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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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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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1545-9683 |
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PMID:26510934 |
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79 |
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Author |
Liebermann, D.G.; Buchman, A.S.; Franks, I.M. |
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Title |
Enhancement of motor rehabilitation through the use of information technologies |
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Journal Article |
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Year |
2006 |
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Clinical Biomechanics (Bristol, Avon) |
Abbreviated Journal |
Clin Biomech (Bristol, Avon) |
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21 |
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1 |
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8-20 |
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Keywords |
Biotechnology/*methods; Humans; Medical Informatics/*methods; Motion Therapy, Continuous Passive/*methods; Movement Disorders/*rehabilitation; Musculoskeletal Manipulations/methods; Rehabilitation/*methods; Robotics/*methods; Therapy, Computer-Assisted/*methods |
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Abstract |
The recent development of information technologies has dramatically increased the tools available for facilitating motor rehabilitation. This review focuses on technologies which can be used to augment movement-related information both to patients as well as to their therapists. A brief outline of the motor system emphasizes the role of spinal motor neurons in the control of voluntary movement and rehabilitative efforts. Technologies which induce passive motion to stimulate spinal motor output as well as technologies that stimulate active voluntary movements are discussed. Finally, we review technologies and notational methods that can be used to quantify and assess the quality of movement for evaluating the efficacy of motor rehabilitation efforts. We conclude that stronger evidence is necessary to determine the applicability of the wide range of technologies now available to clinical rehabilitation efforts. |
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Department of Physical Therapy, Sackler Faculty of Medicine, University of Tel Aviv, Israel. dlieberm@post.tau.ac.il |
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0268-0033 |
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PMID:16198463 |
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49 |
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