| |
Records |
Links |
|
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 |
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 |
| |
|
| |
|
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 |
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 |
|
| Permanent link to this record |
| |
|
| |
|
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 |
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. |
|
| |
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 |
1534-4320 |
ISBN |
|
Medium |
|
|
| |
Area |
|
Expedition |
|
Conference |
|
|
| |
Notes |
PMID:22907972 |
Approved |
no |
|
| |
Call Number |
|
Serial |
28 |
|
| Permanent link to this record |
| |
|
| |
|
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 |
|
|
| |
Volume |
|
Issue |
|
Pages |
179-184 |
|
| |
Keywords |
|
|
| |
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. |
|
| |
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 |
|
ISBN |
|
Medium |
|
|
| |
Area |
|
Expedition |
|
Conference |
|
|
| |
Notes |
|
Approved |
no |
|
| |
Call Number |
|
Serial |
52 |
|
| Permanent link to this record |
| |
|
| |
|
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 |
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 |
|
| Permanent link to this record |
