may be the key to understanding the mechanisms ofasymmetry in human movements.

Manuscript received 31 May 2007Revised manuscript received 6 March 2008

First published online 31 May 2008

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