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Liebermann, D. G., Levin, M. F., McIntyre, J., Weiss, P. L., & Berman, S. (2010). Arm path fragmentation and spatiotemporal features of hand reaching in healthy subjects and stroke patients. Conf Proc IEEE Eng Med Biol Soc, 2010, 5242–5245.
Abstract: Arm motion in healthy humans is characterized by smooth and relatively short paths. The current study focused on 3D reaching in stroke patients. Sixteen right-hemiparetic stroke patients and 8 healthy adults performed 42 reaching movements towards 3 visual targets located at an extended arm distance. Performance was assessed in terms of spatial and temporal features of the movement; i.e., hand path, arm posture and smoothness. Differences between groups and within subjects were hypothesized for spatial and temporal aspects of reaching under the assumption that both are independent. As expected, upper limb motion of patients was characterized by longer and jerkier hand paths and slower speeds. Assessment of the number of sub-movements within each movement did not clearly discriminate between groups. Principal component analyses revealed specific clusters of either spatial or temporal measures, which accounted for a large proportion of the variance in patients but not in healthy controls. These findings support the notion of a separation between spatial and temporal features of movement. Stroke patients may fail to integrate the two aspects when executing reaching movements towards visual targets.
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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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Liebermann, D. G., Buchman, A. S., & Franks, I. M. (2006). Enhancement of motor rehabilitation through the use of information technologies. Clin Biomech (Bristol, Avon), 21(1), 8–20.
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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Liebermann, D. G., & Hoffman, J. R. (2005). Timing of preparatory landing responses as a function of availability of optic flow information. J Electromyogr Kinesiol, 15(1), 120–130.
Abstract: This study investigated temporal patterns of EMG activity during self-initiated falls with different optic flow information ('gaze directions'). Onsets of EMG during the flight phase were monitored from five experienced volunteers that completed 72 landings in three gaze directions (downward, mid-range and horizontal) and six heights of fall (10-130 cm). EMG recordings were obtained from the right gastrocnemius, tibialis anterior, biceps femoris and rectus femoris muscles, and used to determine the latency of onset (L(o)) and the perceived time to contact (T(c)). Impacts at touchdown were also monitored using as estimates the major peak of the vertical ground reaction forces (F(max)) normalized to body mass, time to peak (T(max)), peak impulse (I(norm)) normalized to momentum, and rate of change of force (dF(max)/dt). Results showed that L(o) was longer as heights of fall increased, but remained within a narrow time-window at >50 cm landings. No significant differences in L(o) were observed when gaze direction was changed. The relationship between T(c) and flight time followed a linear trend regardless of gaze direction. Gaze direction did not significantly affect the landing impacts. In conclusion, availability of optic flow during landing does not play a major role in triggering the preparatory muscle actions in self-initiated falls. Once a structured landing plan has been acquired, the relevant muscles respond relative to the start of the fall.
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Friedman, J., Amiaz, A., & Korman, M. (2022). The online and offline effects of changing movement timing variability during training on a finger-opposition task. Sci Rep, 12(1), 13319.
Abstract: In motor learning tasks, there is mixed evidence for whether increased task-relevant variability in early learning stages leads to improved outcomes. One problem is that there may be a connection between skill level and motor variability, such that participants who initially have more variability may also perform worse on the task, so will have more room to improve. To avoid this confound, we experimentally manipulated the amount of movement timing variability (MTV) during training to test whether it improves performance. Based on previous studies showing that most of the improvement in finger-opposition tasks comes from optimizing the relative onset time of the finger movements, we used auditory cues (beeps) to guide the onset times of sequential movements during a training session, and then assessed motor performance after the intervention. Participants were assigned to three groups that either: (a) followed a prescribed random rhythm for their finger touches (Variable MTV), (b) followed a fixed rhythm (Fixed control MTV), or (c) produced the entire sequence following a single beep (Unsupervised control MTV). While the intervention was successful in increasing MTV during training for the Variable group, it did not lead to improved outcomes post-training compared to either control group, and the use of fixed timing led to significantly worse performance compared to the Unsupervised control group. These results suggest that manipulating MTV through auditory cues does not produce greater learning than unconstrained training in motor sequence tasks.
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