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Author Lackritz, H.; Parmet, Y.; Frenkel-Toledo, S.; Banina, M.C.; Soroker, N.; Solomon, J.M.; Liebermann, D.G.; Levin, M.F.; Berman, S. url  doi
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  Title Effect of post-stroke spasticity on voluntary movement of the upper limb Type Journal Article
  Year 2021 Publication (down) Journal of Neuroengineering and Rehabilitation Abbreviated Journal J Neuroeng Rehabil  
  Volume 18 Issue 1 Pages 81  
  Keywords Gaussian mixture model; Hellinger's distance; Hemiparesis; Kinematics; Kullback-Liebler divergence; Spasticity; Stochastic model; Stroke  
  Abstract 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.  
  Address The Zlotowski Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. sigalbe@bgu.ac.il  
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  ISSN 1743-0003 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:33985543 Approved no  
  Call Number Serial 108  
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Author Lerner, O.; Friedman, J.; Frenkel-Toledo, S. pdf  url
doi  openurl
  Title The effect of high-definition transcranial direct current stimulation intensity on motor performance in healthy adults: a randomized controlled trial Type Journal Article
  Year 2021 Publication (down) Journal of NeuroEngineering and Rehabilitation Abbreviated Journal J NeuroEngineering Rehabil  
  Volume 18 Issue Pages 103  
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  Notes Approved no  
  Call Number Serial 109  
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Author Steinhart, S.; Weiss, P.L.; Friedman, J. pdf  url
doi  openurl
  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 (down) 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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  Notes PMID:34930334; PMCID:PMC8690895 Approved no  
  Call Number Serial 118  
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Author Krasovsky, T.; Keren-Capelovitch, T.; Friedman, J.; Weiss, P.L. pdf  url
doi  openurl
  Title Self-feeding kinematics in an ecological setting: typically developing children and children with cerebral palsy Type Journal Article
  Year 2021 Publication (down) IEEE Transactions on Neural Systems and Rehabilitation Engineering : a Publication of the IEEE Engineering in Medicine and Biology Society Abbreviated Journal IEEE Trans Neural Syst Rehabil Eng  
  Volume 29 Issue Pages 1462-1469  
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  Abstract Assessment of self-feeding kinematics is seldom performed in an ecological setting. In preparation for development of an instrumented spoon for measurement of self-feeding in children with cerebral palsy (CP), the current work aimed to evaluate upper extremity kinematics of self-feeding in young children with typical development (TD) and a small, age-matched group of children with CP in a familiar setting, while eating with a spoon. METHODS: Sixty-five TD participants and six children diagnosed with spastic CP, aged 3-9 years, fed themselves while feeding was measured using miniature three-dimensional motion capture sensors (trakStar). Kinematic variables associated with different phases of self-feeding cycle (movement time, curvature, time to peak velocity and smoothness) were compared across age-groups in the TD sample and between TD children and those with CP. RESULTS: Significant between-age group differences were identified in movement times, time to peak velocity and curvature. Children with CP demonstrated slower, less smooth self-feeding movements, potentially related to activity limitations. CONCLUSIONS: The identified kinematic variables form a basis for implementation of self-feeding performance assessment in children of different ages, including those with CP, which can be deployed via an instrumented spoon.  
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  ISSN 1534-4320 ISBN Medium  
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  Notes PMID:34280104 Approved no  
  Call Number Serial 110  
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Author Cantergi, D.; Awasthi, B.; Friedman, J. pdf  url
doi  openurl
  Title Moving objects by imagination? Amount of finger movement and pendulum length determine success in the Chevreul pendulum illusion Type Journal Article
  Year 2021 Publication (down) Human Movement Science Abbreviated Journal Human Movement Science  
  Volume 80 Issue Pages 102879  
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  ISSN 0167-9457 ISBN Medium  
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  Notes Approved no  
  Call Number Serial 111  
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