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Author Levin, M.F.; Berman, S.; Weiss, N.; Parmet, Y.; Banina, M.C.; Frenkel-Toledo, S.; Soroker, N.; Solomon, J.M.; Liebermann, D.G.
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 (up)
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
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Language English Summary Language Original Title
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Series Volume Series Issue Edition
ISSN 2045-2322 ISBN Medium
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Notes PMID:38129527; PMCID:PMC10739929 Approved no
Call Number Serial 121
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Author Liebermann, D.G.; Franks, I. M.
Title The use of feedback-based technologies in skill acquisition Type (up) Book Chapter
Year 2004 Publication Notational analysis of Sport and Coaching Science Abbreviated Journal
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Publisher E & FN Spon Pub Place of Publication Editor M. Hughes; I.M. Franks
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Notes Approved no
Call Number Serial 45
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Author Carmeli E.; Liebermann, D.G.
Title The Function of the Aging Hand Type (up) Book Chapter
Year 2007 Publication The Geriatric Rehabilitation Manual Abbreviated Journal
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Publisher Elsevier Place of Publication NY Editor T. L. Kauffman; M. Moran; J. Barr
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Notes Approved no
Call Number Serial 46
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Author Liebermann, D.G.; Franks I.M.
Title Video-feedback and information technologies Type (up) Book Chapter
Year 2008 Publication Essentials of notational analysis Abbreviated Journal
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Publisher E & FN Spon Pub Place of Publication Editor I.M. Franks; M. Hughes
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Notes Approved no
Call Number Serial 48
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Author Goodman, D.; Liebermann, D.G.
Title Time-to-contact as a determiner of action: vision and motor control Type (up) Book Chapter
Year 1992 Publication Vision and Motor Control Abbreviated Journal
Volume Issue Pages 335-349
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Publisher Elsevier Pub. Co Place of Publication Amsterdam, Holland Editor D. Elliott; J. Proteau
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Notes Approved no
Call Number Serial 43
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