| Records |
| Author |
Levin, M.F.; Berman, S.; Weiss, N.; Parmet, Y.; Banina, M.C.; Frenkel-Toledo, S.; Soroker, N.; Solomon, J.M.; Liebermann, D.G. |
| Title |
ENHANCE proof-of-concept three-arm randomized trial: effects of reaching training of the hemiparetic upper limb restricted to the spasticity-free elbow range |
Type |
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| Year |
2023 |
Publication |
Scientific Reports |
Abbreviated Journal |
Sci Rep |
| Volume |
13 |
Issue |
1 |
Pages |
22934 |
| Keywords |
Humans; Elbow; *Transcranial Direct Current Stimulation; Muscle Spasticity/therapy/complications; Upper Extremity; *Elbow Joint; *Stroke/complications; *Stroke Rehabilitation/methods |
| Abstract |
Post-stroke motor recovery processes remain unknown. Timescales and patterns of upper-limb (UL) recovery suggest a major impact of biological factors, with modest contributions from rehabilitation. We assessed a novel impairment-based training motivated by motor control theory where reaching occurs within the spasticity-free elbow range. Patients with subacute stroke (</= 6 month; n = 46) and elbow flexor spasticity were randomly allocated to a 10-day UL training protocol, either personalized by restricting reaching to the spasticity-free elbow range defined by the tonic stretch reflex threshold (TSRT) or non-personalized (non-restricted) and with/without anodal transcranial direct current stimulation. Outcomes assessed before, after, and 1 month post-intervention were elbow flexor TSRT angle and reach-to-grasp arm kinematics (primary) and stretch reflex velocity sensitivity, clinical impairment, and activity (secondary). Results were analyzed for 3 groups as well as those of the effects of impairment-based training. Clinical measures improved in both groups. Spasticity-free range training resulted in faster and smoother reaches, smaller (i.e., better) arm-plane path length, and closer-to-normal shoulder/elbow movement patterns. Non-personalized training improved clinical scores without improving arm kinematics, suggesting that clinical measures do not account for movement quality. Impairment-based training within a spasticity-free elbow range is promising since it may improve clinical scores together with arm movement quality.Clinical Trial Registration: URL: http://www.clinicaltrials.gov . Unique Identifier: NCT02725853; Initial registration date: 01/04/2016. |
Address  |
Department of Physical Therapy, Faculty of Medicine, Stanley Steyer School of Health Professions, Tel Aviv University, POB 39040, 61390, Ramat Aviv, Tel Aviv, Israel. dlieberm@tauex.tau.ac.il |
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2045-2322 |
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PMID:38129527; PMCID:PMC10739929 |
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no |
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121 |
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Grinberg, A.; Strong, A.; Strandberg, J.; Selling, J.; Liebermann, D.G.; Bjorklund, M.; Hager, C.K. |
| Title |
Electrocortical activity associated with movement-related fear: a methodological exploration of a threat-conditioning paradigm involving destabilising perturbations during quiet standing |
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Journal Article |
| Year |
2024 |
Publication |
Experimental Brain Research |
Abbreviated Journal |
Exp Brain Res |
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Pages |
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Cnv; Eeg; Erp; Kinesiophobia; Moving platform; Re-injury anxiety |
| Abstract |
Musculoskeletal trauma often leads to lasting psychological impacts stemming from concerns of future injuries. Often referred to as kinesiophobia or re-injury anxiety, such concerns have been shown to hinder return to physical activity and are believed to increase the risk for secondary injuries. Screening for re-injury anxiety is currently restricted to subjective questionnaires, which are prone to self-report bias. We introduce a novel approach to objectively identify electrocortical activity associated with the threat of destabilising perturbations. We aimed to explore its feasibility among non-injured persons, with potential future implementation for screening of re-injury anxiety. Twenty-three participants stood blindfolded on a translational balance perturbation platform. Consecutive auditory stimuli were provided as low (neutral stimulus [CS(-)]) or high (conditioned stimulus [CS(+)]) tones. For the main experimental protocol (Protocol I), half of the high tones were followed by a perturbation in one of eight unpredictable directions. A separate validation protocol (Protocol II) requiring voluntary squatting without perturbations was performed with 12 participants. Event-related potentials (ERP) were computed from electroencephalography recordings and significant time-domain components were detected using an interval-wise testing procedure. High-amplitude early contingent negative variation (CNV) waves were significantly greater for CS(+) compared with CS(-) trials in all channels for Protocol I (> 521-800ms), most prominently over frontal and central midline locations (P </= 0.001). For Protocol II, shorter frontal ERP components were observed (541-609ms). Our test paradigm revealed electrocortical activation possibly associated with movement-related fear. Exploring the discriminative validity of the paradigm among individuals with and without self-reported re-injury anxiety is warranted. |
| Address |
Department of Community Medicine and Rehabilitation, Umea University, Umea, Sweden |
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0014-4819 |
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PMID:38896295 |
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no |
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122 |
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Wilf, M.; Korakin, A.; Bahat, Y.; Koren, O.; Galor, N.; Dagan, O.; Wright, W.G.; Friedman, J.; Plotnik, M. |
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Using virtual reality-based neurocognitive testing and eye tracking to study naturalistic cognitive-motor performance |
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Journal Article |
| Year |
2024 |
Publication |
Neuropsychologia |
Abbreviated Journal |
Neuropsychologia |
| Volume |
194 |
Issue |
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Pages |
108744 |
| Keywords |
Humans; Aged; *Eye-Tracking Technology; Cognition; Executive Function; *Virtual Reality; Aging; Color trails test; Fall risk; Hand kinematics; Pupil; Virtual reality |
| Abstract |
Natural human behavior arises from continuous interactions between the cognitive and motor domains. However, assessments of cognitive abilities are typically conducted using pen and paper tests, i.e., in isolation from “real life” cognitive-motor behavior and in artificial contexts. In the current study, we aimed to assess cognitive-motor task performance in a more naturalistic setting while recording multiple motor and eye tracking signals. Specifically, we aimed to (i) delineate the contribution of cognitive and motor components to overall task performance and (ii) probe for a link between cognitive-motor performance and pupil size. To that end, we used a virtual reality (VR) adaptation of a well-established neurocognitive test for executive functions, the 'Color Trails Test' (CTT). The VR-CTT involves performing 3D reaching movements to follow a trail of numbered targets. To tease apart the cognitive and motor components of task performance, we included two additional conditions: a condition where participants only used their eyes to perform the CTT task (using an eye tracking device), incurring reduced motor demands, and a condition where participants manually tracked visually-cued targets without numbers on them, incurring reduced cognitive demands. Our results from a group of 30 older adults (>65) showed that reducing cognitive demands shortened completion times more extensively than reducing motor demands. Conditions with higher cognitive demands had longer target search time, as well as decreased movement execution velocity and head-hand coordination. We found larger pupil sizes in the more cognitively demanding conditions, and an inverse correlation between pupil size and completion times across individuals in all task conditions. Lastly, we found a possible link between VR-CTT performance measures and clinical signatures of participants (fallers versus non-fallers). In summary, performance and pupil parameters were mainly dependent on task cognitive load, while maintaining systematic interindividual differences. We suggest that this paradigm opens the possibility for more detailed profiling of individual cognitive-motor performance capabilities in older adults and other at-risk populations. |
| Address |
Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Israel; Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel. Electronic address: Meir.Plotnik@sheba.health.gov.il |
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0028-3932 |
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PMID:38072162 |
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no |
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123 |
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Friedman, J.; Amiaz, A.; Korman, M. |
| Title |
The online and offline effects of changing movement timing variability during training on a finger-opposition task |
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Journal Article |
| Year |
2022 |
Publication |
Scientific Reports |
Abbreviated Journal |
Sci Rep |
| Volume |
12 |
Issue |
1 |
Pages |
13319 |
| Keywords |
Fingers; Humans; *Learning; *Motor Skills; Movement; Psychomotor Performance; Upper Extremity |
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In motor learning tasks, there is mixed evidence for whether increased task-relevant variability in early learning stages leads to improved outcomes. One problem is that there may be a connection between skill level and motor variability, such that participants who initially have more variability may also perform worse on the task, so will have more room to improve. To avoid this confound, we experimentally manipulated the amount of movement timing variability (MTV) during training to test whether it improves performance. Based on previous studies showing that most of the improvement in finger-opposition tasks comes from optimizing the relative onset time of the finger movements, we used auditory cues (beeps) to guide the onset times of sequential movements during a training session, and then assessed motor performance after the intervention. Participants were assigned to three groups that either: (a) followed a prescribed random rhythm for their finger touches (Variable MTV), (b) followed a fixed rhythm (Fixed control MTV), or (c) produced the entire sequence following a single beep (Unsupervised control MTV). While the intervention was successful in increasing MTV during training for the Variable group, it did not lead to improved outcomes post-training compared to either control group, and the use of fixed timing led to significantly worse performance compared to the Unsupervised control group. These results suggest that manipulating MTV through auditory cues does not produce greater learning than unconstrained training in motor sequence tasks. |
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2045-2322 |
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PMID:35922460; PMCID:PMC9349301 |
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115 |
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Thorpe, A.; Friedman, J.; Evans, S.; Nesbitt, K.; Eidels, A. |
| Title |
Mouse Movement Trajectories as an Indicator of Cognitive Workload |
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Journal Article |
| Year |
2022 |
Publication |
International Journal of Human-Computer Interaction |
Abbreviated Journal |
International Journal of Human-Computer Interaction |
| Volume |
38 |
Issue |
15 |
Pages |
1464-1479 |
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Assessing the cognitive impact of user interfaces is a shared focus of human-computer interaction researchers and cognitive scientists. Methods of cognitive assessment based on data derived from the system itself, rather than external apparatus, have the potential to be applied in a range of scenarios. The current study applied methods of analyzing kinematics to mouse movements in a computer-based task, alongside the detection response task, a standard workload measure. Sixty-five participants completed a task in which stationary stimuli were tar;geted using a mouse, with a within-subjects factor of task workload based on the number of targets to be hovered over with the mouse (one/two), and a between-subjects factor based on whether both targets (exhaustive) or just one target (minimum-time) needed to be hovered over to complete a trial when two targets were presented. Mouse movement onset times were slower and mouse movement trajectories exhibited more submovements when two targets were presented, than when one target was presented. Responses to the detection response task were also slower in this condition, indicating higher cognitive workload. However, these differences were only found for participants in the exhaustive condition, suggesting those in the minimum-time condition were not affected by the presence of the second target. Mouse movement trajectory results agreed with other measures of workload and task performance. Our findings suggest this analysis can be applied to workload assessments in real-world scenarios. |
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1044-7318 |
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117 |
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