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Author Liebermann, D.G.; Berman, S.; Weingarden H.; Levin, M.F.; Weiss, P.L. doi  openurl
  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  
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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 Frenkel-Toledo, S.; Yamanaka, J.; Friedman, J.; Feldman, A.G.; Levin, M.F. pdf  url
doi  openurl
  Title Referent control of anticipatory grip force during reaching in stroke: an experimental and modeling study Type Journal Article
  Year 2019 Publication Experimental Brain Research Abbreviated Journal Exp Brain Res  
  Volume 237 Issue 7 Pages 1655-1672  
  Keywords Anticipatory grip force; Referent control; Stroke  
  Abstract To evaluate normal and impaired control of anticipatory grip force (GF) modulation, we compared GF production during horizontal arm movements in healthy and post-stroke subjects, and, based on a physiologically feasible dynamic model, determined referent control variables underlying the GF-arm motion coordination in each group. 63% of 13 healthy and 48% of 13 stroke subjects produced low sustained initial force (< 10 N) and increased GF prior to arm movement. Movement-related GF increases were higher during fast compared to self-paced arm extension movements only in the healthy group. Differences in the patterns of anticipatory GF increases before the arm movement onset between groups occurred during fast extension arm movement only. In the stroke group, longer delays between the onset of GF change and elbow motion were related to clinical upper limb deficits. Simulations showed that GFs could emerge from the difference between the actual and the referent hand aperture (Ra) specified by the CNS. Similarly, arm movement could result from changes in the referent elbow position (Re) and could be affected by the co-activation (C) command. A subgroup of stroke subjects, who increased GF before arm movement, could specify different patterns of the referent variables while reproducing the healthy typical pattern of GF-arm coordination. Stroke subjects, who increased GF after arm movement onset, also used different referent strategies than controls. Thus, altered anticipatory GF behavior in stroke subjects may be explained by deficits in referent control.  
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  Series Volume Series Issue Edition  
  ISSN (up) 0014-4819 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:30976821 Approved no  
  Call Number Serial 98  
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Author Merdler, T.; Liebermann, D.G.; Levin, M.F.; Berman, S. url  doi
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  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 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  
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  Series Volume Series Issue Edition  
  ISSN (up) 1050-6411 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:23566477 Approved no  
  Call Number Serial 69  
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Author Liebermann, D.G.; Berman, S.; Weiss, P.L.T.; Levin, M.F. url  doi
openurl 
  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  
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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 (up) 1534-4320 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:22907972 Approved no  
  Call Number Serial 28  
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Author Levin, M.F.; Liebermann, D.G.; Parmet, Y.; Berman, S. url  doi
openurl 
  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.  
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  Language English Summary Language Original Title  
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  Series Volume Series Issue Edition  
  ISSN (up) 1545-9683 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:26510934 Approved no  
  Call Number Serial 79  
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