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	Author	Prushansky, T.; Kaplan-Gadasi, L.; Friedman, J.
	Title	The relationship between thoracic posture and ultrasound echo intensity of muscles spanning this region in healthy men and women			Type	Journal Article
	Year	2023	Publication	Physiotherapy Theory and Practice	Abbreviated Journal	Physiother Theory Pract
	Volume	39	Issue	6	Pages	1257-1265
	Keywords	Ultrasound imaging; muscle echogenicity; posture; thoracic kyphosis
	Abstract	PURPOSE: Skeletal muscle echogenicity intensity (EI) is considered a measure of muscle quality, being associated with old age and pathologies. Whether EI variations can be identified in healthy adults, due to habitual shortened or elongated muscle position is unknown. Thus, this study aimed to assess the relationship between thoracic kyphosis angulation and EI scores of muscles spanning this region ((Lower Trapezius (LT), Rhomboid Major (RM), Erector Spine (ES)) in healthy young people and in addition to examine the relationship between the change in thoracic kyphosis angle from relaxed to upright position (â�� degrees ) and the EI of these muscles. METHODS: Thoracic kyphosis in relaxed and erect standing was measured using a digital inclinometer in 29 healthy adults (16 women, 13 men), aged 25-35 years. The thoracic kyphosis angles including the difference between relaxed and erect postures (â�� degrees ) were correlated to the EI scores of right and left LT, RM and ES. RESULTS: No significant differences in EI were found between the 3 muscles EI or between sides, hence they were pooled together to a total thoracic EI score (TTEI). Although the TTEI did not correlate with relaxed or erect thoracic kyphosis, it was significantly but negatively correlated with â�� degrees in the entire group: Pearson's correlation coefficient of r = -0.544; p = .01 and in men; r = -0.732; p = .01, failing to reach significance in women; r = -0.457. CONCLUSION: The negative association between the EI of the explored muscles and â�� degrees could imply a possible relationship between these muscles range of movement excursions and their composition.
	Address	Department of Physical Therapy, the Stanley Stayer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
	Corporate Author				Thesis
	Publisher		Place of Publication		Editor
	Language	English	Summary Language		Original Title
	Series Editor		Series Title		Abbreviated Series Title
	Series Volume		Series Issue		Edition
	ISSN	0959-3985	ISBN		Medium
	Area		Expedition		Conference
	Notes	PMID:35125048			Approved	no
	Call Number				Serial	116
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	Author	Banina, M.C.; Molad, R.; Solomon, J.S.; Berman, S.; Soroker, N.; Frenkel-Toledo, S.; Liebermann, D.G.; Levin, M.F.
	Title	Exercise intensity of the upper limb can be enhanced using a virtual rehabilitation system			Type	Journal Article
	Year	2020	Publication	Disability and Rehabilitation. Assistive Technology	Abbreviated Journal	Disabil Rehabil Assist Technol
	Volume		Issue		Pages	1-7
	Keywords	Stroke; difficulty; exercise therapy; intensity; personalized exercise; upper limb; virtual reality
	Abstract	Purpose: Motor recovery of the upper limb (UL) is related to exercise intensity, defined as movement repetitions divided by minutes in active therapy, and task difficulty. However, the degree to which UL training in virtual reality (VR) applications deliver intense and challenging exercise and whether these factors are considered in different centres for people with different sensorimotor impairment levels is not evidenced. We determined if (1) a VR programme can deliver high UL exercise intensity in people with sub-acute stroke across different environments and (2) exercise intensity and difficulty differed among patients with different levels of UL sensorimotor impairment.Methods: Participants with sub-acute stroke (<6 months) with Fugl-Meyer scores ranging from 14 to 57, completed 10 approximately 50-min UL training sessions using three unilateral and one bilateral VR activity over 2 weeks in centres located in three countries. Training time, number of movement repetitions, and success rates were extracted from game activity logs. Exercise intensity was calculated for each participant, related to UL impairment, and compared between centres.Results: Exercise intensity was high and was progressed similarly in all centres. Participants had most difficulty with bilateral and lateral reaching activities. Exercise intensity was not, while success rate of only one unilateral activity was related to UL severity.Conclusion: The level of intensity attained with this VR exercise programme was higher than that reported in current stroke therapy practice. Although progression through different activity levels was similar between centres, clearer guidelines for exercise progression should be provided by the VR application.Implications for rehabilitationVR rehabilitation systems can be used to deliver intensive exercise programmes.VR rehabilitation systems need to be designed with measurable progressions through difficulty levels.
	Address	Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Laval, Canada
	Corporate Author				Thesis
	Publisher		Place of Publication		Editor
	Language	English	Summary Language		Original Title
	Series Editor		Series Title		Abbreviated Series Title
	Series Volume		Series Issue		Edition
	ISSN	1748-3107	ISBN		Medium
	Area		Expedition		Conference
	Notes	PMID:32421460			Approved	no
	Call Number				Serial	106
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	Author	Ezrati, O.; Friedman, J.; Dar, R.
	Title	Attenuation of access to internal states in high obsessive-compulsive individuals might increase susceptibility to false feedback: Evidence from a visuo-motor hand-reaching task			Type	Journal Article
	Year	2019	Publication	Journal of Behavior Therapy and Experimental Psychiatry	Abbreviated Journal	Journal of Behavior Therapy and Experimental Psychiatry
	Volume	65	Issue		Pages	101445
	Keywords	Obsessive-compulsive disorder; Movement; Agency; Proprioception; Proxies
	Abstract	Background and objectives The Seeking Proxies for Internal States (SPIS) model of obsessive-compulsive disorder (OCD) posits that obsessive-compulsive (OC) individuals have attenuated access to their internal states. Hence, they seek and rely on proxies, or discernible substitutes for these internal states. In previous studies, participants with high OC tendencies and OCD patients, compared to controls, showed increased reliance on external proxies and were more influenced by false feedback when judging their internal states. This study is the first to examine the effects of false feedback on performance of hand movements in participants with high and low OC tendencies. Method Thirty-four participants with high OC tendencies and 34 participants with low OC tendencies were asked to perform accurate hand reaches without visual feedback in two separate sessions of a computerized hand-reaching task: once after valid feedback training of their hand location and once with false-rotated feedback. We assessed the accuracy and directional adaptation of participants' reaches. Results As predicted, high OC participants evidenced a larger decrease in their hand positioning accuracy after training with false feedback compared to low OC participants. Limitations The generalization of our findings to OCD requires replication with a clinical sample. Conclusions These results suggest that in addition to self-perceptions, motor performance of OC individuals is prone to be overly influenced by false feedback, possibly due to attenuated access to proprioceptive cues. These findings may be particularly relevant to understanding the distorted sense of agency in OCD.
	Address
	Corporate Author				Thesis
	Publisher		Place of Publication		Editor
	Language		Summary Language		Original Title
	Series Editor		Series Title		Abbreviated Series Title
	Series Volume		Series Issue		Edition
	ISSN	0005-7916	ISBN		Medium
	Area		Expedition		Conference
	Notes				Approved	no
	Call Number				Serial	95
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	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
	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
	Corporate Author				Thesis
	Publisher		Place of Publication		Editor
	Language	English	Summary Language		Original Title
	Series Editor		Series Title		Abbreviated Series Title
	Series Volume		Series Issue		Edition
	ISSN	2045-2322	ISBN		Medium
	Area		Expedition		Conference
	Notes	PMID:38129527; PMCID:PMC10739929			Approved	no
	Call Number				Serial	121
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	Author	Lackritz, H.; Parmet, Y.; Frenkel-Toledo, S.; Banina, M.C.; Soroker, N.; Solomon, J.M.; Liebermann, D.G.; Levin, M.F.; Berman, S.
	Title	Effect of post-stroke spasticity on voluntary movement of the upper limb			Type	Journal Article
	Year	2021	Publication	Journal of Neuroengineering and Rehabilitation	Abbreviated Journal	J Neuroeng Rehabil
	Volume	18	Issue	1	Pages	81
	Keywords	Gaussian mixture model; Hellinger's distance; Hemiparesis; Kinematics; Kullback-Liebler divergence; Spasticity; Stochastic model; Stroke
	Abstract	BACKGROUND: Hemiparesis following stroke is often accompanied by spasticity. Spasticity is one factor among the multiple components of the upper motor neuron syndrome that contributes to movement impairment. However, the specific contribution of spasticity is difficult to isolate and quantify. We propose a new method of quantification and evaluation of the impact of spasticity on the quality of movement following stroke. METHODS: Spasticity was assessed using the Tonic Stretch Reflex Threshold (TSRT). TSRT was analyzed in relation to stochastic models of motion to quantify the deviation of the hemiparetic upper limb motion from the normal motion patterns during a reaching task. Specifically, we assessed the impact of spasticity in the elbow flexors on reaching motion patterns using two distinct measures of the 'distance' between pathological and normal movement, (a) the bidirectional Kullback-Liebler divergence (BKLD) and (b) Hellinger's distance (HD). These measures differ in their sensitivity to different confounding variables. Motor impairment was assessed clinically by the Fugl-Meyer assessment scale for the upper extremity (FMA-UE). Forty-two first-event stroke patients in the subacute phase and 13 healthy controls of similar age participated in the study. Elbow motion was analyzed in the context of repeated reach-to-grasp movements towards four differently located targets. Log-BKLD and HD along with movement time, final elbow extension angle, mean elbow velocity, peak elbow velocity, and the number of velocity peaks of the elbow motion were computed. RESULTS: Upper limb kinematics in patients with lower FMA-UE scores (greater impairment) showed greater deviation from normality when the distance between impaired and normal elbow motion was analyzed either with the BKLD or HD measures. The severity of spasticity, reflected by the TSRT, was related to the distance between impaired and normal elbow motion analyzed with either distance measure. Mean elbow velocity differed between targets, however HD was not sensitive to target location. This may point at effects of spasticity on motion quality that go beyond effects on velocity. CONCLUSIONS: The two methods for analyzing pathological movement post-stroke provide new options for studying the relationship between spasticity and movement quality under different spatiotemporal constraints.
	Address	The Zlotowski Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. sigalbe@bgu.ac.il
	Corporate Author				Thesis
	Publisher		Place of Publication		Editor
	Language	English	Summary Language		Original Title
	Series Editor		Series Title		Abbreviated Series Title
	Series Volume		Series Issue		Edition
	ISSN	1743-0003	ISBN		Medium
	Area		Expedition		Conference
	Notes	PMID:33985543			Approved	no
	Call Number				Serial	108
Permanent link to this record