Records |
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 |
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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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English |
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2045-2322 |
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PMID:38129527; PMCID:PMC10739929 |
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121 |
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Author |
Liebermann, D.G.; Franks, I. M. |
Title |
The use of feedback-based technologies in skill acquisition |
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Book Chapter |
Year |
2004 |
Publication |
Notational analysis of Sport and Coaching Science |
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E & FN Spon Pub |
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Editor |
M. Hughes; I.M. Franks |
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45 |
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Author |
Carmeli E.; Liebermann, D.G. |
Title |
The Function of the Aging Hand |
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Book Chapter |
Year |
2007 |
Publication |
The Geriatric Rehabilitation Manual |
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Elsevier |
Place of Publication |
NY |
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T. L. Kauffman; M. Moran; J. Barr |
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46 |
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Author |
Liebermann, D.G.; Franks I.M. |
Title |
Video-feedback and information technologies |
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Book Chapter |
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2008 |
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Essentials of notational analysis |
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E & FN Spon Pub |
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I.M. Franks; M. Hughes |
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48 |
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Author |
Goodman, D.; Liebermann, D.G. |
Title |
Time-to-contact as a determiner of action: vision and motor control |
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Book Chapter |
Year |
1992 |
Publication |
Vision and Motor Control |
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335-349 |
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Elsevier Pub. Co |
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Amsterdam, Holland |
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D. Elliott; J. Proteau |
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43 |
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