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Author |
Steinhart, S.; Weiss, P.L.; Friedman, J. |
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Title |
Proximal and distal movement patterns during a graphomotor task in typically developing children and children with handwriting problems |
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Journal Article |
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Year |
2021 |
Publication |
Journal of Neuroengineering and Rehabilitation |
Abbreviated Journal |
J Neuroeng Rehabil |
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Volume |
18 |
Issue |
1 |
Pages |
178 |
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Keywords |
Arm; Biomechanical Phenomena; Child; *Handwriting; Humans; Motor Skills; *Movement; Upper Extremity; Distal joints; Handwriting; Motor control; Movement analysis; Proximal; Stability |
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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. |
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Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel. jason@tau.ac.il |
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1743-0003 |
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PMID:34930334; PMCID:PMC8690895 |
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118 |
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Author |
Levin, M.F.; Liebermann, D.G.; Parmet, Y.; Berman, S. |
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Title |
Compensatory Versus Noncompensatory Shoulder Movements Used for Reaching in Stroke |
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Journal Article |
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Year |
2015 |
Publication |
Neurorehabilitation and Neural Repair |
Abbreviated Journal |
Neurorehabil Neural Repair |
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Keywords |
adaptation; arm movement; compensation; kinematics; recovery; rehabilitation |
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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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1545-9683 |
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PMID:26510934 |
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79 |
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Liebermann, D.G.; Defrin, R. |
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Title |
Characteristics of the nociceptive withdrawal response elicited under aware and unaware conditions |
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Journal Article |
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2009 |
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Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology |
Abbreviated Journal |
J Electromyogr Kinesiol |
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19 |
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2 |
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e114-22 |
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Adult; Arm/*physiopathology; Attention; *Awareness; Cues; Female; Humans; Male; Movement; *Muscle Contraction; Muscle, Skeletal/*physiopathology; Pain/*physiopathology; *Reflex; *Startle Reaction |
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BACKGROUND: Nociceptive withdrawal reflexes (NWR) are subject to supraspinal modulation. Therefore, awareness about a noxious stimulation may affect its characteristics. The goal of this study was to investigate the effect of different degrees of awareness on the NWR. METHOD: Eight subjects performed back and forth hand movements from a common starting point towards four visual targets during which NWR was evoked when subjects were either unaware or aware of a noxious stimulation (unaware-NWR and aware-NWR). For the comparison between the NWR under both conditions, onset latencies and kinematic variables were computed respectively from the recorded Biceps Brachii EMG and from the spatial coordinates of hand reflective markers. RESULTS: The onset latency of unaware-NWR (mean+/-SD 73.9+/-13 ms) was significantly shorter than that of the aware-NWR (91.1+/-27 ms, p<0.05). The total duration of the muscular activation was shorter in unaware-NWR than in aware-NWR. The slopes of the tangential velocity-time curves were steeper for unaware-NWR than for aware-NWR (p=0.057). CONCLUSIONS: The results suggest that supraspinal regulation of NWR under different degrees of awareness involves the re-parameterization of selected spatiotemporal aspects of a pre-structured motor response. |
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Department of Physical Therapy, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel Aviv 69978, Israel |
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1050-6411 |
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PMID:18063387 |
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34 |
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Krasovsky, T.; Berman, S.; Liebermann, D.G. |
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Title |
Kinematic features of continuous hand reaching movements under simple and complex rhythmical constraints |
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Journal Article |
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2010 |
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Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology |
Abbreviated Journal |
J Electromyogr Kinesiol |
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20 |
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4 |
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636-641 |
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*Acoustic Stimulation; Adult; Biomechanics; *Cues; Female; Hand/*physiology; Humans; Male; Movement/*physiology |
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BACKGROUND: Auditory cues are known to alter movement kinematics in healthy people as well as in people with neurological conditions (e.g., Parkinson's disease or stroke). Pacing movement to rhythmical constraints is known to change both the spatial and temporal features of movement. However, the effect of complexity of pacing on the spatial and temporal kinematic properties is still poorly understood. The current study investigated spatial and temporal aspects of movement (path and speed, respectively) and their integration while subjects followed simple isochronous or complex non-isochronous rhythmical constraints. Spatiotemporal decoupling was expected under the latter constraint. METHODS: Ten subjects performed point-to-point hand movements towards visual targets on the surface of a hemisphere, while following continuous auditory cues of different pace and meter. The spatial and temporal properties of movement were compared to geodesic paths and unimodal bell-shaped speed profiles, respectively. Multiple two-way RM-ANOVAs (pace [1-2 Hz] x meter [duple-triple]) were performed on the different kinematic variables calculated to assess hand deviations from the model data (p< or = 0.05). RESULTS: As expected, increasing pace resulted in straighter hand paths and smoother speed profiles. Meter, however, affected only the path (shorter and straighter under triple) without significantly changing speed. Such an effect was observed at the slow pace only. CONCLUSIONS: Under simple rhythmic cues, an increase in pace causes spontaneous adjustments in spatial features (straighter hand paths) while preserving temporal ones (maximally-smoothed hand speeds). Complex rhythmical cues in contrast perturb spatiotemporal coupling and challenge movement control. These results may have important practical implications in motor rehabilitation. |
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Department of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Canada |
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1050-6411 |
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PMID:20382031 |
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32 |
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Roijezon, U.; Djupsjobacka, M.; Bjorklund, M.; Hager-Ross, C.; Grip, H.; Liebermann, D.G. |
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Title |
Kinematics of fast cervical rotations in persons with chronic neck pain: a cross-sectional and reliability study |
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Journal Article |
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2010 |
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BMC Musculoskeletal Disorders |
Abbreviated Journal |
BMC Musculoskelet Disord |
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11 |
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222 |
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Adult; Aged; Biomechanics/*physiology; Cervical Vertebrae/*physiopathology; Chronic Disease; Cross-Sectional Studies; Female; Head Movements/*physiology; Humans; Middle Aged; Neck Pain/*diagnosis/*etiology/physiopathology; Physical Examination/methods; Reproducibility of Results; Rotation/*adverse effects; Time Factors; Young Adult |
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BACKGROUND: Assessment of sensorimotor function is useful for classification and treatment evaluation of neck pain disorders. Several studies have investigated various aspects of cervical motor functions. Most of these have involved slow or self-paced movements, while few have investigated fast cervical movements. Moreover, the reliability of assessment of fast cervical axial rotation has, to our knowledge, not been evaluated before. METHODS: Cervical kinematics was assessed during fast axial head rotations in 118 women with chronic nonspecific neck pain (NS) and compared to 49 healthy controls (CON). The relationship between cervical kinematics and symptoms, self-rated functioning and fear of movement was evaluated in the NS group. A sub-sample of 16 NS and 16 CON was re-tested after one week to assess the reliability of kinematic variables. Six cervical kinematic variables were calculated: peak speed, range of movement, conjunct movements and three variables related to the shape of the speed profile. RESULTS: Together, peak speed and conjunct movements had a sensitivity of 76% and a specificity of 78% in discriminating between NS and CON, of which the major part could be attributed to peak speed (NS: 226 +/- 88 degrees /s and CON: 348 +/- 92 degrees /s, p < 0.01). Peak speed was slower in NS compared to healthy controls and even slower in NS with comorbidity of low-back pain. Associations were found between reduced peak speed and self-rated difficulties with running, performing head movements, car driving, sleeping and pain. Peak speed showed reasonably high reliability, while the reliability for conjunct movements was poor. CONCLUSIONS: Peak speed of fast cervical axial rotations is reduced in people with chronic neck pain, and even further reduced in subjects with concomitant low back pain. Fast cervical rotation test seems to be a reliable and valid tool for assessment of neck pain disorders on group level, while a rather large between subject variation and overlap between groups calls for caution in the interpretation of individual assessments. |
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Centre for Musculoskeletal Research, University of Gavle, Sweden. ulrik.roijezon@ltu.se |
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1471-2474 |
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PMID:20875135 |
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31 |
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