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Author Merdler, T.; Liebermann, D.G.; Levin, M.F.; Berman, S.
Title Arm-plane representation of shoulder compensation during pointing movements in patients with stroke Type Journal Article
Year 2013 Publication Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology Abbreviated Journal J Electromyogr Kinesiol
Volume (down) 23 Issue 4 Pages 938–947
Keywords Kinematics; Arm movement; Rehabilitation
Abstract Improvements in functional motor activities are often accompanied by motor compensations to overcome persistent motor impairment in the upper limb. Kinematic analysis is used to objectively quantify movement patterns including common motor compensations such as excessive trunk displacement during reaching. However, a common motor compensation to assist reaching, shoulder abduction, is not adequately characterized by current motion analysis approaches. We apply the arm-plane representation that accounts for the co-variation between movements of the whole arm, and investigate its ability to identify and quantify compensatory arm movements in stroke subjects when making forward arm reaches. This method has not been previously applied to the analysis of motion deficits. Sixteen adults with right post-stroke hemiparesis and eight healthy age-matched controls reached in three target directions (14 trials/target; sampling rate: 100Hz). Arm-plane movement was validated against endpoint, joint, and trunk kinematics and compared between groups. In stroke subjects, arm-plane measures were correlated with arm impairment (Fugl-Meyer Assessment) and ability (Box and Blocks) scores and were more sensitive than clinical measures to detect mild motor impairment. Arm-plane motion analysis provides new information about motor compensations involving the co-variation of shoulder and elbow movements that may help to understand the underlying motor deficits in patients with stroke.
Address Department of Industrial Engineering and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Series Volume Series Issue Edition
ISSN 1050-6411 ISBN Medium
Area Expedition Conference
Notes PMID:23566477 Approved no
Call Number Serial 69
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Author Harel Arzi; Tal Krasovsky; Moshe Pritsch; Dario G. Liebermann
Title Movement control in patients with shoulder instability: a comparison between patients after open surgery and nonoperated patients Type Journal Article
Year 2014 Publication Journal of Shoulder and Elbow Surgery Abbreviated Journal
Volume (down) 23 Issue 7 Pages 982–992
Keywords Smoothness; kinesthesis; arm kinematics; shoulder instability; open surgery
Abstract Background

Open surgery to correct shoulder instability is deemed to facilitate recovery of static and dynamic motor functions. Postoperative assessments focus primarily on static outcomes (e.g., repositioning accuracy). We introduce kinematic measures of arm smoothness to assess shoulder patients after open surgery and compare them with nonoperated patients. Performance among both groups of patients was hypothesized to differ. Postsurgery patients were expected to match healthy controls.

Methods

All participants performed pointing movements with the affected/dominant arm fully extended at fast, preferred, and slow speeds (36 trials per subject). Kinematic data were collected (100 Hz, 3 seconds), and mixed-design analyses of variance (group, speed) were performed with movement time, movement amplitude, acceleration time, and model-observed similarities as dependent variables. Nonparametric tests were performed for number of velocity peaks.

Results

Nonoperated and postsurgery patients showed similarities at preferred and faster movement speeds but not at slower speed. Postsurgery patients were closer to maximally smoothed motion and differed from healthy controls mainly during slow arm movements (closer to maximal smoothness, larger movement amplitude, shorter movement time, and lower number of peaks; i.e., less movement fragmentation).

Conclusions

Arm kinematic analyses suggest that open surgery stabilizes the shoulder but does not necessarily restore normal movement quality. Patients with recurrent anterior shoulder instability (RASI) seem to implement a “safe” but nonadaptive mode of action whereby preplanned stereotypical movements may be executed without depending on feedback. Rehabilitation of RASI patients should focus on restoring feedback-based movement control. Clinical assessment of RASI patients should include higher order kinematic descriptors.
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Notes Approved no
Call Number Serial 74
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Author Nahab, Fatta; Kundu, Prantik; Gallea, Cecile; Kakareka, John; Pursley, Randy; Pohida, Tom; Miletta, Nathaniel; Friedman, Jason; Hallett, Mark
Title The neural processes underlying self-agency Type Journal Article
Year 2011 Publication Cerebral Cortex Abbreviated Journal
Volume (down) 21 Issue 1 Pages 48-55
Keywords
Abstract Self-agency (SA) is the individual’s perception that an action is the consequence of his/her own intention. The neural networks underlying SA are not well understood. We carried out a novel, ecologically valid, virtual-reality experiment using BOLD-fMRI where SA could be modulated in real-time while subjects performed voluntary finger movements. Behavioral testing was also performed to assess the explicit judgment of SA. Twenty healthy volunteers completed the experiment. Results of the behavioral testing demonstrated paradigm validity along with the identification of a bias that led subjects to over- or underestimate the amount of control they had. The fMRI experiment identified two discrete networks. These leading and lagging networks likely represent a spatial and temporal flow of information, with the leading network serving the role of mismatch detection and the lagging network receiving this information and

mediating its elevation to conscious awareness, giving rise to SA.
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Notes Approved no
Call Number Penn State @ write.to.jason @ Serial 21
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Author Liebermann, D.G.; Buchman, A.S.; Franks, I.M.
Title Enhancement of motor rehabilitation through the use of information technologies Type Journal Article
Year 2006 Publication Clinical Biomechanics (Bristol, Avon) Abbreviated Journal Clin Biomech (Bristol, Avon)
Volume (down) 21 Issue 1 Pages 8-20
Keywords Biotechnology/*methods; Humans; Medical Informatics/*methods; Motion Therapy, Continuous Passive/*methods; Movement Disorders/*rehabilitation; Musculoskeletal Manipulations/methods; Rehabilitation/*methods; Robotics/*methods; Therapy, Computer-Assisted/*methods
Abstract The recent development of information technologies has dramatically increased the tools available for facilitating motor rehabilitation. This review focuses on technologies which can be used to augment movement-related information both to patients as well as to their therapists. A brief outline of the motor system emphasizes the role of spinal motor neurons in the control of voluntary movement and rehabilitative efforts. Technologies which induce passive motion to stimulate spinal motor output as well as technologies that stimulate active voluntary movements are discussed. Finally, we review technologies and notational methods that can be used to quantify and assess the quality of movement for evaluating the efficacy of motor rehabilitation efforts. We conclude that stronger evidence is necessary to determine the applicability of the wide range of technologies now available to clinical rehabilitation efforts.
Address Department of Physical Therapy, Sackler Faculty of Medicine, University of Tel Aviv, Israel. dlieberm@post.tau.ac.il
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Language English Summary Language Original Title
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ISSN 0268-0033 ISBN Medium
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Notes PMID:16198463 Approved no
Call Number Serial 49
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Author Liebermann, D.G.; Berman, S.; Weiss, P.L.T.; Levin, M.F.
Title Kinematics of reaching movements in a 2-d virtual environment in adults with and without stroke Type Journal Article
Year 2012 Publication IEEE Transactions on Neural Systems and Rehabilitation Engineering : a Publication of the IEEE Engineering in Medicine and Biology Society Abbreviated Journal IEEE Trans Neural Syst Rehabil Eng
Volume (down) 20 Issue 6 Pages 778-787
Keywords
Abstract Virtual reality environments are increasingly being used for upper limb rehabilitation in poststroke patients. Our goal was to determine if arm reaching movements made in a 2-D video-capture virtual reality environment are similar to those made in a comparable physical environment. We compared arm and trunk kinematics for reaches made with the right, dominant arm to three targets (14 trials per target) in both environments by 16 adults with right poststroke hemiparesis and by eight healthy age-matched controls. Movement kinematics were recorded with a three-camera optoelectronic system at 100 samples/s. Reaching movements made by both control and stroke subjects were affected by viewing the targets in the video-capture 2-D virtual environment. Movements were slower, shorter, less straight, less accurate and involved smaller ranges of shoulder and elbow joint excursions for target reaches in the virtual environment compared to the physical environment in all subjects. Thus, there was a decrease in the overall movement quality for movements made in the 2-D virtual environment. This suggests that 2-D video-capture virtual reality environments should be used with caution when the goal of the rehabilitation program is to improve the quality of movement patterns of the upper limb.
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Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 1534-4320 ISBN Medium
Area Expedition Conference
Notes PMID:22907972 Approved no
Call Number Serial 28
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