|   | 
Details
   web
Records
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 23 Issue 4 Pages 938947
Keywords (up) 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
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 1050-6411 ISBN Medium
Area Expedition Conference
Notes PMID:23566477 Approved no
Call Number Serial 69
Permanent link to this record
 

 
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 (up) 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 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 Disabil Rehabil Assist Technol
Volume Issue Pages 1-7
Keywords (up) 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
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 1748-3107 ISBN Medium
Area Expedition Conference
Notes PMID:32421460 Approved no
Call Number Serial 106
Permanent link to this record