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	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
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	Author	Frenkel-Toledo, S.; Yamanaka, J.; Friedman, J.; Feldman, A.G.; Levin, M.F.
	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.
	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	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.
	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
	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	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
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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	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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