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Author Levin, M.F.; Banina, M.C.; Frenkel-Toledo, S.; Berman, S.; Soroker, N.; Solomon, J.M.; Liebermann, D.G. url  doi
openurl 
  Title Personalized upper limb training combined with anodal-tDCS for sensorimotor recovery in spastic hemiparesis: study protocol for a randomized controlled trial Type Journal Article
  Year 2018 Publication Trials Abbreviated Journal Trials  
  Volume 19 Issue 1 Pages 7  
  Keywords (down) Neurorehabilitation; Spasticity; Spatial threshold; Stroke; tDCS  
  Abstract BACKGROUND: Recovery of voluntary movement is a main rehabilitation goal. Efforts to identify effective upper limb (UL) interventions after stroke have been unsatisfactory. This study includes personalized impairment-based UL reaching training in virtual reality (VR) combined with non-invasive brain stimulation to enhance motor learning. The approach is guided by limiting reaching training to the angular zone in which active control is preserved (“active control zone”) after identification of a “spasticity zone”. Anodal transcranial direct current stimulation (a-tDCS) is used to facilitate activation of the affected hemisphere and enhance inter-hemispheric balance. The purpose of the study is to investigate the effectiveness of personalized reaching training, with and without a-tDCS, to increase the range of active elbow control and improve UL function. METHODS: This single-blind randomized controlled trial will take place at four academic rehabilitation centers in Canada, India and Israel. The intervention involves 10 days of personalized VR reaching training with both groups receiving the same intensity of treatment. Participants with sub-acute stroke aged 25 to 80 years with elbow spasticity will be randomized to one of three groups: personalized training (reaching within individually determined active control zones) with a-tDCS (group 1) or sham-tDCS (group 2), or non-personalized training (reaching regardless of active control zones) with a-tDCS (group 3). A baseline assessment will be performed at randomization and two follow-up assessments will occur at the end of the intervention and at 1 month post intervention. Main outcomes are elbow-flexor spatial threshold and ratio of spasticity zone to full elbow-extension range. Secondary outcomes include the Modified Ashworth Scale, Fugl-Meyer Assessment, Streamlined Wolf Motor Function Test and UL kinematics during a standardized reach-to-grasp task. DISCUSSION: This study will provide evidence on the effectiveness of personalized treatment on spasticity and UL motor ability and feasibility of using low-cost interventions in low-to-middle-income countries. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT02725853 . Initially registered on 12 January 2016.  
  Address Department of Physical Therapy, Stanley Steyer 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 1745-6215 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:29301545 Approved no  
  Call Number Serial 87  
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Author Raveh, E.; Portnoy, S.; Friedman, J. pdf  url
doi  openurl
  Title Adding vibrotactile feedback to a myoelectric-controlled hand improves performance when online visual feedback is disturbed Type Journal Article
  Year 2018 Publication Human Movement Science Abbreviated Journal Hum Mov Sci  
  Volume 58 Issue Pages 32-40  
  Keywords (down) Myoelectric prostheses; Sensorimotor control; Upper limb amputation; Visual feedback  
  Abstract We investigated whether adding vibrotactile feedback to a myoelectric-controlled hand, when visual feedback is disturbed, can improve performance during a functional test. For this purpose, able-bodied subjects, activating a myoelectric-controlled hand attached to their right hand performed the modified Box & Blocks test, grasping and manipulating wooden blocks over a partition. This was performed in 3 conditions, using a repeated-measures design: in full light, in a dark room where visual feedback was disturbed and no auditory feedback – one time with the addition of tactile feedback provided during object grasping and manipulation, and one time without any tactile feedback. The average time needed to transfer one block was measured, and an infrared camera was used to give information on the number of grasping errors during performance of the test. Our results show that when vibrotactile feedback was provided, performance time was reduced significantly, compared with when no vibrotactile feedback was available. Furthermore, the accuracy of grasping and manipulation was improved, reflected by significantly fewer errors during test performance. In conclusion, adding vibrotactile feedback to a myoelectric-controlled hand has positive effects on functional performance when visual feedback is disturbed. This may have applications to current myoelectric-controlled hands, as adding tactile feedback may help prosthesis users to improve their functional ability during daily life activities in different environments, particularly when limited visual feedback is available or desirable.  
  Address Physical Therapy Department, Sackler Faculty of Medicine, Tel Aviv University, Israel. Electronic address: jason@post.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 0167-9457 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:29353091 Approved no  
  Call Number Serial 88  
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Author Zopf, R.; Friedman, J.; Williams, M.A. pdf  url
doi  openurl
  Title The plausibility of visual information for hand ownership modulates multisensory synchrony perception Type Journal Article
  Year 2015 Publication Abbreviated Journal Experimental Brain Research  
  Volume 233 Issue 8 Pages 2311-2321  
  Keywords (down) Multisensory perception; Temporal synchrony perception; Virtual hand; Body representations; Body ownership; Sensory predictions  
  Abstract We are frequently changing the position of our bodies and body parts within complex environments. How does the brain keep track of one’s own body? Current models of body ownership state that visual body ownership cues such as viewed object form and orientation are combined with multisensory information to correctly identify one’s own body, estimate its current location and evoke an experience of body ownership. Within this framework, it may be possible that the brain relies on a separate perceptual analysis of body ownership cues (e.g. form, orientation, multisensory synchrony). Alternatively, these cues may interact in earlier stages of perceptual processing—visually derived body form and orientation cues may, for example, directly modulate temporal synchrony perception. The aim of the present study was to distinguish between these two alternatives. We employed a virtual hand set-up and psychophysical methods. In a two-interval force-choice task, participants were asked to detect temporal delays between executed index finger movements and observed movements. We found that body-specifying cues interact in perceptual processing. Specifically, we show that plausible visual information (both form and orientation) for one’s own body led to significantly better detection performance for small multisensory asynchronies compared to implausible visual information. We suggest that this perceptual modulation when visual information plausible for one’s own body is present is a consequence of body-specific sensory predictions.  
  Address  
  Corporate Author Thesis  
  Publisher Springer Berlin Heidelberg Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0014-4819 ISBN Medium  
  Area Expedition Conference  
  Notes Approved no  
  Call Number Serial 78  
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Author Portnoy, S.; Rosenberg, L.; Alazraki, T.; Elyakim, E.; Friedman, J. pdf  url
doi  openurl
  Title Differences in Muscle Activity Patterns and Graphical Product Quality in Children Copying and Tracing Activities on Horizontal or Vertical Surfaces Type Journal Article
  Year 2015 Publication Journal of Electromyography and Kinesiology Abbreviated Journal Journal of Electromyography and Kinesiology  
  Volume 25 Issue 3 Pages 540�547  
  Keywords (down) Motor equivalence; Electromyography; Tablet; Occupational Therapy; Muscle fatigue; Motor control  
  Abstract The observation that a given task, e.g. producing a signature, looks similar when created by different motor commands and different muscles groups is known as motor equivalence. Relatively little data exists regarding the characteristics of motor equivalence in children. In this study, we compared the level of performance when performing a tracing task and copying figures in two common postures: while sitting at a desk and while standing in front of a wall, among preschool children. In addition, we compared muscle activity patterns in both postures. Specifically, we compared the movements of 35 five- to six-year old children, recording the same movements of copying figures and path tracing on an electronic tablet in both a horizontal orientation, while sitting, and a vertical orientation, while standing. Different muscle activation patterns were observed between the postures, however no significant difference in the performance level was found, providing evidence of motor equivalence at this young age. The study presents a straightforward method of assessing motor equivalence that can be extended to other stages of development as well as motor disorders.  
  Address  
  Corporate Author Thesis  
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  Language Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1050-6411 ISBN Medium  
  Area Expedition Conference  
  Notes Approved no  
  Call Number Serial 77  
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Author Friedman, J.; Korman, M. pdf  url
doi  openurl
  Title Offline Optimization of the Relative Timing of Movements in a Sequence Is Blocked by Retroactive Behavioral Interference Type Journal Article
  Year 2016 Publication Frontiers in Human Neuroscience Abbreviated Journal Front. Hum. Neurosci.  
  Volume 10 Issue Pages 623  
  Keywords (down) learning; interference; consolidation; finger movements; kinematics  
  Abstract Acquisition of motor skills often involves the concatenation of single movements into sequences. Along the course of learning, sequential performance becomes progressively faster and smoother, presumably by optimization of both motor planning and motor execution. Following its encoding during training, “how-to” memory undergoes consolidation, reflecting transformations in performance and its neurobiological underpinnings over time. This offline post-training memory process is characterized by two phenomena: reduced sensitivity to interference and the emergence of delayed, typically overnight, gains in performance. Here, using a training protocol that effectively induces motor sequence memory consolidation, we tested temporal and kinematic parameters of performance within (online) and between (offline) sessions, and their sensitivity to retroactive interference. One group learned a given finger-to-thumb opposition sequence (FOS), and showed robust delayed (consolidation) gains in the number of correct sequences performed at 24 h. A second group learned an additional (interference) FOS shortly after the first and did not show delayed gains. Reduction of touch times and inter-movement intervals significantly contributed to the overall offline improvement of performance overnight. However, only the offline inter-movement interval shortening was selectively blocked by the interference experience. Velocity and amplitude, comprising movement time, also significantly changed across the consolidation period but were interference-insensitive. Moreover, they paradoxically canceled out each other. Current results suggest that shifts in the representation of the trained sequence are subserved by multiple processes: from distinct changes in kinematic characteristics of individual finger movements to high-level, temporal reorganization of the movements as a unit. Each of these processes has a distinct time course and a specific susceptibility to retroactive interference. This multiple-component view may bridge the gap in understanding the link between the behavioral changes, which define online and offline learning, and the biological mechanisms that support those changes.  
  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 1662-5161 ISBN Medium  
  Area Expedition Conference  
  Notes Approved no  
  Call Number Serial 83  
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