toggle visibility Search & Display Options

Select All    Deselect All
 |   | 
Details
   print
  Records Links
Author Frenkel-Toledo, S.; Levin, M.F.; Berman, S.; Liebermann, D.G.; Baniña, M.C.; Solomon, J.M.; Ofir-Geva, S.; Soroker, N. url  doi
openurl 
  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 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 (down) 2045-2322 ISBN Medium  
  Area Expedition Conference  
  Notes Approved no  
  Call Number Serial 113  
Permanent link to this record
 

 
Author Levin, M.F.; Berman, S.; Weiss, N.; Parmet, Y.; Banina, M.C.; Frenkel-Toledo, S.; Soroker, N.; Solomon, J.M.; Liebermann, D.G. url  doi
openurl 
  Title ENHANCE proof-of-concept three-arm randomized trial: effects of reaching training of the hemiparetic upper limb restricted to the spasticity-free elbow range Type
  Year 2023 Publication Scientific Reports Abbreviated Journal Sci Rep  
  Volume 13 Issue 1 Pages 22934  
  Keywords Humans; Elbow; *Transcranial Direct Current Stimulation; Muscle Spasticity/therapy/complications; Upper Extremity; *Elbow Joint; *Stroke/complications; *Stroke Rehabilitation/methods  
  Abstract Post-stroke motor recovery processes remain unknown. Timescales and patterns of upper-limb (UL) recovery suggest a major impact of biological factors, with modest contributions from rehabilitation. We assessed a novel impairment-based training motivated by motor control theory where reaching occurs within the spasticity-free elbow range. Patients with subacute stroke (</= 6 month; n = 46) and elbow flexor spasticity were randomly allocated to a 10-day UL training protocol, either personalized by restricting reaching to the spasticity-free elbow range defined by the tonic stretch reflex threshold (TSRT) or non-personalized (non-restricted) and with/without anodal transcranial direct current stimulation. Outcomes assessed before, after, and 1 month post-intervention were elbow flexor TSRT angle and reach-to-grasp arm kinematics (primary) and stretch reflex velocity sensitivity, clinical impairment, and activity (secondary). Results were analyzed for 3 groups as well as those of the effects of impairment-based training. Clinical measures improved in both groups. Spasticity-free range training resulted in faster and smoother reaches, smaller (i.e., better) arm-plane path length, and closer-to-normal shoulder/elbow movement patterns. Non-personalized training improved clinical scores without improving arm kinematics, suggesting that clinical measures do not account for movement quality. Impairment-based training within a spasticity-free elbow range is promising since it may improve clinical scores together with arm movement quality.Clinical Trial Registration: URL: http://www.clinicaltrials.gov . Unique Identifier: NCT02725853; Initial registration date: 01/04/2016.  
  Address Department of Physical Therapy, Faculty of Medicine, Stanley Steyer School of Health Professions, Tel Aviv University, POB 39040, 61390, Ramat Aviv, Tel Aviv, Israel. dlieberm@tauex.tau.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 (down) 2045-2322 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:38129527; PMCID:PMC10739929 Approved no  
  Call Number Serial 121  
Permanent link to this record
 

 
Author Lowenthal-Raz, J.; Liebermann, D.G.; Friedman, J.; Soroker, N. url  doi
openurl 
  Title Kinematic descriptors of arm reaching movement are sensitive to hemisphere-specific immediate neuromodulatory effects of transcranial direct current stimulation post stroke Type Journal Article
  Year 2024 Publication Scientific Reports Abbreviated Journal Sci Rep  
  Volume 14 Issue 1 Pages 11971  
  Keywords Humans; *Transcranial Direct Current Stimulation/methods; Male; Female; Middle Aged; *Stroke/physiopathology/therapy; Biomechanical Phenomena; Aged; *Arm/physiopathology; *Movement/physiology; *Stroke Rehabilitation/methods; Single-Blind Method; Cross-Over Studies  
  Abstract Transcranial direct current stimulation (tDCS) exerts beneficial effects on motor recovery after stroke, presumably by enhancement of adaptive neural plasticity. However, patients with extensive damage may experience null or deleterious effects with the predominant application mode of anodal (excitatory) stimulation of the damaged hemisphere. In such cases, excitatory stimulation of the non-damaged hemisphere might be considered. Here we asked whether tDCS exerts a measurable effect on movement quality of the hemiparetic upper limb, following just a single treatment session. Such effect may inform on the hemisphere that should be excited. Using a single-blinded crossover experimental design, stroke patients and healthy control subjects were assessed before and after anodal, cathodal and sham tDCS, each provided during a single session of reaching training (repeated point-to-point hand movement on an electronic tablet). Group comparisons of endpoint kinematics at baseline-number of peaks in the speed profile (NoP; smoothness), hand-path deviations from the straight line (SLD; accuracy) and movement time (MT; speed)-disclosed greater NoP, larger SLD and longer MT in the stroke group. NoP and MT revealed an advantage for anodal compared to sham stimulation of the lesioned hemisphere. NoP and MT improvements under anodal stimulation of the non-lesioned hemisphere correlated positively with the severity of hemiparesis. Damage to specific cortical regions and white-matter tracts was associated with lower kinematic gains from tDCS. The study shows that simple descriptors of movement kinematics of the hemiparetic upper limb are sensitive enough to demonstrate gain from neuromodulation by tDCS, following just a single session of reaching training. Moreover, the results show that tDCS-related gain is affected by the severity of baseline motor impairment, and by lesion topography.  
  Address Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel. nachum@soroker.online  
  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 (down) 2045-2322 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:38796610; PMCID:PMC11127956 Approved no  
  Call Number Serial 125  
Permanent link to this record
 

 
Author Grip, H.; Tengman, E.; Liebermann, D.G.; Hager, C.K. url  doi
openurl 
  Title Kinematic analyses including finite helical axes of drop jump landings demonstrate decreased knee control long after anterior cruciate ligament injury Type Journal Article
  Year 2019 Publication PloS one Abbreviated Journal PLoS One  
  Volume 14 Issue 10 Pages e0224261  
  Keywords  
  Abstract The purpose was to evaluate the dynamic knee control during a drop jump test following injury of the anterior cruciate ligament injury (ACL) using finite helical axes. Persons injured 17-28 years ago, treated with either physiotherapy (ACLPT, n = 23) or reconstruction and physiotherapy (ACLR, n = 28) and asymptomatic controls (CTRL, n = 22) performed a drop jump test, while kinematics were registered by motion capture. We analysed the Preparation phase (from maximal knee extension during flight until 50 ms post-touchdown) followed by an Action phase (until maximal knee flexion post-touchdown). Range of knee motion (RoM), and the length of each phase (Duration) were computed. The finite knee helical axis was analysed for momentary intervals of ~15 degrees of knee motion by its intersection (DeltaAP position) and inclination (DeltaAP Inclination) with the knee's Anterior-Posterior (AP) axis. Static knee laxity (KT100) and self-reported knee function (Lysholm score) were also assessed. The results showed that both phases were shorter for the ACL groups compared to controls (CTRL-ACLR: Duration 35+/-8 ms, p = 0.000, CTRL-ACLPT: 33+/-9 ms, p = 0.000) and involved less knee flexion (CTRL-ACLR: RoM 6.6+/-1.9 degrees , p = 0.002, CTRL-ACLR: 7.5 +/-2.0 degrees , p = 0.001). Low RoM and Duration correlated significantly with worse knee function according to Lysholm and higher knee laxity according to KT-1000. Three finite helical axes were analysed. The DeltaAP position for the first axis was most anterior in ACLPT compared to ACLR (DeltaAP position -1, ACLPT-ACLR: 13+/-3 mm, p = 0.004), with correlations to KT-1000 (rho 0.316, p = 0.008), while the DeltaAP inclination for the third axis was smaller in the ACLPT group compared to controls (DeltaAP inclination -3 ACLPT-CTRL: -13+/-5 degrees , p = 0.004) and showed a significant side difference in ACL injured groups during Action (Injured-Non-injured: 8+/-2.7 degrees , p = 0.006). Small DeltaAP inclination -3 correlated with low Lysholm (rho 0.391, p = 0.002) and high KT-1000 (rho -0.450, p = 0.001). Conclusions Compensatory movement strategies seem to be used to protect the injured knee during landing. A decreased DeltaAP inclination in injured knees during Action suggests that the dynamic knee control may remain compromised even long after injury.  
  Address Department of Community Medicine and Rehabilitation, Physiotherapy, Umea University, Umea, Sweden  
  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 (down) 1932-6203 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:31671111 Approved no  
  Call Number Serial 102  
Permanent link to this record
 

 
Author Banina, M.C.; Molad, R.; Solomon, J.S.; Berman, S.; Soroker, N.; Frenkel-Toledo, S.; Liebermann, D.G.; Levin, M.F. url  doi
openurl 
  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 (down) 1748-3107 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:32421460 Approved no  
  Call Number Serial 106  
Permanent link to this record
Select All    Deselect All
 |   | 
Details
   print

Save Citations:
Export Records: