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Bezalel, G.; Nachoum Arad, G.; Plotnik, M.; Friedman, J. |
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Title |
Voluntary step execution in patients with knee osteoarthritis: Symptomatic vs. non-symptomatic legs |
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Journal Article |
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Year |
2021 |
Publication |
Gait & Posture |
Abbreviated Journal |
Gait Posture |
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83 |
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60-66 |
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Keywords |
Accidental falls; Gait; Knee; Osteoarthritis; Voluntary step |
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BACKGROUND: Individuals with osteoarthritis fall at a greater rate than the general population, likely as a result of weakness, pain, movement limitations, and a decline in balance. Due to the high prevalence of osteoarthritis in the population, understanding the mechanisms leading to greater fall risk is an important issue to better understand. RESEARCH QUESTION: What is the influence of unilateral knee osteoarthritis on the characteristics of performing a voluntary step (i.e., similar to that performed to avoid a fall after a perturbation), compared to healthy age-matched controls? METHODS: Case-control study performed in a Health maintenance organization physical therapy clinic. The research group consisted of a referred sample of 21 patients with unilateral knee osteoarthritis. The control group consisted of 22 age-matched healthy individuals. All participants were over 65 years of age. Participants were excluded if they had a surgical procedure to back or lower limb within one year before testing, oncological or neurological disease or a deficit in tactile sense. Movements were performed with and without dual tasking. MEASUREMENTS: Duration of the initiation phase (cue to step initiation), preparatory phase (step initiation to foot off) and swing phase (foot off to foot contact). RESULTS: In the preparatory phase and swing phase, the osteoarthritis group moved more slowly than the control group, and these differences were larger for forward compared to backward movements. Dual-tasking slowed responses in the pre-movement initiation stage across groups. SIGNIFICANCE: The differences in basic parameters, and the slower movements in the osteoarthritis group, are consistent with known features of osteoarthritis, being a disease commonly regarded as primarily “mechanical”, and are likely to increase fall risk. These response deficits suggest we should take advantage of advanced rehabilitation techniques, including cognitive loading, to help prevent falls in older adults with osteoarthritis. |
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Dept. Physical Therapy, Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel. Electronic address: jason@tau.ac.il |
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0966-6362 |
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PMID:33080457 |
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107 |
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Lackritz, H.; Parmet, Y.; Frenkel-Toledo, S.; Banina, M.C.; Soroker, N.; Solomon, J.M.; Liebermann, D.G.; Levin, M.F.; Berman, S. |
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Title |
Effect of post-stroke spasticity on voluntary movement of the upper limb |
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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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18 |
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1 |
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81 |
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Keywords |
Gaussian mixture model; Hellinger's distance; Hemiparesis; Kinematics; Kullback-Liebler divergence; Spasticity; Stochastic model; Stroke |
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BACKGROUND: Hemiparesis following stroke is often accompanied by spasticity. Spasticity is one factor among the multiple components of the upper motor neuron syndrome that contributes to movement impairment. However, the specific contribution of spasticity is difficult to isolate and quantify. We propose a new method of quantification and evaluation of the impact of spasticity on the quality of movement following stroke. METHODS: Spasticity was assessed using the Tonic Stretch Reflex Threshold (TSRT). TSRT was analyzed in relation to stochastic models of motion to quantify the deviation of the hemiparetic upper limb motion from the normal motion patterns during a reaching task. Specifically, we assessed the impact of spasticity in the elbow flexors on reaching motion patterns using two distinct measures of the 'distance' between pathological and normal movement, (a) the bidirectional Kullback-Liebler divergence (BKLD) and (b) Hellinger's distance (HD). These measures differ in their sensitivity to different confounding variables. Motor impairment was assessed clinically by the Fugl-Meyer assessment scale for the upper extremity (FMA-UE). Forty-two first-event stroke patients in the subacute phase and 13 healthy controls of similar age participated in the study. Elbow motion was analyzed in the context of repeated reach-to-grasp movements towards four differently located targets. Log-BKLD and HD along with movement time, final elbow extension angle, mean elbow velocity, peak elbow velocity, and the number of velocity peaks of the elbow motion were computed. RESULTS: Upper limb kinematics in patients with lower FMA-UE scores (greater impairment) showed greater deviation from normality when the distance between impaired and normal elbow motion was analyzed either with the BKLD or HD measures. The severity of spasticity, reflected by the TSRT, was related to the distance between impaired and normal elbow motion analyzed with either distance measure. Mean elbow velocity differed between targets, however HD was not sensitive to target location. This may point at effects of spasticity on motion quality that go beyond effects on velocity. CONCLUSIONS: The two methods for analyzing pathological movement post-stroke provide new options for studying the relationship between spasticity and movement quality under different spatiotemporal constraints. |
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The Zlotowski Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. sigalbe@bgu.ac.il |
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1743-0003 |
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PMID:33985543 |
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108 |
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Dario G. Liebermann; Murray E. Maitland; Larry Katz |
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Lower-limb extension power: How well does it predict short distance speed skating performance? |
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2002 |
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Isokinetics and Exercise Science |
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10 |
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2 |
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87-95 |
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This study was aimed to explore the relationship between lower limb extension power measured by isokinetic knee extensions (IK) and vertical jumps performed on a force plate (VJ) and speed skating (SS) sprint power measured by a laser device.
Methods: Twenty elite short- and long-track speed skaters performed 100 m sprints followed by VJ and IK trials. Power-time curves were calculated off-line. Pearson correlation coefficients were used to determine the degree of association between the variables.
Results: SS sprint power correlates strongly with VJ power (r=0.870; p<0.001) while IK power showed a weaker but significant correlation to both (r=0.707 and r=0.706, respectively; p<0.01). As expected, SS times at 15 m and 100 m were inversely associated with SS sprint power (r=-0.818 and r=-0.909; p<0.001) and VJ power (r=-0.730 and r=-0.763; p<0.001), and to a lesser degree with IK power (r=-0.602; r=-0.618; p<0.01).
Conclusion: The analyses differentiate between methods of estimating power in speed skaters, and show a strong relationship between initial SS performance and muscular power. Given that 100 m split times strongly relate to final 500 m results (r=0.972; p<0.001, N=332), it is reasonable to believe that an initial power and a stable peak speed before the first curve may lead to achieving the winning edge in short SS events. A finding of particular interest is that isokinetic power results are correlated significantly with the practical outcomes of the performance in spite of the high specificity of the isokinetic testing method. |
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62 |
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Dario G. Liebermann; Larry Katz |
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On the assessment of lower-limb power capability |
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2003 |
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Isokinetics and Exercise Science |
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11 |
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2 |
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87-94 |
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Purpose: This study assessed the reliability and validity of different methods used to estimate lower-limb muscular power capability based on mechanical variables. For this purpose, vertical jumping was compared with isokinetic knee extensions and with power tests used by practitioners.
Methods: Four groups of subjects (N = 106) were tested in different conditions. Group-I performed countermovement vertical jumps (CMJ) on a force plate followed by left and right knee extensions on an isokinetic device at 120, 180 and 240 deg�s-1. Group-II performed CMJ trials followed by 20-m sprints, hand-reach jumps and 1RM leg-press testing. Group-III carried out squat jumps (SJ) in addition to CMJ trials. Finally, Group-IV performed the CMJ test and was retested twice after a short inter-session interval (1–4 days) and after a long one (4.5–5 months). The Pearson correlation was used to assess the validity and reliability of CMJ (p ≤ 0.01, ).
Results: Mean peak power during CMJ was correlated with sprint time (r = -0.882) and leg-press 1 RM (r = 0.797), but less with peak hand-reach height (r = 0.695; p ≤ 0.05). Isokinetic knee extension power showed also a significant correlation with CMJ power, but its strength depended on the angular velocity (Isok-120 r = 0.702; Isok-180 r = 0.737; Isok-240 r = 0.599). Test-retests showed a strong correlation after a short interval (r = 0.915) and after a long one (r = 0.890). Using the SJ technique did not have any effect on reliability (r = 0.914**).
Conclusions: CMJ matches other methods used for testing lower-limb power capability. It is highly reliable and it allows a valid assessment of muscular power. Since CMJ is also simple and accurate to perform, it is the recommended method. |
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Kapur, Shweta; Friedman, Jason; Zatsiorsky, Vladimir M.; Latash, Mark L. |
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Finger interaction in a three-dimensional pressing task |
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2010 |
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Experimental Brain Research |
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203 |
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101-118 |
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Accurate control of forces produced by the fingers is essential for performing object manipulation. This study examines the indices of finger interaction when accurate time profiles of force are produced in different directions, while using one of the fingers or all four fingers of the hand. We hypothesized that patterns of unintended force production among shear force components may involve features not observed in the earlier studies of vertical force production. In particular, we expected to see unintended forces generated by non-task fingers not in the
direction on the instructed force but in the opposite direction as well as substantial force production in directions orthogonal to the instructed direction. We also tested a hypothesis that multi-finger synergies, quantified using the framework of the uncontrolled manifold hypothesis, will help reduce across-trials variance of both total force magnitude and direction. Young, healthy subjects were required to produce accurate ramps of force in five different directions by
pressing on force sensors with the fingers of the right (dominant) hand. The index finger induced the smallest unintended forces in non-task fingers. The little finger showed the smallest unintended forces when it was a non-task finger. Task fingers showed substantial force production in directions orthogonal to the intended force direction. During four-finger tasks, individual force vectors typically pointed off the task direction, with these deviations nearly
perfectly matched to produce a resultant force in the task direction. Multi-finger synergy indices reflected strong co-variation in the space of finger modes (commands to fingers) that reduced variability of the total force magnitude and direction across trials. The synergy indices increased in magnitude over the first 30% of the trial time and then stayed at a nearly constant level. The synergy index for stabilization of total force magnitude was higher for shear force components as compared to the downward pressing force component. The results suggest complex interactions between enslaving and synergic force adjustments, possibly reflecting the experience with everyday prehensile tasks. For the first time, the data document multi-finger synergies stabilizing both shear force magnitude and force vector direction. These synergies may play a major role in
stabilizing the hand action during object manipulation. |
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in press |
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Penn State @ write.to.jason @ |
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