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Author Liebermann, D.G.; Levin, M.F.; McIntyre, J.; Weiss, P.L.; Berman, S.
Title (up) 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 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
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 1557-170X ISBN Medium
Area Expedition Conference
Notes PMID:21096047 Approved no
Call Number Serial 30
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Author Merdler, T.; Liebermann, D.G.; Levin, M.F.; Berman, S.
Title (up) 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 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
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Author Levin, M.F.; Liebermann, D.G.; Parmet, Y.; Berman, S.
Title (up) Compensatory Versus Noncompensatory Shoulder Movements Used for Reaching in Stroke Type Journal Article
Year 2015 Publication Neurorehabilitation and Neural Repair Abbreviated Journal Neurorehabil Neural Repair
Volume Issue Pages
Keywords adaptation; arm movement; compensation; kinematics; recovery; rehabilitation
Abstract BACKGROUND: The extent to which the upper-limb flexor synergy constrains or compensates for arm motor impairment during reaching is controversial. This synergy can be quantified with a minimal marker set describing movements of the arm-plane. OBJECTIVES: To determine whether and how (a) upper-limb flexor synergy in patients with chronic stroke contributes to reaching movements to different arm workspace locations and (b) reaching deficits can be characterized by arm-plane motion. METHODS: Sixteen post-stroke and 8 healthy control subjects made unrestrained reaching movements to targets located in ipsilateral, central, and contralateral arm workspaces. Arm-plane, arm, and trunk motion, and their temporal and spatial linkages were analyzed. RESULTS: Individuals with moderate/severe stroke used greater arm-plane movement and compensatory trunk movement compared to those with mild stroke and control subjects. Arm-plane and trunk movements were more temporally coupled in stroke compared with controls. Reaching accuracy was related to different segment and joint combinations for each target and group: arm-plane movement in controls and mild stroke subjects, and trunk and elbow movements in moderate/severe stroke subjects. Arm-plane movement increased with time since stroke and when combined with trunk rotation, discriminated between different subject groups for reaching the central and contralateral targets. Trunk movement and arm-plane angle during target reaches predicted the subject group. CONCLUSIONS: The upper-limb flexor synergy was used adaptively for reaching accuracy by patients with mild, but not moderate/severe stroke. The flexor synergy, as parameterized by the amount of arm-plane motion, can be used by clinicians to identify levels of motor recovery in patients with stroke.
Address
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 1545-9683 ISBN Medium
Area Expedition Conference
Notes PMID:26510934 Approved no
Call Number Serial 79
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Author Berman, S.; Liebermann, D.G.; McIntyre, J.
Title (up) Constrained Motion Control on a Hemispherical Surface – Path Planning Type Journal Article
Year 2014 Publication Journal of Neurophysiology Abbreviated Journal J Neurophysiol
Volume 111 Issue 5 Pages 954-968
Keywords Constrained motion; geodesics; path planning
Abstract Surface-constrained motion, i.e., motion constraint by a rigid surface, is commonly found in daily activities. The current work investigates the choice of hand paths constrained to a concave hemispherical surface. To gain insight regarding the paths and their relationship with task dynamics, we simulated various control policies. The simulations demonstrated that following a geodesic path is advantageous not only in terms of path length, but also in terms of motor planning and sensitivity to motor command errors. These stem from the fact that the applied forces lie in a single plane (that of the geodesic path itself). To test whether human subjects indeed follow the geodesic, and to see how such motion compares to other paths, we recorded movements in a virtual haptic-visual environment from eleven healthy subjects. The task was comprised of point-to-point motion between targets at two elevations (30 degrees and 60 degrees ). Three typical choices of paths were observed from a frontal plane projection of the paths: circular arcs, straight lines, and arcs close to the geodesic path for each elevation. Based on the measured hand paths, we applied k-means blind separation to divide the subjects into three groups and compared performance indicators. The analysis confirmed that subjects who followed paths closest to the geodesic produced faster and smoother movements, compared to the others. The 'better' performance reflects the dynamical advantages of following the geodesic path, as shown by the simulations, and may also reflect invariant features of the control policies used to produce such a surface-constrained motion.
Address Ben-Gurion University of the Negev
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 0022-3077 ISBN Medium
Area Expedition Conference
Notes PMID:24259548 Approved no
Call Number Serial 72
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Author Lackritz, H.; Parmet, Y.; Frenkel-Toledo, S.; Banina, M.C.; Soroker, N.; Solomon, J.M.; Liebermann, D.G.; Levin, M.F.; Berman, S.
Title (up) Effect of post-stroke spasticity on voluntary movement of the upper limb Type Journal Article
Year 2021 Publication Journal of Neuroengineering and Rehabilitation Abbreviated Journal J Neuroeng Rehabil
Volume 18 Issue 1 Pages 81
Keywords Gaussian mixture model; Hellinger's distance; Hemiparesis; Kinematics; Kullback-Liebler divergence; Spasticity; Stochastic model; Stroke
Abstract BACKGROUND: Hemiparesis following stroke is often accompanied by spasticity. Spasticity is one factor among the multiple components of the upper motor neuron syndrome that contributes to movement impairment. However, the specific contribution of spasticity is difficult to isolate and quantify. We propose a new method of quantification and evaluation of the impact of spasticity on the quality of movement following stroke. METHODS: Spasticity was assessed using the Tonic Stretch Reflex Threshold (TSRT). TSRT was analyzed in relation to stochastic models of motion to quantify the deviation of the hemiparetic upper limb motion from the normal motion patterns during a reaching task. Specifically, we assessed the impact of spasticity in the elbow flexors on reaching motion patterns using two distinct measures of the 'distance' between pathological and normal movement, (a) the bidirectional Kullback-Liebler divergence (BKLD) and (b) Hellinger's distance (HD). These measures differ in their sensitivity to different confounding variables. Motor impairment was assessed clinically by the Fugl-Meyer assessment scale for the upper extremity (FMA-UE). Forty-two first-event stroke patients in the subacute phase and 13 healthy controls of similar age participated in the study. Elbow motion was analyzed in the context of repeated reach-to-grasp movements towards four differently located targets. Log-BKLD and HD along with movement time, final elbow extension angle, mean elbow velocity, peak elbow velocity, and the number of velocity peaks of the elbow motion were computed. RESULTS: Upper limb kinematics in patients with lower FMA-UE scores (greater impairment) showed greater deviation from normality when the distance between impaired and normal elbow motion was analyzed either with the BKLD or HD measures. The severity of spasticity, reflected by the TSRT, was related to the distance between impaired and normal elbow motion analyzed with either distance measure. Mean elbow velocity differed between targets, however HD was not sensitive to target location. This may point at effects of spasticity on motion quality that go beyond effects on velocity. CONCLUSIONS: The two methods for analyzing pathological movement post-stroke provide new options for studying the relationship between spasticity and movement quality under different spatiotemporal constraints.
Address The Zlotowski Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. sigalbe@bgu.ac.il
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 1743-0003 ISBN Medium
Area Expedition Conference
Notes PMID:33985543 Approved no
Call Number Serial 108
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