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Mindy F. Levin; Osnat Snir; Dario G. Liebermann; Harold Weingarden; Patrice L. Weiss |
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Title |
Virtual Reality Versus Conventional Treatment of Reaching Ability in Chronic Stroke: Clinical Feasibility Study |
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2012 |
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Neurology and Therapy |
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1 |
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3 |
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1-15 |
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Abstract |
Introduction
The objective of this study was to evaluate the potential of exercises performed in a 2D video-capture virtual reality (VR) training environment to improve upper limb motor ability in stroke patients compared to those performed in conventional therapy.
Methods
A small sample randomized control trial, in an outpatient rehabilitation center with 12 patients with chronic stroke, aged 33–80 years, who were randomly allocated to video-capture VR therapy and conventional therapy groups. All patients participated in four clinical evaluation sessions (pre-test 1, pre-test 2, post-test, follow-up) and nine 45-minute intervention sessions over a 3-week period. Main outcomes assessed were Body Structure and Function (impairment: Fugl–Meyer Assessment [FMA]; Composite Spasticity Index [CSI]; Reaching Performance Scale for Stroke), Activity (Box and Blocks; Wolf Motor Function Test [WMFT]), and Participation (Motor Activity Log) levels of the International Classification of Functioning.
Results
Improvements occurred in both groups, but more patients in the VR group improved upper limb clinical impairment (FMA, CSI) and activity scores (WMFT) and improvements occurred earlier. Patients in the VR group also reported satisfaction with the novel treatment.
Conclusions
The modest advantage of VR over conventional training supports further investigation of the effect of video-capture VR or VR combined with conventional therapy in larger-scale randomized, more intense controlled studies. |
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42 |
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Author |
Kapur, Shweta; Friedman, Jason; Zatsiorsky, Vladimir M.; Latash, Mark L. |
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Title |
Finger interaction in a three-dimensional pressing task |
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Journal Article |
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Year |
2010 |
Publication |
Experimental Brain Research |
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203 |
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1 |
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101-118 |
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Accurate control of forces produced by the fingers is essential for performing object manipulation. This study examines the indices of finger interaction when accurate time profiles of force are produced in different directions, while using one of the fingers or all four fingers of the hand. We hypothesized that patterns of unintended force production among shear force components may involve features not observed in the earlier studies of vertical force production. In particular, we expected to see unintended forces generated by non-task fingers not in the
direction on the instructed force but in the opposite direction as well as substantial force production in directions orthogonal to the instructed direction. We also tested a hypothesis that multi-finger synergies, quantified using the framework of the uncontrolled manifold hypothesis, will help reduce across-trials variance of both total force magnitude and direction. Young, healthy subjects were required to produce accurate ramps of force in five different directions by
pressing on force sensors with the fingers of the right (dominant) hand. The index finger induced the smallest unintended forces in non-task fingers. The little finger showed the smallest unintended forces when it was a non-task finger. Task fingers showed substantial force production in directions orthogonal to the intended force direction. During four-finger tasks, individual force vectors typically pointed off the task direction, with these deviations nearly
perfectly matched to produce a resultant force in the task direction. Multi-finger synergy indices reflected strong co-variation in the space of finger modes (commands to fingers) that reduced variability of the total force magnitude and direction across trials. The synergy indices increased in magnitude over the first 30% of the trial time and then stayed at a nearly constant level. The synergy index for stabilization of total force magnitude was higher for shear force components as compared to the downward pressing force component. The results suggest complex interactions between enslaving and synergic force adjustments, possibly reflecting the experience with everyday prehensile tasks. For the first time, the data document multi-finger synergies stabilizing both shear force magnitude and force vector direction. These synergies may play a major role in
stabilizing the hand action during object manipulation. |
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Penn State @ write.to.jason @ |
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20 |
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Flash, T.; Richardson, M. E.; Handzel, A. A.; Liebermann, D. G. |
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Title |
Computational Models and Geometric Approaches in Arm Trajectory Control Studies |
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2003 |
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Progress in Motor Control III: From Basic Science to Applications |
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Human Kinetics |
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Champaign, Il |
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M. L. Latash; M. F. Levin |
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44 |
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Liebermann, D.G.; Franks, I. M. |
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The use of feedback-based technologies in skill acquisition |
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2004 |
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Notational analysis of Sport and Coaching Science |
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E & FN Spon Pub |
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M. Hughes; I.M. Franks |
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45 |
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Carmeli E.; Liebermann, D.G. |
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Title |
The Function of the Aging Hand |
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2007 |
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The Geriatric Rehabilitation Manual |
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Elsevier |
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NY |
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T. L. Kauffman; M. Moran; J. Barr |
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