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Author |
Lackritz, H.; 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 |
Effect of post-stroke spasticity on voluntary movement of the upper limb |
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Journal Article |
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Year |
2021 |
Publication |
Journal of Neuroengineering and Rehabilitation |
Abbreviated Journal |
J Neuroeng Rehabil |
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18 |
Issue |
1 |
Pages |
81 |
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Keywords |
Gaussian mixture model; Hellinger's distance; Hemiparesis; Kinematics; Kullback-Liebler divergence; Spasticity; Stochastic model; Stroke |
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Abstract |
BACKGROUND: Hemiparesis following stroke is often accompanied by spasticity. Spasticity is one factor among the multiple components of the upper motor neuron syndrome that contributes to movement impairment. However, the specific contribution of spasticity is difficult to isolate and quantify. We propose a new method of quantification and evaluation of the impact of spasticity on the quality of movement following stroke. METHODS: Spasticity was assessed using the Tonic Stretch Reflex Threshold (TSRT). TSRT was analyzed in relation to stochastic models of motion to quantify the deviation of the hemiparetic upper limb motion from the normal motion patterns during a reaching task. Specifically, we assessed the impact of spasticity in the elbow flexors on reaching motion patterns using two distinct measures of the 'distance' between pathological and normal movement, (a) the bidirectional Kullback-Liebler divergence (BKLD) and (b) Hellinger's distance (HD). These measures differ in their sensitivity to different confounding variables. Motor impairment was assessed clinically by the Fugl-Meyer assessment scale for the upper extremity (FMA-UE). Forty-two first-event stroke patients in the subacute phase and 13 healthy controls of similar age participated in the study. Elbow motion was analyzed in the context of repeated reach-to-grasp movements towards four differently located targets. Log-BKLD and HD along with movement time, final elbow extension angle, mean elbow velocity, peak elbow velocity, and the number of velocity peaks of the elbow motion were computed. RESULTS: Upper limb kinematics in patients with lower FMA-UE scores (greater impairment) showed greater deviation from normality when the distance between impaired and normal elbow motion was analyzed either with the BKLD or HD measures. The severity of spasticity, reflected by the TSRT, was related to the distance between impaired and normal elbow motion analyzed with either distance measure. Mean elbow velocity differed between targets, however HD was not sensitive to target location. This may point at effects of spasticity on motion quality that go beyond effects on velocity. CONCLUSIONS: The two methods for analyzing pathological movement post-stroke provide new options for studying the relationship between spasticity and movement quality under different spatiotemporal constraints. |
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The Zlotowski Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. sigalbe@bgu.ac.il |
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1743-0003 |
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PMID:33985543 |
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108 |
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Author |
Frenkel-Toledo, S.; Bentin, S.; Perry, A.; Liebermann, D.G.; Soroker, N. |
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Title |
Dynamics of the EEG Power in the Frequency and Spatial Domains During Observation and Execution of Manual Movements |
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Journal Article |
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Year |
2013 |
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Brain Research |
Abbreviated Journal |
Brain Res |
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Volume |
1509 |
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43-57 |
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Mu suppression is the attenuation of EEG power in the alpha frequency range (8-12Hz) while executing or observing a motor action. Whereas typically observed at central scalp sites, there are diverging reports about the extent of the attenuation over the cortical mantle, its exact frequency range and the specificity of this phenomenon. We investigated the modulation of EEG oscillations in frequency-bands from 4 to 12Hz at frontal, central, parietal and occipital sites during the execution of manual movements and during observation of similar actions from allocentric (i.e., facing the actor) and egocentric (i.e., seeing the actor from behind) viewpoints. Suppression was determined relative to observation of a non-biological movement. Action observation elicited greater suppression in the lower (8-10Hz) compared to the higher mu range (10-12Hz), and greater suppression in the entire 4-12Hz range at frontal and central sites compared to parietal and occipital sites. In addition, suppression tended to be greater during observation of a motor action from allocentric compared to egocentric viewpoints. During execution of movement, suppression of the EEG occurred primarily in the higher alpha range and was absent at occipital sites. In the theta range (4-8Hz), the EEG amplitude was suppressed during action observation and execution. The results suggest a functional distinction between modulation of mu and alpha rhythms, and between the higher and lower ranges of the mu rhythms. The activity of the presumed human mirror neuron system seems primarily evident in the lower mu range and in the theta range. |
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Sackler Faculty of Medicine, Tel Aviv University, Israel; Department of Neurological Rehabilitation, Loewenstein Hospital, Raanana, Israel. Electronic address: silvi197@bezeqint.net |
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0006-8993 |
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PMID:23500633 |
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68 |
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Issurin, V.B.; Liebermann, D.G.; Tenenbaum, G. |
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Title |
Effect of vibratory stimulation training on maximal force and flexibility |
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1994 |
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Journal of Sports Sciences |
Abbreviated Journal |
J Sports Sci |
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12 |
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6 |
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561-566 |
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Adult; Humans; Male; Muscle Contraction/physiology; Muscle, Skeletal/*physiology; *Physical Education and Training; Vibration/*therapeutic use |
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In this study, we investigated a new method of training for maximal strength and flexibility, which included exertion with superimposed vibration (vibratory stimulation, VS) on target muscles. Twenty-eight male athletes were divided into three groups, and trained three times a week for 3 weeks in one of the following conditions: (A) conventional exercises for strength of the arms and VS stretching exercises for the legs; (B) VS strength exercises for the arms and conventional stretching exercises for the legs; (C) irrelevant training (control group). The vibration was applied at 44 Hz while its amplitude was 3 mm. The effect of training was evaluated by means of isotonic maximal force, heel-to-heel length in the two-leg split across, and flex-and-reach test for body flexion. The VS strength training yielded an average increase in isotonic maximal strength of 49.8%, compared with an average gain of 16% with conventional training, while no gain was observed for the control group. The VS flexibility training resulted in an average gain in the legs split of 14.5 cm compared with 4.1 cm for the conventional training and 2 cm for the control groups, respectively. The ANOVA revealed significant pre-post training effects and an interaction between pre-post training and 'treatment' effects (P < 0.001) for the isotonic maximal force and both flexibility tests. It was concluded that superimposed vibrations applied for short periods allow for increased gains in maximal strength and flexibility. |
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Ribstein Centre for Research and Sport Medicine Sciences, Wingate Institute, Wingate Post, Israel |
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0264-0414 |
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PMID:7853452 |
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56 |
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Falk, B.; Eliakim, A.; Dotan, R.; Liebermann, D.G.; Regev, R.; Bar-Or, O. |
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Title |
Birth weight and physical ability in 5- to 8-yr-old healthy children born prematurely |
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Journal Article |
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Year |
1997 |
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Medicine and Science in Sports and Exercise |
Abbreviated Journal |
Med Sci Sports Exerc |
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29 |
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9 |
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1124-1130 |
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*Birth Weight; Child; Child Development/physiology; Child, Preschool; Female; Follow-Up Studies; Humans; Infant, Newborn; *Infant, Premature; Male; *Motor Skills; *Physical Fitness |
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Recent advances in perinatal care have resulted in increased survival rates of extremely small and immature newborns. This has resulted in some neurodevelopmental impairment. The purpose of this study was to quantitatively evaluate and compare neuromuscular performance in children born prematurely at various levels of subnormal birth weight (BW). Subjects were 5- to 8-yr-old children born prematurely at different levels of subnormal BW (535-1760 g, N = 22, PM), and age-matched controls born at full term (> 2500 g, N = 15, CON). None of the subjects had any clinically defined neuromuscular disabilities. Body mass (BM) of PM was lower than that of CON (18.3 +/- 2.7 vs 21.7 +/- 3.8 kg) with no difference in height or sum of 4 skinfolds. Peak mechanical power output determined with a 15-s modified Wingate Anaerobic Test and corrected for BM was lower (P = 0.07) in PM than in CON (5.11 +/- 1.07 vs 5.94 +/- 1.00 W.kg-1). This was especially noticeable in children born at extremely low BW (ELBW, < 1000 g, 4.49 +/- 1.04 W.kg-1, P < 0.01). Peak power, determined in a force-plate vertical jump, corrected for BM was lower in PM vs CON (25.5 +/- 5.4 vs 30.8 +/- 5.2 W.kg-1, respectively P = 0.01), especially in the ELBW group (20.0 +/- 5.5 W.kg-1). Similarly, the elapsed time between peak velocity and actual jump take-off was longer in PM than in CON (41.2 +/- 9.4 vs 35.8 +/- 5.8 ms, respectively, P = 0.04). No differences were observed in peak force. The results suggest that performance deficiencies of prematurely-born children may be a result of inferior inter-muscular coordination. The precise neuromotor factors responsible for this should be identified by future research. |
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Ribstein Center for Research and Sport Medicine Sciences, Wingate Institute, Netanya, Israel. bfalk@ccsg.tau.ac.il |
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0195-9131 |
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PMID:9309621 |
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64 |
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Author |
Liebermann, D.G.; Goodman, D. |
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Title |
Effects of visual guidance on the reduction of impacts during landings |
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Journal Article |
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Year |
1991 |
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Ergonomics |
Abbreviated Journal |
Ergonomics |
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34 |
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11 |
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1399-1406 |
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Adult; Analysis of Variance; Biomechanics; *Cues; Humans; Male; Motor Activity/*physiology; Psychomotor Performance/physiology; Vision, Ocular/*physiology |
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While a common view is that vision is essential to motor performance, some recent studies have shown that continuous visual guidance may not always be required within certain time constraints. This study investigated a landing-related task (self-released falls) to assess the extent to which visual information enhances the ability to reduce the impacts at touchdown. Six individuals performed six blocked trials from four height categories in semi-counterbalanced order (5-10, 20-25, 60-65, and 90-95 cm) in vision and no-vision conditions randomly assigned. A series of two-way ANOVA with repeated measures were carried out separately on each dependent variable collapsed over six trials. The results indicated that vision during the flight did not produce softer landings. Indeed, in analysing the first peak (PFP) a main effect for visual condition was revealed in that the mean amplitude was slightly higher when vision was available (F(1,5) = 6.57; p less than 0.05), thus implicating higher forces at impact. The results obtained when the time to the first peak (TFP) was applied showed no significant differences between conditions (F(1,5) less than 1). As expected, in all cases, the analyses yielded significant main effects for the height categories factor. It appears that during self-initiated falls in which the environmental cues are known before the event, visual guidance is not necessary in order to adopt a softer landing strategy. |
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Research Department, Wingate Institute, Israel |
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0014-0139 |
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PMID:1800107 |
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55 |
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