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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 |
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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Year |
2010 |
Publication |
BMC Musculoskeletal Disorders |
Abbreviated Journal |
BMC Musculoskelet Disord |
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Volume |
11 |
Issue |
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Pages |
222 |
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Keywords |
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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Abstract |
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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Author |
Merdler, T.; Liebermann, D.G.; Levin, M.F.; Berman, S. |
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Title |
Arm-plane representation of shoulder compensation during pointing movements in patients with stroke |
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Journal Article |
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Year |
2013 |
Publication |
Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology |
Abbreviated Journal |
J Electromyogr Kinesiol |
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23 |
Issue |
4 |
Pages |
938–947 |
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Keywords |
Kinematics; Arm movement; Rehabilitation |
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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. |
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Department of Industrial Engineering and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel |
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1050-6411 |
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PMID:23566477 |
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69 |
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Author |
Liebermann, D.G.; Levin, M.F.; McIntyre, J.; Weiss, P.L.; Berman, S. |
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Title |
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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Year |
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 |
Abbreviated Journal |
Conf Proc IEEE Eng Med Biol Soc |
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Volume |
2010 |
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Pages |
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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Author |
Liebermann, D.G.; Krasovsky, T.; Berman, S. |
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Title |
Planning maximally smooth hand movements constrained to nonplanar workspaces |
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Journal Article |
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Year |
2008 |
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Journal of Motor Behavior |
Abbreviated Journal |
J Mot Behav |
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40 |
Issue |
6 |
Pages |
516-531 |
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Adaptation, Physiological; Adult; Algorithms; Female; Hand/*physiology; Humans; *Intention; Kinesthesis/*physiology; Male; Models, Statistical; Movement/*physiology; Psychomotor Performance/*physiology; Reference Values; Writing |
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The article characterizes hand paths and speed profiles for movements performed in a nonplanar, 2-dimensional workspace (a hemisphere of constant curvature). The authors assessed endpoint kinematics (i.e., paths and speeds) under the minimum-jerk model assumptions and calculated minimal amplitude paths (geodesics) and the corresponding speed profiles. The authors also calculated hand speeds using the 2/3 power law. They then compared modeled results with the empirical observations. In all, 10 participants moved their hands forward and backward from a common starting position toward 3 targets located within a hemispheric workspace of small or large curvature. Comparisons of modeled observed differences using 2-way RM-ANOVAs showed that movement direction had no clear influence on hand kinetics (p < .05). Workspace curvature affected the hand paths, which seldom followed geodesic lines. Constraining the paths to different curvatures did not affect the hand speed profiles. Minimum-jerk speed profiles closely matched the observations and were superior to those predicted by 2/3 power law (p < .001). The authors conclude that speed and path cannot be unambiguously linked under the minimum-jerk assumption when individuals move the hand in a nonplanar 2-dimensional workspace. In such a case, the hands do not follow geodesic paths, but they preserve the speed profile, regardless of the geometric features of the workspace. |
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Department of Physical Therapy, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Israel. dlieberm@post.tau.ac.il |
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0022-2895 |
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PMID:18980905 |
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33 |
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