| |
Records |
Links |
|
Author |
Levin, M.F.; Banina, M.C.; Frenkel-Toledo, S.; Berman, S.; Soroker, N.; Solomon, J.M.; Liebermann, D.G. |
|
| |
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 |
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 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Raveh, E.; Portnoy, S.; Friedman, J. |
|
| |
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 |
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 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Davidowitz, I.; Parmet, Y.; Frenkel-Toledo, S.; Banina, M.C.; Soroker, N.; Solomon, J.M.; Liebermann, D.G.; Levin, M.F.; Berman, S. |
|
| |
Title |
Relationship Between Spasticity and Upper-Limb Movement Disorders in Individuals With Subacute Stroke Using Stochastic Spatiotemporal Modeling |
Type |
Journal Article |
| |
Year |
2019 |
Publication |
Neurorehabilitation and Neural Repair |
Abbreviated Journal |
Neurorehabil Neural Repair |
|
| |
Volume |
33 |
Issue |
2 |
Pages |
141-152 |
|
| |
Keywords |
Gaussian mixture model; Kullback-Liebler divergence; spasticity; stroke; upper-limb kinematics |
|
| |
Abstract |
BACKGROUND: Spasticity is common in patients with stroke, yet current quantification methods are insufficient for determining the relationship between spasticity and voluntary movement deficits. This is partly a result of the effects of spasticity on spatiotemporal characteristics of movement and the variability of voluntary movement. These can be captured by Gaussian mixture models (GMMs). OBJECTIVES: To determine the influence of spasticity on upper-limb voluntary motion, as assessed by the bidirectional Kullback-Liebler divergence (BKLD) between motion GMMs. METHODS: A total of 16 individuals with subacute stroke and 13 healthy aged-equivalent controls reached to grasp 4 targets (near-center, contralateral, far-center, and ipsilateral). Two-dimensional GMMs (angle and time) were estimated for elbow extension motion. BKLD was computed for each individual and target, within the control group and between the control and stroke groups. Movement time, final elbow angle, average elbow velocity, and velocity smoothness were computed. RESULTS: Between-group BKLDs were much larger than within control-group BKLDs. Between-group BKLDs for the near-center target were lower than those for the far-center and contralateral targets, but similar to that for the ipsilateral target. For those with stroke, the final angle was lower for the near-center target, and the average velocity was higher. Velocity smoothness was lower for the near-center than for the ipsilateral target. Elbow flexor and extensor passive muscle resistance (Modified Ashworth Scale) strongly explained BKLD values. CONCLUSIONS: Results support the view that individuals with poststroke spasticity have a velocity-dependent reduction in active elbow joint range and that BKLD can be used as an objective measure of the effects of spasticity on reaching kinematics. |
|
| |
Address |
1 Ben-Gurion University of the Negev, Beer-Sheva, 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 |
1545-9683 |
ISBN |
|
Medium |
|
|
| |
Area |
|
Expedition |
|
Conference |
|
|
| |
Notes |
PMID:30744528 |
Approved |
no |
|
| |
Call Number |
|
Serial |
93 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Friedman, J.; Korman, M. |
|
| |
Title |
Observation of an expert model induces a skilled movement coordination pattern in a single session of intermittent practice |
Type |
Journal Article |
| |
Year |
2019 |
Publication |
Scientific Reports |
Abbreviated Journal |
Sci Rep |
|
| |
Volume |
9 |
Issue |
1 |
Pages |
4609 |
|
| |
Keywords |
|
|
| |
Abstract |
We tested how observation of a skilled pattern of planar movements can assist in the learning of a new motor skill, which otherwise requires rigorous long-term practice to achieve fast and smooth performance. Sixty participants performed a sequence of planar hand movements on pre-test, acquisition, post-test and 24 h post-training blocks, under 1 of 4 conditions: an observation group (OG), a slowed observation group (SOG), a random motion control group (RMCG) and a double physical training control group (DPTCG). The OG and SOG observed an expert model's right hand performing the study task intermittently throughout acquisition, RMCG observed random dots movement instead of a model. Participants in the DPTCG received extra physical practice trials instead of the visually observed trials. Kinematic analysis revealed that only in conditions with observation of an expert model there was an instant robust improvement in motor planning of the task. This step-wise improvement was not only persistent in post-training retests but was also apparently implicit and subject to further incremental improvements in movement strategy over the period of 24 hours. The rapid change in motor strategy was accompanied by a transient within-session increase in spatial error for the observation groups, but this went away by 24 h post-training. We suggest that observation of hand movements of an expert model coaligned with self-produced movements during training can significantly condense the time-course of ecologically relevant drawing/writing skill mastery. |
|
| |
Address |
|
|
| |
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:30872661 |
Approved |
no |
|
| |
Call Number |
|
Serial |
94 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Raveh, E.; Portnoy, S.; Friedman, J. |
|
| |
Title |
Myoelectric Prosthesis Users Improve Performance Time and Accuracy Using Vibrotactile Feedback When Visual Feedback Is Disturbed |
Type |
Journal Article |
| |
Year |
2018 |
Publication |
Archives of Physical Medicine and Rehabilitation |
Abbreviated Journal |
Arch Phys Med Rehabil |
|
| |
Volume |
99 |
Issue |
11 |
Pages |
2263-2270 |
|
| |
Keywords |
Amputation; Prosthesis; Rehabilitation; Sensory feedback; Visual feedback |
|
| |
Abstract |
OBJECTIVE: To evaluate the effects of adding vibrotactile feedback (VTF) in myoelectric prosthesis users during performance of a functional task when visual feedback is disturbed. DESIGN: A repeated-measures design with a counter-balanced order of 3 conditions. SETTING: Laboratory setting. PARTICIPANTS: Transradial amputees using a myoelectric prosthesis with normal or corrected eyesight (N=12, median age 65+/-13y). Exclusion criteria were orthopedic or neurologic problems. INTERVENTIONS: All participants performed the modified Box and Blocks Test, grasping and manipulating 16 blocks over a partition using their myoelectric prosthesis. This was performed 3 times: in full light, in a dark room without VTF, and in a dark room with VTF. MAIN OUTCOME MEASURES: Performance time, that is, the time needed to transfer 1 block, and accuracy during performance, measured by number of empty grips, empty transitions with no block and block drops from the hand. RESULTS: Significant differences were found in all outcome measures when VTF was added, with improved performance time (4.2 vs 5.3s) and a reduced number of grasping errors (3.0 vs 6.5 empty grips, 1.5 vs 4 empty transitions, 2.0 vs 4.5 block drops). CONCLUSIONS: Adding VTF to myoelectric prosthesis users has positive effects on performance time and accuracy when visual feedback is disturbed. |
|
| |
Address |
|
|
| |
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 |
0003-9993 |
ISBN |
|
Medium |
|
|
| |
Area |
|
Expedition |
|
Conference |
|
|
| |
Notes |
PMID:29935153 |
Approved |
no |
|
| |
Call Number |
|
Serial |
96 |
|
| Permanent link to this record |
