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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 (up) J Electromyogr Kinesiol
Volume 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
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 Lackritz, H.; Parmet, Y.; Frenkel-Toledo, S.; Banina, M.C.; Soroker, N.; Solomon, J.M.; Liebermann, D.G.; Levin, M.F.; Berman, S.
Title 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 (up) 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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Author Levin, M.F.; Liebermann, D.G.; Parmet, Y.; Berman, S.
Title Compensatory Versus Noncompensatory Shoulder Movements Used for Reaching in Stroke Type Journal Article
Year 2015 Publication Neurorehabilitation and Neural Repair Abbreviated Journal (up) 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 Davidowitz, I.; Parmet, Y.; Frenkel-Toledo, S.; Banina, M.C.; Soroker, N.; Solomon, J.M.; Liebermann, D.G.; Levin, M.F.; Berman, S.
Title Relationship Between Spasticity and Upper-Limb Movement Disorders in Individuals With Subacute Stroke Using Stochastic Spatiotemporal Modeling Type Journal Article
Year 2019 Publication Neurorehabilitation and Neural Repair Abbreviated Journal (up) Neurorehabil Neural Repair
Volume 33 Issue 2 Pages 141-152
Keywords Gaussian mixture model; Kullback-Liebler divergence; spasticity; stroke; upper-limb kinematics
Abstract BACKGROUND: Spasticity is common in patients with stroke, yet current quantification methods are insufficient for determining the relationship between spasticity and voluntary movement deficits. This is partly a result of the effects of spasticity on spatiotemporal characteristics of movement and the variability of voluntary movement. These can be captured by Gaussian mixture models (GMMs). OBJECTIVES: To determine the influence of spasticity on upper-limb voluntary motion, as assessed by the bidirectional Kullback-Liebler divergence (BKLD) between motion GMMs. METHODS: A total of 16 individuals with subacute stroke and 13 healthy aged-equivalent controls reached to grasp 4 targets (near-center, contralateral, far-center, and ipsilateral). Two-dimensional GMMs (angle and time) were estimated for elbow extension motion. BKLD was computed for each individual and target, within the control group and between the control and stroke groups. Movement time, final elbow angle, average elbow velocity, and velocity smoothness were computed. RESULTS: Between-group BKLDs were much larger than within control-group BKLDs. Between-group BKLDs for the near-center target were lower than those for the far-center and contralateral targets, but similar to that for the ipsilateral target. For those with stroke, the final angle was lower for the near-center target, and the average velocity was higher. Velocity smoothness was lower for the near-center than for the ipsilateral target. Elbow flexor and extensor passive muscle resistance (Modified Ashworth Scale) strongly explained BKLD values. CONCLUSIONS: Results support the view that individuals with poststroke spasticity have a velocity-dependent reduction in active elbow joint range and that BKLD can be used as an objective measure of the effects of spasticity on reaching kinematics.
Address 1 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 1545-9683 ISBN Medium
Area Expedition Conference
Notes PMID:30744528 Approved no
Call Number Serial 93
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Author Frenkel-Toledo, S.; Levin, M.F.; Berman, S.; Liebermann, D.G.; Baniña, M.C.; Solomon, J.M.; Ofir-Geva, S.; Soroker, N.
Title Shared and distinct voxel-based lesion-symptom mappings for spasticity and impaired movement in the hemiparetic upper limb Type Journal Article
Year 2022 Publication Scientific Reports Abbreviated Journal (up) Sci Rep
Volume 12 Issue 1 Pages
Keywords
Abstract
Address
Corporate Author Thesis
Publisher Place of Publication Editor
Language Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 2045-2322 ISBN Medium
Area Expedition Conference
Notes Approved no
Call Number Serial 113
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