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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121 |
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Author |
Geller, N.; Moringen, A.; Friedman, J. |
Title |
Learning juggling by gradually increasing difficulty vs. learning the complete skill results in different learning patterns |
Type |
Journal Article |
Year |
2023 |
Publication |
Frontiers in Psychology |
Abbreviated Journal |
Front Psychol |
Volume |
14 |
Issue |
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Pages |
1284053 |
Keywords |
coordination; difficulty; juggling; learning strategies; motor learning |
Abstract |
Motor learning is central to sports, medicine, and other health professions as it entails learning through practice. To achieve proficiency in a complex motor task, many hours of practice are required. Therefore, finding ways to speed up the learning process is important. This study examines the impact of different training approaches on learning three-ball cascade juggling. Participants were assigned to one of two groups: practicing by gradually increasing difficulty and elements of the juggling movement (“learning in parts”) or training on the complete skill from the start (“all-at-once”). Results revealed that although the all-at-once group in the early stages of learning showed greater improvement in performance, the “learning in parts” group managed to catch up, even over a relatively short period of time. The lack of difference in performance between the groups at the end of the training session suggests that the choice of training regime (between all-at-once and learning in parts), at least in the short term, can be selected based on other factors such as the learner's preference, practical considerations, and cognitive style. |
Address |
Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel |
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1664-1078 |
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PMID:38022928; PMCID:PMC10679398 |
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120 |
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Author |
Friedman, J.; Amiaz, A.; Korman, M. |
Title |
The online and offline effects of changing movement timing variability during training on a finger-opposition task |
Type |
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 |
Abstract |
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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no |
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Serial |
115 |
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Author |
Markstrom, J.L.; Liebermann, D.G.; Schelin, L.; Hager, C.K. |
Title |
Atypical Lower Limb Mechanics During Weight Acceptance of Stair Descent at Different Time Frames After Anterior Cruciate Ligament Reconstruction |
Type |
Journal Article |
Year |
2022 |
Publication |
The American Journal of Sports Medicine |
Abbreviated Journal |
Am J Sports Med |
Volume |
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Issue |
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Pages |
1-9 |
Keywords |
Acl; biomechanics; functional data analysis; motion analysis; stepping down |
Abstract |
BACKGROUND: An anterior cruciate ligament (ACL) rupture may result in poor sensorimotor knee control and, consequentially, adapted movement strategies to help maintain knee stability. Whether patients display atypical lower limb mechanics during weight acceptance of stair descent at different time frames after ACL reconstruction (ACLR) is unknown. PURPOSE: To compare the presence of atypical lower limb mechanics during the weight acceptance phase of stair descent among athletes at early, middle, and late time frames after unilateral ACLR. STUDY DESIGN: Controlled laboratory study. METHODS: A total of 49 athletes with ACLR were classified into 3 groups according to time after ACLR-early (<6 months; n = 17), middle (6-18 months; n = 16), and late (>18 months; n = 16)-and compared with asymptomatic athletes (control; n = 18). Sagittal plane hip, knee, and ankle angles; angular velocities; moments; and powers were compared between the ACLR groups' injured and noninjured legs and the control group as well as between legs within groups using functional data analysis methods. RESULTS: All 3 ACLR groups showed greater knee flexion angles and moments than the control group for injured and noninjured legs. For the other outcomes, the early group had, compared with the control group, less hip power absorption, more knee power absorption, lower ankle plantarflexion angle, lower ankle dorsiflexion moment, and less ankle power absorption for the injured leg and more knee power absorption and higher vertical ground reaction force for the noninjured leg. In addition, the late group showed differences from the control group for the injured leg revealing more knee power absorption and lower ankle plantarflexion angle. Only the early group took a longer time than the control group to complete weight acceptance and demonstrated asymmetry for multiple outcomes. CONCLUSION: Athletes with different time frames after ACLR revealed atypically large knee angles and moments during weight acceptance of stair descent for both the injured and the noninjured legs. These findings may express a chronically adapted strategy to increase knee control. In contrast, atypical hip and ankle mechanics seem restricted to an early time frame after ACLR. CLINICAL RELEVANCE: Rehabilitation after ACLR should include early training in controlling weight acceptance. Including a control group is essential when evaluating movement patterns after ACLR because both legs may be affected. |
Address |
Department of Community Medicine and Rehabilitation, Physiotherapy, Umea University, Umea, Sweden |
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0363-5465 |
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PMID:35604127 |
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no |
Call Number |
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Serial |
112 |
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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 (� 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 (� 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 � 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 � 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 |
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0959-3985 |
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PMID:35125048 |
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no |
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Serial |
116 |
Permanent link to this record |