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Krasovsky, T., Keren-Capelovitch, T., Friedman, J., & Weiss, P. L. (2021). Self-feeding kinematics in an ecological setting: typically developing children and children with cerebral palsy. IEEE Trans Neural Syst Rehabil Eng, 29, 1462–1469.
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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Park, J., Pazin, N., Friedman, J., Zatsiorsky, V. M., & Latash, M. L. (2014). Mechanical properties of the human hand digits: Age-related differences. Clinical Biomechanics, 29(2), 129–137.
Abstract: Background
Mechanical properties of human digits may have significant implications for the hand function. We quantified several mechanical characteristics of individual digits in young and older adults. Methods Digit tip friction was measured at several normal force values using a method of induced relative motion between the digit tip and the object surface. A modified quick-release paradigm was used to estimate digit apparent stiffness, damping, and inertial parameters. The subjects grasped a vertical handle instrumented with force/moment sensors using a prismatic grasp with four digits; the handle was fixed to the table. Unexpectedly, one of the sensors yielded leading to a quick displacement of the corresponding digit. A second-order, linear model was used to fit the force/displacement data. Findings Friction of the digit pads was significantly lower in older adults. The apparent stiffness coefficient values were higher while the damping coefficients were lower in older adults leading to lower damping ratio. The damping ratio was above unity for most data in young adults and below unity for older adults. Quick release of a digit led to force changes in other digits of the hand, likely due to inertial hand properties. These phenomena of “mechanical enslaving” were smaller in older adults although no significant difference was found in the inertial parameter in the two groups. Interpretations The decreased friction and damping ratio present challenges for the control of everyday prehensile tasks. They may lead to excessive digit forces and low stability of the grasped object. Keywords: hand; aging; friction; apparent stiffness; damping
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Ezrati, O., Friedman, J., & Dar, R. (2019). Attenuation of access to internal states in high obsessive-compulsive individuals might increase susceptibility to false feedback: Evidence from a visuo-motor hand-reaching task. Journal of Behavior Therapy and Experimental Psychiatry, 65, 101445.
Abstract: Background and objectives
The Seeking Proxies for Internal States (SPIS) model of obsessive-compulsive disorder (OCD) posits that obsessive-compulsive (OC) individuals have attenuated access to their internal states. Hence, they seek and rely on proxies, or discernible substitutes for these internal states. In previous studies, participants with high OC tendencies and OCD patients, compared to controls, showed increased reliance on external proxies and were more influenced by false feedback when judging their internal states. This study is the first to examine the effects of false feedback on performance of hand movements in participants with high and low OC tendencies. Method Thirty-four participants with high OC tendencies and 34 participants with low OC tendencies were asked to perform accurate hand reaches without visual feedback in two separate sessions of a computerized hand-reaching task: once after valid feedback training of their hand location and once with false-rotated feedback. We assessed the accuracy and directional adaptation of participants' reaches. Results As predicted, high OC participants evidenced a larger decrease in their hand positioning accuracy after training with false feedback compared to low OC participants. Limitations The generalization of our findings to OCD requires replication with a clinical sample. Conclusions These results suggest that in addition to self-perceptions, motor performance of OC individuals is prone to be overly influenced by false feedback, possibly due to attenuated access to proprioceptive cues. These findings may be particularly relevant to understanding the distorted sense of agency in OCD. Keywords: Obsessive-compulsive disorder; Movement; Agency; Proprioception; Proxies
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Bezalel, G., Nachoum Arad, G., Plotnik, M., & Friedman, J. (2021). Voluntary step execution in patients with knee osteoarthritis: Symptomatic vs. non-symptomatic legs. Gait Posture, 83, 60–66.
Abstract: 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.
Keywords: Accidental falls; Gait; Knee; Osteoarthritis; Voluntary step
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Steinhart, S., Weiss, P. L., & Friedman, J. (2021). Proximal and distal movement patterns during a graphomotor task in typically developing children and children with handwriting problems. J Neuroeng Rehabil, 18(1), 178.
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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