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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. |
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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 |
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Year |
2023 |
Publication |
Scientific Reports |
Abbreviated Journal |
Sci Rep |
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Volume |
13 |
Issue |
1 |
Pages |
22934 |
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Keywords |
Humans; Elbow; *Transcranial Direct Current Stimulation; Muscle Spasticity/therapy/complications; Upper Extremity; *Elbow Joint; *Stroke/complications; *Stroke Rehabilitation/methods |
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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. |
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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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2045-2322 |
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PMID:38129527; PMCID:PMC10739929 |
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121 |
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Author |
Dempsey-Jones, H.; Wesselink, D.B.; Friedman, J.; Makin, T.R. |
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Title |
Organized Toe Maps in Extreme Foot Users |
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Journal Article |
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Year |
2019 |
Publication |
Cell Reports |
Abbreviated Journal |
Cell Reports |
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Volume |
28 |
Issue |
11 |
Pages |
2748-2756.e4 |
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Abstract |
Although the fine-grained features of topographic maps in the somatosensory cortex can be shaped by everyday experience, it is unknown whether behavior can support the expression of somatotopic maps where they do not typically occur. Unlike the fingers, represented in all primates, individuated toe maps have only been found in non-human primates. Using 1-mm resolution fMRI, we identify organized toe maps in two individuals born without either upper limb who use their feet to substitute missing hand function and even support their profession as foot artists. We demonstrate that the ordering and structure of the artists’ toe representation mimics typical hand representation. We further reveal “hand-like” features of activity patterns, not only in the foot area but also similarly in the missing hand area. We suggest humans may have an innate capacity for forming additional topographic maps that can be expressed with appropriate experience. |
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Elsevier |
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2211-1247 |
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doi: 10.1016/j.celrep.2019.08.027 |
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99 |
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Kaufman-Cohen, Y.; Portnoy, S.; Levanon, Y.; Friedman, J. |
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Title |
Does Object Height Affect the Dart Throwing Motion Angle during Seated Activities of Daily Living? |
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Journal Article |
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2019 |
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Journal of Motor Behavior |
Abbreviated Journal |
J Mot Behav |
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1-10 |
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Keywords |
dart throwing motion (DTM); heights; kinematics; seated activities of daily living (ADL); upper extremity; wrist rehabilitation |
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Abstract |
Complex wrist motions are needed to complete various daily activities. Analyzing the multidimensional motion of the wrist is crucial for understanding our functional movement. Several studies have shown that numerous activities of daily livings (ADLs) are performed using an oblique plane of wrist motion from radial-extension to ulnar-flexion, named the Dart Throwing Motion (DTM) plane. To the best of our knowledge, the DTM plane angle performed during ADLs has not been compared between different heights (e.g. table, shoulder and head height), as is common when performing day-to-day tasks. In this study, we compared DTM plane angles when performing different ADLs at three different heights and examined the relationship between DTM plane angles and limb position. We found that height had a significant effect on the DTM plane angles – the mean DTM plane angle was greater at the lower level compared to the mid and higher levels. A significant effect of shoulder orientation on mean DTM plane angles was shown in the sagittal and coronal planes. Our findings support the importance of training daily tasks at different heights during rehabilitation following wrist injuries, in order to explore a large range of DTM angles, to accommodate needs of common ADLs. |
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0022-2895 |
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PMID:31359843 |
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100 |
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Author |
Grip, H.; Tengman, E.; Liebermann, D.G.; Hager, C.K. |
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Title |
Kinematic analyses including finite helical axes of drop jump landings demonstrate decreased knee control long after anterior cruciate ligament injury |
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Journal Article |
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Year |
2019 |
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PloS one |
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PLoS One |
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14 |
Issue |
10 |
Pages |
e0224261 |
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The purpose was to evaluate the dynamic knee control during a drop jump test following injury of the anterior cruciate ligament injury (ACL) using finite helical axes. Persons injured 17-28 years ago, treated with either physiotherapy (ACLPT, n = 23) or reconstruction and physiotherapy (ACLR, n = 28) and asymptomatic controls (CTRL, n = 22) performed a drop jump test, while kinematics were registered by motion capture. We analysed the Preparation phase (from maximal knee extension during flight until 50 ms post-touchdown) followed by an Action phase (until maximal knee flexion post-touchdown). Range of knee motion (RoM), and the length of each phase (Duration) were computed. The finite knee helical axis was analysed for momentary intervals of ~15 degrees of knee motion by its intersection (DeltaAP position) and inclination (DeltaAP Inclination) with the knee's Anterior-Posterior (AP) axis. Static knee laxity (KT100) and self-reported knee function (Lysholm score) were also assessed. The results showed that both phases were shorter for the ACL groups compared to controls (CTRL-ACLR: Duration 35+/-8 ms, p = 0.000, CTRL-ACLPT: 33+/-9 ms, p = 0.000) and involved less knee flexion (CTRL-ACLR: RoM 6.6+/-1.9 degrees , p = 0.002, CTRL-ACLR: 7.5 +/-2.0 degrees , p = 0.001). Low RoM and Duration correlated significantly with worse knee function according to Lysholm and higher knee laxity according to KT-1000. Three finite helical axes were analysed. The DeltaAP position for the first axis was most anterior in ACLPT compared to ACLR (DeltaAP position -1, ACLPT-ACLR: 13+/-3 mm, p = 0.004), with correlations to KT-1000 (rho 0.316, p = 0.008), while the DeltaAP inclination for the third axis was smaller in the ACLPT group compared to controls (DeltaAP inclination -3 ACLPT-CTRL: -13+/-5 degrees , p = 0.004) and showed a significant side difference in ACL injured groups during Action (Injured-Non-injured: 8+/-2.7 degrees , p = 0.006). Small DeltaAP inclination -3 correlated with low Lysholm (rho 0.391, p = 0.002) and high KT-1000 (rho -0.450, p = 0.001). Conclusions Compensatory movement strategies seem to be used to protect the injured knee during landing. A decreased DeltaAP inclination in injured knees during Action suggests that the dynamic knee control may remain compromised even long after injury. |
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Department of Community Medicine and Rehabilitation, Physiotherapy, Umea University, Umea, Sweden |
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1932-6203 |
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PMID:31671111 |
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102 |
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Author |
Kaufman-Cohen, Y.; Levanon, Y.; Friedman, J.; Yaniv, Y.; Portnoy, S. |
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Title |
Home exercise in the dart-throwing motion plane after distal radius fractures: A Pilot Randomized Controlled Trial |
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Journal Article |
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2020 |
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Journal of Hand Therapy |
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103 |
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