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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 (up) 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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Author Frenkel-Toledo, S.; Liebermann, D.G.; Bentin, S.; Soroker, N.
Title Dysfunction of the Human Mirror Neuron System in Ideomotor Apraxia: Evidence from Mu Suppression Type Journal Article
Year 2016 Publication Journal of Cognitive Neuroscience Abbreviated Journal J Cogn Neurosci
Volume Issue (up) Pages
Keywords
Abstract Stroke patients with ideomotor apraxia (IMA) have difficulties controlling voluntary motor actions, as clearly seen when asked to imitate simple gestures performed by the examiner. Despite extensive research, the neurophysiological mechanisms underlying failure to imitate gestures in IMA remain controversial. The aim of the current study was to explore the relationship between imitation failure in IMA and mirror neuron system (MNS) functioning. Mirror neurons were found to play a crucial role in movement imitation and in imitation-based motor learning. Their recruitment during movement observation and execution is signaled in EEG recording by suppression of the lower (8-10 Hz) mu range. We examined the modulation of EEG in this range in stroke patients with left (n = 21) and right (n = 15) hemisphere damage during observation of video clips showing different manual movements. IMA severity was assessed by the DeRenzi's standardized diagnostic test. Results showed that failure to imitate observed manual movements correlated with diminished mu suppression in patients with damage to the right inferior parietal lobule and in patients with damage to the right inferior frontal gyrus pars opercularis-areas where major components of the human MNS are assumed to reside. Voxel-based lesion symptom mapping revealed a significant impact on imitation capacity for the left inferior and superior parietal lobules and the left post central gyrus. Both left and right hemisphere damages were associated with imitation failure typical of IMA, yet a clear demonstration of relationship to the MNS was obtained only in the right hemisphere damage group. Suppression of the 8-10 Hz range was stronger in central compared with occipital sites, pointing to a dominant implication of mu rather than alpha rhythms. However, the suppression correlated with De Renzi's apraxia test scores not only in central but also in occipital sites, suggesting a multifactorial mechanism for IMA, with a possible impact for deranged visual attention (alpha suppression) beyond the effect of MNS damage (mu suppression).
Address Loewenstein Hospital, Ra'anana, 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 0898-929X ISBN Medium
Area Expedition Conference
Notes PMID:26942323 Approved no
Call Number Serial 82
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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 (up) 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
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Author Liebermann, D.G.; Buchman, A.S.; Franks, I.M.
Title Enhancement of motor rehabilitation through the use of information technologies Type Journal Article
Year 2006 Publication Clinical Biomechanics (Bristol, Avon) Abbreviated Journal Clin Biomech (Bristol, Avon)
Volume 21 Issue (up) 1 Pages 8-20
Keywords Biotechnology/*methods; Humans; Medical Informatics/*methods; Motion Therapy, Continuous Passive/*methods; Movement Disorders/*rehabilitation; Musculoskeletal Manipulations/methods; Rehabilitation/*methods; Robotics/*methods; Therapy, Computer-Assisted/*methods
Abstract The recent development of information technologies has dramatically increased the tools available for facilitating motor rehabilitation. This review focuses on technologies which can be used to augment movement-related information both to patients as well as to their therapists. A brief outline of the motor system emphasizes the role of spinal motor neurons in the control of voluntary movement and rehabilitative efforts. Technologies which induce passive motion to stimulate spinal motor output as well as technologies that stimulate active voluntary movements are discussed. Finally, we review technologies and notational methods that can be used to quantify and assess the quality of movement for evaluating the efficacy of motor rehabilitation efforts. We conclude that stronger evidence is necessary to determine the applicability of the wide range of technologies now available to clinical rehabilitation efforts.
Address Department of Physical Therapy, Sackler Faculty of Medicine, University of Tel Aviv, Israel. dlieberm@post.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 0268-0033 ISBN Medium
Area Expedition Conference
Notes PMID:16198463 Approved no
Call Number Serial 49
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Author Liebermann, D.G.; Hoffman, J.R.
Title Timing of preparatory landing responses as a function of availability of optic flow information Type Journal Article
Year 2005 Publication Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology Abbreviated Journal J Electromyogr Kinesiol
Volume 15 Issue (up) 1 Pages 120-130
Keywords Adult; Cues; Electromyography; Humans; Male; Movement/physiology; Muscle, Skeletal/*physiology; Posture/physiology; Psychomotor Performance/*physiology; Vision, Ocular/*physiology
Abstract This study investigated temporal patterns of EMG activity during self-initiated falls with different optic flow information ('gaze directions'). Onsets of EMG during the flight phase were monitored from five experienced volunteers that completed 72 landings in three gaze directions (downward, mid-range and horizontal) and six heights of fall (10-130 cm). EMG recordings were obtained from the right gastrocnemius, tibialis anterior, biceps femoris and rectus femoris muscles, and used to determine the latency of onset (L(o)) and the perceived time to contact (T(c)). Impacts at touchdown were also monitored using as estimates the major peak of the vertical ground reaction forces (F(max)) normalized to body mass, time to peak (T(max)), peak impulse (I(norm)) normalized to momentum, and rate of change of force (dF(max)/dt). Results showed that L(o) was longer as heights of fall increased, but remained within a narrow time-window at >50 cm landings. No significant differences in L(o) were observed when gaze direction was changed. The relationship between T(c) and flight time followed a linear trend regardless of gaze direction. Gaze direction did not significantly affect the landing impacts. In conclusion, availability of optic flow during landing does not play a major role in triggering the preparatory muscle actions in self-initiated falls. Once a structured landing plan has been acquired, the relevant muscles respond relative to the start of the fall.
Address Department of Physical Therapy, Sackler Faculty of Medicine, Stanley Steyer School of Health Professions, University of Tel Aviv, Ramat Aviv, 69978 Tel Aviv, 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:15642660 Approved no
Call Number Serial 39
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