Roijezon, U., Djupsjobacka, M., Bjorklund, M., Hager-Ross, C., Grip, H., & Liebermann, D. G. (2010). Kinematics of fast cervical rotations in persons with chronic neck pain: a cross-sectional and reliability study. BMC Musculoskelet Disord, 11, 222.
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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Krasovsky, T., Berman, S., & Liebermann, D. G. (2010). Kinematic features of continuous hand reaching movements under simple and complex rhythmical constraints. J Electromyogr Kinesiol, 20(4), 636–641.
Abstract: BACKGROUND: Auditory cues are known to alter movement kinematics in healthy people as well as in people with neurological conditions (e.g., Parkinson's disease or stroke). Pacing movement to rhythmical constraints is known to change both the spatial and temporal features of movement. However, the effect of complexity of pacing on the spatial and temporal kinematic properties is still poorly understood. The current study investigated spatial and temporal aspects of movement (path and speed, respectively) and their integration while subjects followed simple isochronous or complex non-isochronous rhythmical constraints. Spatiotemporal decoupling was expected under the latter constraint. METHODS: Ten subjects performed point-to-point hand movements towards visual targets on the surface of a hemisphere, while following continuous auditory cues of different pace and meter. The spatial and temporal properties of movement were compared to geodesic paths and unimodal bell-shaped speed profiles, respectively. Multiple two-way RM-ANOVAs (pace [1-2 Hz] x meter [duple-triple]) were performed on the different kinematic variables calculated to assess hand deviations from the model data (p< or = 0.05). RESULTS: As expected, increasing pace resulted in straighter hand paths and smoother speed profiles. Meter, however, affected only the path (shorter and straighter under triple) without significantly changing speed. Such an effect was observed at the slow pace only. CONCLUSIONS: Under simple rhythmic cues, an increase in pace causes spontaneous adjustments in spatial features (straighter hand paths) while preserving temporal ones (maximally-smoothed hand speeds). Complex rhythmical cues in contrast perturb spatiotemporal coupling and challenge movement control. These results may have important practical implications in motor rehabilitation.
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Lackritz, H., Parmet, Y., Frenkel-Toledo, S., Banina, M. C., Soroker, N., Solomon, J. M., et al. (2021). Effect of post-stroke spasticity on voluntary movement of the upper limb. J Neuroeng Rehabil, 18(1), 81.
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.
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Liebermann, D. G., & Defrin, R. (2009). Characteristics of the nociceptive withdrawal response elicited under aware and unaware conditions. J Electromyogr Kinesiol, 19(2), e114–22.
Abstract: BACKGROUND: Nociceptive withdrawal reflexes (NWR) are subject to supraspinal modulation. Therefore, awareness about a noxious stimulation may affect its characteristics. The goal of this study was to investigate the effect of different degrees of awareness on the NWR. METHOD: Eight subjects performed back and forth hand movements from a common starting point towards four visual targets during which NWR was evoked when subjects were either unaware or aware of a noxious stimulation (unaware-NWR and aware-NWR). For the comparison between the NWR under both conditions, onset latencies and kinematic variables were computed respectively from the recorded Biceps Brachii EMG and from the spatial coordinates of hand reflective markers. RESULTS: The onset latency of unaware-NWR (mean+/-SD 73.9+/-13 ms) was significantly shorter than that of the aware-NWR (91.1+/-27 ms, p<0.05). The total duration of the muscular activation was shorter in unaware-NWR than in aware-NWR. The slopes of the tangential velocity-time curves were steeper for unaware-NWR than for aware-NWR (p=0.057). CONCLUSIONS: The results suggest that supraspinal regulation of NWR under different degrees of awareness involves the re-parameterization of selected spatiotemporal aspects of a pre-structured motor response.
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Melzer, I., Liebermann, D. G., Krasovsky, T., & Oddsson, L. I. E. (2010). Cognitive load affects lower limb force-time relations during voluntary rapid stepping in healthy old and young adults. J Gerontol A Biol Sci Med Sci, 65(4), 400–406.
Abstract: BACKGROUND: Quick step execution may prevent falls when balance is lost; adding a concurrent task delays this function. We investigate whether push-off force-time relations during the execution of rapid voluntary stepping is affected by a secondary task in older and young adults. METHODS: Nineteen healthy older adults and 12 young adults performed rapid voluntary stepping under single- and dual-task conditions. Peak power, peak force, and time to peak force during preparatory and swing phases of stepping were extracted from center of pressure and ground reaction force data. RESULTS: For dual-task condition compared with single-task condition, older adults show a longer time to reach peak force during the preparation and swing phases compared with young adults (approximately 25% vs approximately 10%, respectively). Peak power and peak force were not affected by a concurrent attention-demanding task. CONCLUSION: Older adults have difficulty allocating sufficient attention for fast muscle recruitment when concurrently challenged by an attention-demanding task.
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