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Author (up) 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 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 (up) Davidowitz, I.; Parmet, Y.; Frenkel-Toledo, S.; Banina, M.C.; Soroker, N.; Solomon, J.M.; Liebermann, D.G.; Levin, M.F.; Berman, S.
Title Relationship Between Spasticity and Upper-Limb Movement Disorders in Individuals With Subacute Stroke Using Stochastic Spatiotemporal Modeling Type Journal Article
Year 2019 Publication Neurorehabilitation and Neural Repair Abbreviated Journal Neurorehabil Neural Repair
Volume 33 Issue 2 Pages 141-152
Keywords Gaussian mixture model; Kullback-Liebler divergence; spasticity; stroke; upper-limb kinematics
Abstract BACKGROUND: Spasticity is common in patients with stroke, yet current quantification methods are insufficient for determining the relationship between spasticity and voluntary movement deficits. This is partly a result of the effects of spasticity on spatiotemporal characteristics of movement and the variability of voluntary movement. These can be captured by Gaussian mixture models (GMMs). OBJECTIVES: To determine the influence of spasticity on upper-limb voluntary motion, as assessed by the bidirectional Kullback-Liebler divergence (BKLD) between motion GMMs. METHODS: A total of 16 individuals with subacute stroke and 13 healthy aged-equivalent controls reached to grasp 4 targets (near-center, contralateral, far-center, and ipsilateral). Two-dimensional GMMs (angle and time) were estimated for elbow extension motion. BKLD was computed for each individual and target, within the control group and between the control and stroke groups. Movement time, final elbow angle, average elbow velocity, and velocity smoothness were computed. RESULTS: Between-group BKLDs were much larger than within control-group BKLDs. Between-group BKLDs for the near-center target were lower than those for the far-center and contralateral targets, but similar to that for the ipsilateral target. For those with stroke, the final angle was lower for the near-center target, and the average velocity was higher. Velocity smoothness was lower for the near-center than for the ipsilateral target. Elbow flexor and extensor passive muscle resistance (Modified Ashworth Scale) strongly explained BKLD values. CONCLUSIONS: Results support the view that individuals with poststroke spasticity have a velocity-dependent reduction in active elbow joint range and that BKLD can be used as an objective measure of the effects of spasticity on reaching kinematics.
Address 1 Ben-Gurion University of the Negev, Beer-Sheva, 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 1545-9683 ISBN Medium
Area Expedition Conference
Notes PMID:30744528 Approved no
Call Number Serial 93
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Author (up) Frenkel-Toledo, S.; Bentin, S.; Perry, A.; Liebermann, D.G.; Soroker, N.
Title Dynamics of the EEG Power in the Frequency and Spatial Domains During Observation and Execution of Manual Movements Type Journal Article
Year 2013 Publication Brain Research Abbreviated Journal Brain Res
Volume 1509 Issue Pages 43-57
Keywords
Abstract 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.
Address Sackler Faculty of Medicine, Tel Aviv University, Israel; Department of Neurological Rehabilitation, Loewenstein Hospital, Raanana, Israel. Electronic address: silvi197@bezeqint.net
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 0006-8993 ISBN Medium
Area Expedition Conference
Notes PMID:23500633 Approved no
Call Number Serial 68
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Author (up) Frenkel-Toledo, S.; Levin, M.F.; Berman, S.; Liebermann, D.G.; Baniña, M.C.; Solomon, J.M.; Ofir-Geva, S.; Soroker, N.
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
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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 2045-2322 ISBN Medium
Area Expedition Conference
Notes Approved no
Call Number Serial 113
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Author (up) 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 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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