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Tamir-Ostrover, H.; Hassin-Baer, S.; Fay-Karmon, T.; Friedman, J. |
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Title |
Quantifying Changes in Dexterity as a Result of Piano Training in People with Parkinson's Disease |
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Journal Article |
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Year |
2024 |
Publication |
Sensors (Basel, Switzerland) |
Abbreviated Journal  |
Sensors (Basel) |
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Volume |
24 |
Issue |
11 |
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Keywords |
Humans; *Parkinson Disease/physiopathology; Pilot Projects; Male; Aged; Female; Quality of Life; Middle Aged; Motor Skills/physiology; Music; Surveys and Questionnaires; Activities of Daily Living; Fingers/physiology/physiopathology; Parkinson's disease; dexterity; force sensors; music; piano; sonification; training; uncontrolled manifold |
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Abstract |
People with Parkinson's disease often show deficits in dexterity, which, in turn, can lead to limitations in performing activities of daily life. Previous studies have suggested that training in playing the piano may improve or prevent a decline in dexterity in this population. In this pilot study, we tested three participants on a six-week, custom, piano-based training protocol, and quantified dexterity before and after the intervention using a sensor-enabled version of the nine-hole peg test, the box and block test, a test of finger synergies using unidimensional force sensors, and the Quantitative Digitography test using a digital piano, as well as selected relevant items from the motor parts of the MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and the Parkinson's Disease Questionnaire (PDQ-39) quality of life questionnaire. The participants showed improved dexterity following the training program in several of the measures used. This pilot study proposes measures that can track changes in dexterity as a result of practice in people with Parkinson's disease and describes a potential protocol that needs to be tested in a larger cohort. |
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Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel |
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1424-8220 |
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PMID:38894110; PMCID:PMC11174779 |
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124 |
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Lowenthal-Raz, J.; Liebermann, D.G.; Friedman, J.; Soroker, N. |
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Title |
Kinematic descriptors of arm reaching movement are sensitive to hemisphere-specific immediate neuromodulatory effects of transcranial direct current stimulation post stroke |
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Journal Article |
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Year |
2024 |
Publication |
Scientific Reports |
Abbreviated Journal |
Sci Rep |
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Volume |
14 |
Issue |
1 |
Pages |
11971 |
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Keywords |
Humans; *Transcranial Direct Current Stimulation/methods; Male; Female; Middle Aged; *Stroke/physiopathology/therapy; Biomechanical Phenomena; Aged; *Arm/physiopathology; *Movement/physiology; *Stroke Rehabilitation/methods; Single-Blind Method; Cross-Over Studies |
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Transcranial direct current stimulation (tDCS) exerts beneficial effects on motor recovery after stroke, presumably by enhancement of adaptive neural plasticity. However, patients with extensive damage may experience null or deleterious effects with the predominant application mode of anodal (excitatory) stimulation of the damaged hemisphere. In such cases, excitatory stimulation of the non-damaged hemisphere might be considered. Here we asked whether tDCS exerts a measurable effect on movement quality of the hemiparetic upper limb, following just a single treatment session. Such effect may inform on the hemisphere that should be excited. Using a single-blinded crossover experimental design, stroke patients and healthy control subjects were assessed before and after anodal, cathodal and sham tDCS, each provided during a single session of reaching training (repeated point-to-point hand movement on an electronic tablet). Group comparisons of endpoint kinematics at baseline-number of peaks in the speed profile (NoP; smoothness), hand-path deviations from the straight line (SLD; accuracy) and movement time (MT; speed)-disclosed greater NoP, larger SLD and longer MT in the stroke group. NoP and MT revealed an advantage for anodal compared to sham stimulation of the lesioned hemisphere. NoP and MT improvements under anodal stimulation of the non-lesioned hemisphere correlated positively with the severity of hemiparesis. Damage to specific cortical regions and white-matter tracts was associated with lower kinematic gains from tDCS. The study shows that simple descriptors of movement kinematics of the hemiparetic upper limb are sensitive enough to demonstrate gain from neuromodulation by tDCS, following just a single session of reaching training. Moreover, the results show that tDCS-related gain is affected by the severity of baseline motor impairment, and by lesion topography. |
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Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel. nachum@soroker.online |
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2045-2322 |
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PMID:38796610; PMCID:PMC11127956 |
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125 |
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Wilf, M.; Korakin, A.; Bahat, Y.; Koren, O.; Galor, N.; Dagan, O.; Wright, W.G.; Friedman, J.; Plotnik, M. |
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Title |
Using virtual reality-based neurocognitive testing and eye tracking to study naturalistic cognitive-motor performance |
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Journal Article |
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Year |
2024 |
Publication |
Neuropsychologia |
Abbreviated Journal |
Neuropsychologia |
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194 |
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108744 |
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Humans; Aged; *Eye-Tracking Technology; Cognition; Executive Function; *Virtual Reality; Aging; Color trails test; Fall risk; Hand kinematics; Pupil; Virtual reality |
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Natural human behavior arises from continuous interactions between the cognitive and motor domains. However, assessments of cognitive abilities are typically conducted using pen and paper tests, i.e., in isolation from “real life” cognitive-motor behavior and in artificial contexts. In the current study, we aimed to assess cognitive-motor task performance in a more naturalistic setting while recording multiple motor and eye tracking signals. Specifically, we aimed to (i) delineate the contribution of cognitive and motor components to overall task performance and (ii) probe for a link between cognitive-motor performance and pupil size. To that end, we used a virtual reality (VR) adaptation of a well-established neurocognitive test for executive functions, the 'Color Trails Test' (CTT). The VR-CTT involves performing 3D reaching movements to follow a trail of numbered targets. To tease apart the cognitive and motor components of task performance, we included two additional conditions: a condition where participants only used their eyes to perform the CTT task (using an eye tracking device), incurring reduced motor demands, and a condition where participants manually tracked visually-cued targets without numbers on them, incurring reduced cognitive demands. Our results from a group of 30 older adults (>65) showed that reducing cognitive demands shortened completion times more extensively than reducing motor demands. Conditions with higher cognitive demands had longer target search time, as well as decreased movement execution velocity and head-hand coordination. We found larger pupil sizes in the more cognitively demanding conditions, and an inverse correlation between pupil size and completion times across individuals in all task conditions. Lastly, we found a possible link between VR-CTT performance measures and clinical signatures of participants (fallers versus non-fallers). In summary, performance and pupil parameters were mainly dependent on task cognitive load, while maintaining systematic interindividual differences. We suggest that this paradigm opens the possibility for more detailed profiling of individual cognitive-motor performance capabilities in older adults and other at-risk populations. |
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Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Israel; Department of Physiology and Pharmacology, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel. Electronic address: Meir.Plotnik@sheba.health.gov.il |
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0028-3932 |
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PMID:38072162 |
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123 |
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Melzer, I.; Liebermann, D.G.; Krasovsky, T.; Oddsson, L.I.E. |
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Title |
Cognitive load affects lower limb force-time relations during voluntary rapid stepping in healthy old and young adults |
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Journal Article |
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Year |
2010 |
Publication |
The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences |
Abbreviated Journal |
J Gerontol A Biol Sci Med Sci |
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Volume |
65 |
Issue |
4 |
Pages |
400-406 |
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Keywords |
*Accidental Falls; Adult; Aged; Aged, 80 and over; Aging/*physiology; Attention/physiology; Cognition/*physiology; Gait/*physiology; Humans; Postural Balance/*physiology; Reaction Time |
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BACKGROUND: Quick step execution may prevent falls when balance is lost; adding a concurrent task delays this function. We investigate whether push-off force-time relations during the execution of rapid voluntary stepping is affected by a secondary task in older and young adults. METHODS: Nineteen healthy older adults and 12 young adults performed rapid voluntary stepping under single- and dual-task conditions. Peak power, peak force, and time to peak force during preparatory and swing phases of stepping were extracted from center of pressure and ground reaction force data. RESULTS: For dual-task condition compared with single-task condition, older adults show a longer time to reach peak force during the preparation and swing phases compared with young adults (approximately 25% vs approximately 10%, respectively). Peak power and peak force were not affected by a concurrent attention-demanding task. CONCLUSION: Older adults have difficulty allocating sufficient attention for fast muscle recruitment when concurrently challenged by an attention-demanding task. |
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Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel |
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1079-5006 |
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PMID:19939911 |
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50 |
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Liebermann, D.G.; Levin, M.F.; McIntyre, J.; Weiss, P.L.; Berman, S. |
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Arm path fragmentation and spatiotemporal features of hand reaching in healthy subjects and stroke patients |
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Journal Article |
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2010 |
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Conference Proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference |
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Conf Proc IEEE Eng Med Biol Soc |
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2010 |
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5242-5245 |
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Keywords |
Aged; Aged, 80 and over; Analysis of Variance; Arm/*physiology; Biomechanics/physiology; Female; Hand/*physiology; *Health; Humans; Male; Middle Aged; Movement/*physiology; Posture/physiology; Principal Component Analysis; Stroke/*physiopathology; Time Factors |
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Arm motion in healthy humans is characterized by smooth and relatively short paths. The current study focused on 3D reaching in stroke patients. Sixteen right-hemiparetic stroke patients and 8 healthy adults performed 42 reaching movements towards 3 visual targets located at an extended arm distance. Performance was assessed in terms of spatial and temporal features of the movement; i.e., hand path, arm posture and smoothness. Differences between groups and within subjects were hypothesized for spatial and temporal aspects of reaching under the assumption that both are independent. As expected, upper limb motion of patients was characterized by longer and jerkier hand paths and slower speeds. Assessment of the number of sub-movements within each movement did not clearly discriminate between groups. Principal component analyses revealed specific clusters of either spatial or temporal measures, which accounted for a large proportion of the variance in patients but not in healthy controls. These findings support the notion of a separation between spatial and temporal features of movement. Stroke patients may fail to integrate the two aspects when executing reaching movements towards visual targets. |
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Physical Therapy Dept., Sackler Faculty of Medicine, Tel Aviv University, 69978 Israel. dlieberm@post.tau.ac.il |
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1557-170X |
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PMID:21096047 |
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30 |
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