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| Author | Lowenthal-Raz, J.; Liebermann, D.G.; Friedman, J.; Soroker, N. | ||||
| Title | Kinematic descriptors of arm reaching movement are sensitive to hemisphere-specific immediate neuromodulatory effects of transcranial direct current stimulation post stroke | Type | Journal Article | ||
Year  |
2024 | Publication | Scientific Reports | Abbreviated Journal | Sci Rep |
| Volume | 14 | Issue | 1 | Pages | 11971 |
| 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 | ||||
| Abstract | 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. | ||||
| Address | Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel. nachum@soroker.online | ||||
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| Language | English | Summary Language | Original Title | ||
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| ISSN | 2045-2322 | ISBN | Medium | ||
| Area | Expedition | Conference | |||
| Notes | PMID:38796610; PMCID:PMC11127956 | Approved | no | ||
| Call Number | Serial | 125 | |||
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| Author | Steinhart, S.; Weiss, P.L.; Friedman, J. | ||||
| Title | Proximal and distal movement patterns during a graphomotor task in typically developing children and children with handwriting problems | Type | Journal Article | ||
| Year |
2021 | Publication | Journal of Neuroengineering and Rehabilitation | Abbreviated Journal | J Neuroeng Rehabil |
| Volume | 18 | Issue | 1 | Pages | 178 |
| Keywords | Arm; Biomechanical Phenomena; Child; *Handwriting; Humans; Motor Skills; *Movement; Upper Extremity; Distal joints; Handwriting; Motor control; Movement analysis; Proximal; Stability | ||||
| Abstract | BACKGROUND: Therapists specializing in handwriting difficulties in children often address motor problems including both proximal and distal movements in the upper extremity. Kinematic measures can be used to investigate various aspects of handwriting. This study examined differences in movement patterns in proximal and distal joints of the upper extremity during graphomotor tasks between typically developing children with and without handwriting problems. Additionally, it explored relationships between movement patterns, speed, and legibility of writing. METHODS: Forty-one children, aged 7-11 years, were assessed with the Aleph Aleph Ktav Yad Hebrew Handwriting assessment and the Beery Test of Visual Motor Integration and, based on their scores, were divided into a research group (with handwriting difficulties) and a control group (without handwriting difficulties). Upper extremity joint movement patterns were analyzed with a motion capture system. Differences in the quality of shapes traced and copied on a graphics tablet positioned horizontally and vertically were compared. Between-group differences and relationships with speed and legibility were analyzed. RESULTS: In both groups, there was greater movement in the distal compared to the proximal joints, greater movement when performing the task in a horizontal compared to a vertical plane, and greater movement when tracing than copying. Joint movements in the arm executed scaled-down versions of the shapes being drawn. While the amount of joint displacement was similar between groups, children in the research group showed greater dissimilarity between the drawn shape and the shape produced by the proximal joints. Finally, the drawing measure on the tablet was a significant predictor of legibility, speed of writing, visual motor integration and motor coordination, whereas the dissimilarity measure of joint movement was a significant predictor of speed of writing and motor coordination. CONCLUSIONS: This study provides support for the role of the distal upper extremity joints in the writing process and some guidance to assist clinicians in devising treatment strategies for movement-related handwriting problems. While we observed differences in proximal joint movements between the children with and without handwriting difficulties, the extent to which they are responsible for the differences in drawing quality remains to be determined. Further studies should use a similar methodology to examine additional tasks such as drawing shapes of varying sizes. | ||||
| Address | Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel. jason@tau.ac.il | ||||
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| Language | English | Summary Language | Original Title | ||
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| ISSN | 1743-0003 | ISBN | Medium | ||
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| Notes | PMID:34930334; PMCID:PMC8690895 | Approved | no | ||
| Call Number | Serial | 118 | |||
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| Author | Levin, M.F.; Liebermann, D.G.; Parmet, Y.; Berman, S. | ||||
| Title | Compensatory Versus Noncompensatory Shoulder Movements Used for Reaching in Stroke | Type | Journal Article | ||
| Year |
2015 | Publication | Neurorehabilitation and Neural Repair | Abbreviated Journal | Neurorehabil Neural Repair |
| Volume | Issue | Pages | |||
| Keywords | adaptation; arm movement; compensation; kinematics; recovery; rehabilitation | ||||
| Abstract | BACKGROUND: The extent to which the upper-limb flexor synergy constrains or compensates for arm motor impairment during reaching is controversial. This synergy can be quantified with a minimal marker set describing movements of the arm-plane. OBJECTIVES: To determine whether and how (a) upper-limb flexor synergy in patients with chronic stroke contributes to reaching movements to different arm workspace locations and (b) reaching deficits can be characterized by arm-plane motion. METHODS: Sixteen post-stroke and 8 healthy control subjects made unrestrained reaching movements to targets located in ipsilateral, central, and contralateral arm workspaces. Arm-plane, arm, and trunk motion, and their temporal and spatial linkages were analyzed. RESULTS: Individuals with moderate/severe stroke used greater arm-plane movement and compensatory trunk movement compared to those with mild stroke and control subjects. Arm-plane and trunk movements were more temporally coupled in stroke compared with controls. Reaching accuracy was related to different segment and joint combinations for each target and group: arm-plane movement in controls and mild stroke subjects, and trunk and elbow movements in moderate/severe stroke subjects. Arm-plane movement increased with time since stroke and when combined with trunk rotation, discriminated between different subject groups for reaching the central and contralateral targets. Trunk movement and arm-plane angle during target reaches predicted the subject group. CONCLUSIONS: The upper-limb flexor synergy was used adaptively for reaching accuracy by patients with mild, but not moderate/severe stroke. The flexor synergy, as parameterized by the amount of arm-plane motion, can be used by clinicians to identify levels of motor recovery in patients with stroke. | ||||
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| Language | English | Summary Language | Original Title | ||
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| ISSN | 1545-9683 | ISBN | Medium | ||
| Area | Expedition | Conference | |||
| Notes | PMID:26510934 | Approved | no | ||
| Call Number | Serial | 79 | |||
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| Author | Harel Arzi; Tal Krasovsky; Moshe Pritsch; Dario G. Liebermann | ||||
| Title | Movement control in patients with shoulder instability: a comparison between patients after open surgery and nonoperated patients | Type | Journal Article | ||
| Year |
2014 | Publication | Journal of Shoulder and Elbow Surgery | Abbreviated Journal | |
| Volume | 23 | Issue | 7 | Pages | 982–992 |
| Keywords | Smoothness; kinesthesis; arm kinematics; shoulder instability; open surgery | ||||
| Abstract | Background Open surgery to correct shoulder instability is deemed to facilitate recovery of static and dynamic motor functions. Postoperative assessments focus primarily on static outcomes (e.g., repositioning accuracy). We introduce kinematic measures of arm smoothness to assess shoulder patients after open surgery and compare them with nonoperated patients. Performance among both groups of patients was hypothesized to differ. Postsurgery patients were expected to match healthy controls. Methods All participants performed pointing movements with the affected/dominant arm fully extended at fast, preferred, and slow speeds (36 trials per subject). Kinematic data were collected (100 Hz, 3 seconds), and mixed-design analyses of variance (group, speed) were performed with movement time, movement amplitude, acceleration time, and model-observed similarities as dependent variables. Nonparametric tests were performed for number of velocity peaks. Results Nonoperated and postsurgery patients showed similarities at preferred and faster movement speeds but not at slower speed. Postsurgery patients were closer to maximally smoothed motion and differed from healthy controls mainly during slow arm movements (closer to maximal smoothness, larger movement amplitude, shorter movement time, and lower number of peaks; i.e., less movement fragmentation). Conclusions Arm kinematic analyses suggest that open surgery stabilizes the shoulder but does not necessarily restore normal movement quality. Patients with recurrent anterior shoulder instability (RASI) seem to implement a “safe” but nonadaptive mode of action whereby preplanned stereotypical movements may be executed without depending on feedback. Rehabilitation of RASI patients should focus on restoring feedback-based movement control. Clinical assessment of RASI patients should include higher order kinematic descriptors. |
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| Notes | Approved | no | |||
| Call Number | Serial | 74 | |||
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| Author | Merdler, T.; Liebermann, D.G.; Levin, M.F.; Berman, S. | ||||
| Title | Arm-plane representation of shoulder compensation during pointing movements in patients with stroke | Type | Journal Article | ||
| Year |
2013 | Publication | Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology | Abbreviated Journal | J Electromyogr Kinesiol |
| Volume | 23 | Issue | 4 | Pages | 938–947 |
| Keywords | Kinematics; Arm movement; Rehabilitation | ||||
| Abstract | Improvements in functional motor activities are often accompanied by motor compensations to overcome persistent motor impairment in the upper limb. Kinematic analysis is used to objectively quantify movement patterns including common motor compensations such as excessive trunk displacement during reaching. However, a common motor compensation to assist reaching, shoulder abduction, is not adequately characterized by current motion analysis approaches. We apply the arm-plane representation that accounts for the co-variation between movements of the whole arm, and investigate its ability to identify and quantify compensatory arm movements in stroke subjects when making forward arm reaches. This method has not been previously applied to the analysis of motion deficits. Sixteen adults with right post-stroke hemiparesis and eight healthy age-matched controls reached in three target directions (14 trials/target; sampling rate: 100Hz). Arm-plane movement was validated against endpoint, joint, and trunk kinematics and compared between groups. In stroke subjects, arm-plane measures were correlated with arm impairment (Fugl-Meyer Assessment) and ability (Box and Blocks) scores and were more sensitive than clinical measures to detect mild motor impairment. Arm-plane motion analysis provides new information about motor compensations involving the co-variation of shoulder and elbow movements that may help to understand the underlying motor deficits in patients with stroke. | ||||
| Address | Department of Industrial Engineering and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel | ||||
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| Language | English | Summary Language | Original Title | ||
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| ISSN | 1050-6411 | ISBN | Medium | ||
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| Notes | PMID:23566477 | Approved | no | ||
| Call Number | Serial | 69 | |||
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