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Author Liebermann, D.G.; Berman, S.; Weingarden H.; Levin, M.F.; Weiss, P.L.
Title Kinematic features of arm and trunk movements in stroke patients and age-matched healthy controls during reaching in virtual and physical environments Type Conference Article
Year 2009 Publication Virtual Rehabilitation International Conference Abbreviated Journal (up)
Volume Issue Pages 179-184
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Abstract Motor performance of stroke patients and healthy individuals was compared in terms of selected kinematic features of arm and trunk movements while subjects reached for visual targets in virtual (VR) and physical (PH) environments. In PH, the targets were placed at an extended arm distance, while in VR comparably placed virtual targets were presented via GestureTek's IREX system. Our goal was to obtain further insights into research methods related to VR-based rehabilitation. Eight right-hemiparetic stroke patients (age =46-87 years) and 8 healthy adults (age =51-73 years) completed 84 reaching movements in VR and PH environments while seated. The results showed that arm and trunk movements differed in the two environments in patients and to a lesser extent in healthy individuals. Arm motion of patients became jerkier in VR, with larger paths and longer movement durations, and presented greater arm torsion (i.e., larger elbow rotations around the hand-shoulder axis). Interestingly, patients also showed a significant reduction of compensatory trunk movements during VR reaching. The findings indicate that when targets were perceived to be beyond hand reach, stroke patients may be less able to estimate 3D virtual target locations obtained from the 2D TV planar displays. This was not the case for healthy participants.
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Call Number Serial 52
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Author Liebermann, D.G.; Levin, M.F.; McIntyre, J.; Weiss, P.L.; Berman, S.
Title Arm path fragmentation and spatiotemporal features of hand reaching in healthy subjects and stroke patients Type Journal Article
Year 2010 Publication Conference Proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference Abbreviated Journal (up) Conf Proc IEEE Eng Med Biol Soc
Volume 2010 Issue Pages 5242-5245
Keywords Aged; Aged, 80 and over; Analysis of Variance; Arm/*physiology; Biomechanics/physiology; Female; Hand/*physiology; *Health; Humans; Male; Middle Aged; Movement/*physiology; Posture/physiology; Principal Component Analysis; Stroke/*physiopathology; Time Factors
Abstract Arm motion in healthy humans is characterized by smooth and relatively short paths. The current study focused on 3D reaching in stroke patients. Sixteen right-hemiparetic stroke patients and 8 healthy adults performed 42 reaching movements towards 3 visual targets located at an extended arm distance. Performance was assessed in terms of spatial and temporal features of the movement; i.e., hand path, arm posture and smoothness. Differences between groups and within subjects were hypothesized for spatial and temporal aspects of reaching under the assumption that both are independent. As expected, upper limb motion of patients was characterized by longer and jerkier hand paths and slower speeds. Assessment of the number of sub-movements within each movement did not clearly discriminate between groups. Principal component analyses revealed specific clusters of either spatial or temporal measures, which accounted for a large proportion of the variance in patients but not in healthy controls. These findings support the notion of a separation between spatial and temporal features of movement. Stroke patients may fail to integrate the two aspects when executing reaching movements towards visual targets.
Address Physical Therapy Dept., Sackler Faculty of Medicine, Tel Aviv University, 69978 Israel. dlieberm@post.tau.ac.il
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Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 1557-170X ISBN Medium
Area Expedition Conference
Notes PMID:21096047 Approved no
Call Number Serial 30
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Author Banina, M.C.; Molad, R.; Solomon, J.S.; Berman, S.; Soroker, N.; Frenkel-Toledo, S.; Liebermann, D.G.; Levin, M.F.
Title Exercise intensity of the upper limb can be enhanced using a virtual rehabilitation system Type Journal Article
Year 2020 Publication Disability and Rehabilitation. Assistive Technology Abbreviated Journal (up) Disabil Rehabil Assist Technol
Volume Issue Pages 1-7
Keywords Stroke; difficulty; exercise therapy; intensity; personalized exercise; upper limb; virtual reality
Abstract Purpose: Motor recovery of the upper limb (UL) is related to exercise intensity, defined as movement repetitions divided by minutes in active therapy, and task difficulty. However, the degree to which UL training in virtual reality (VR) applications deliver intense and challenging exercise and whether these factors are considered in different centres for people with different sensorimotor impairment levels is not evidenced. We determined if (1) a VR programme can deliver high UL exercise intensity in people with sub-acute stroke across different environments and (2) exercise intensity and difficulty differed among patients with different levels of UL sensorimotor impairment.Methods: Participants with sub-acute stroke (<6 months) with Fugl-Meyer scores ranging from 14 to 57, completed 10 approximately 50-min UL training sessions using three unilateral and one bilateral VR activity over 2 weeks in centres located in three countries. Training time, number of movement repetitions, and success rates were extracted from game activity logs. Exercise intensity was calculated for each participant, related to UL impairment, and compared between centres.Results: Exercise intensity was high and was progressed similarly in all centres. Participants had most difficulty with bilateral and lateral reaching activities. Exercise intensity was not, while success rate of only one unilateral activity was related to UL severity.Conclusion: The level of intensity attained with this VR exercise programme was higher than that reported in current stroke therapy practice. Although progression through different activity levels was similar between centres, clearer guidelines for exercise progression should be provided by the VR application.Implications for rehabilitationVR rehabilitation systems can be used to deliver intensive exercise programmes.VR rehabilitation systems need to be designed with measurable progressions through difficulty levels.
Address Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Laval, Canada
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Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 1748-3107 ISBN Medium
Area Expedition Conference
Notes PMID:32421460 Approved no
Call Number Serial 106
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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 (up) IEEE Trans Neural Syst Rehabil Eng
Volume 20 Issue 6 Pages 778-787
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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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Author Krasovsky, T.; Berman, S.; Liebermann, D.G.
Title Kinematic features of continuous hand reaching movements under simple and complex rhythmical constraints Type Journal Article
Year 2010 Publication Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology Abbreviated Journal (up) J Electromyogr Kinesiol
Volume 20 Issue 4 Pages 636-641
Keywords *Acoustic Stimulation; Adult; Biomechanics; *Cues; Female; Hand/*physiology; Humans; Male; Movement/*physiology
Abstract BACKGROUND: Auditory cues are known to alter movement kinematics in healthy people as well as in people with neurological conditions (e.g., Parkinson's disease or stroke). Pacing movement to rhythmical constraints is known to change both the spatial and temporal features of movement. However, the effect of complexity of pacing on the spatial and temporal kinematic properties is still poorly understood. The current study investigated spatial and temporal aspects of movement (path and speed, respectively) and their integration while subjects followed simple isochronous or complex non-isochronous rhythmical constraints. Spatiotemporal decoupling was expected under the latter constraint. METHODS: Ten subjects performed point-to-point hand movements towards visual targets on the surface of a hemisphere, while following continuous auditory cues of different pace and meter. The spatial and temporal properties of movement were compared to geodesic paths and unimodal bell-shaped speed profiles, respectively. Multiple two-way RM-ANOVAs (pace [1-2 Hz] x meter [duple-triple]) were performed on the different kinematic variables calculated to assess hand deviations from the model data (p< or = 0.05). RESULTS: As expected, increasing pace resulted in straighter hand paths and smoother speed profiles. Meter, however, affected only the path (shorter and straighter under triple) without significantly changing speed. Such an effect was observed at the slow pace only. CONCLUSIONS: Under simple rhythmic cues, an increase in pace causes spontaneous adjustments in spatial features (straighter hand paths) while preserving temporal ones (maximally-smoothed hand speeds). Complex rhythmical cues in contrast perturb spatiotemporal coupling and challenge movement control. These results may have important practical implications in motor rehabilitation.
Address Department of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Canada
Corporate Author Thesis
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Language English 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 PMID:20382031 Approved no
Call Number Serial 32
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