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Davidowitz, I.; Parmet, Y.; Frenkel-Toledo, S.; Banina, M.C.; Soroker, N.; Solomon, J.M.; Liebermann, D.G.; Levin, M.F.; Berman, S. |
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Title |
Relationship Between Spasticity and Upper-Limb Movement Disorders in Individuals With Subacute Stroke Using Stochastic Spatiotemporal Modeling |
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Journal Article |
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Year |
2019 |
Publication |
Neurorehabilitation and Neural Repair |
Abbreviated Journal |
Neurorehabil Neural Repair |
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33 |
Issue |
2 |
Pages |
141-152 |
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Keywords |
Gaussian mixture model; Kullback-Liebler divergence; spasticity; stroke; upper-limb kinematics |
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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. |
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1 Ben-Gurion University of the Negev, Beer-Sheva, Israel |
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1545-9683 |
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PMID:30744528 |
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93 |
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Liebermann, D.G.; Berman, S.; Weiss, P.L.T.; Levin, M.F. |
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Title |
Kinematics of reaching movements in a 2-d virtual environment in adults with and without stroke |
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Journal Article |
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Year |
2012 |
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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 |
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20 |
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6 |
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778-787 |
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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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1534-4320 |
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PMID:22907972 |
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28 |
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Flash, T.; Richardson, M. E.; Handzel, A. A.; Liebermann, D. G. |
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Title |
Computational Models and Geometric Approaches in Arm Trajectory Control Studies |
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Book Chapter |
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2003 |
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Progress in Motor Control III: From Basic Science to Applications |
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Human Kinetics |
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Champaign, Il |
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M. L. Latash; M. F. Levin |
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44 |
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Liebermann, D.G.; Franks, I. M. |
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Title |
The use of feedback-based technologies in skill acquisition |
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2004 |
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Notational analysis of Sport and Coaching Science |
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E & FN Spon Pub |
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M. Hughes; I.M. Franks |
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45 |
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Author |
Carmeli E.; Liebermann, D.G. |
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Title |
The Function of the Aging Hand |
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2007 |
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The Geriatric Rehabilitation Manual |
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Elsevier |
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NY |
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T. L. Kauffman; M. Moran; J. Barr |
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