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Raveh, E., Portnoy, S., & Friedman, J. (2018). Myoelectric Prosthesis Users Improve Performance Time and Accuracy Using Vibrotactile Feedback When Visual Feedback Is Disturbed. Arch Phys Med Rehabil, 99(11), 2263–2270.
Abstract: OBJECTIVE: To evaluate the effects of adding vibrotactile feedback (VTF) in myoelectric prosthesis users during performance of a functional task when visual feedback is disturbed. DESIGN: A repeated-measures design with a counter-balanced order of 3 conditions. SETTING: Laboratory setting. PARTICIPANTS: Transradial amputees using a myoelectric prosthesis with normal or corrected eyesight (N=12, median age 65+/-13y). Exclusion criteria were orthopedic or neurologic problems. INTERVENTIONS: All participants performed the modified Box and Blocks Test, grasping and manipulating 16 blocks over a partition using their myoelectric prosthesis. This was performed 3 times: in full light, in a dark room without VTF, and in a dark room with VTF. MAIN OUTCOME MEASURES: Performance time, that is, the time needed to transfer 1 block, and accuracy during performance, measured by number of empty grips, empty transitions with no block and block drops from the hand. RESULTS: Significant differences were found in all outcome measures when VTF was added, with improved performance time (4.2 vs 5.3s) and a reduced number of grasping errors (3.0 vs 6.5 empty grips, 1.5 vs 4 empty transitions, 2.0 vs 4.5 block drops). CONCLUSIONS: Adding VTF to myoelectric prosthesis users has positive effects on performance time and accuracy when visual feedback is disturbed.
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Kaufman-Cohen, Y., Portnoy, S., Levanon, Y., & Friedman, J. (2019). Does Object Height Affect the Dart Throwing Motion Angle during Seated Activities of Daily Living? J Mot Behav, , 1–10.
Abstract: Complex wrist motions are needed to complete various daily activities. Analyzing the multidimensional motion of the wrist is crucial for understanding our functional movement. Several studies have shown that numerous activities of daily livings (ADLs) are performed using an oblique plane of wrist motion from radial-extension to ulnar-flexion, named the Dart Throwing Motion (DTM) plane. To the best of our knowledge, the DTM plane angle performed during ADLs has not been compared between different heights (e.g. table, shoulder and head height), as is common when performing day-to-day tasks. In this study, we compared DTM plane angles when performing different ADLs at three different heights and examined the relationship between DTM plane angles and limb position. We found that height had a significant effect on the DTM plane angles – the mean DTM plane angle was greater at the lower level compared to the mid and higher levels. A significant effect of shoulder orientation on mean DTM plane angles was shown in the sagittal and coronal planes. Our findings support the importance of training daily tasks at different heights during rehabilitation following wrist injuries, in order to explore a large range of DTM angles, to accommodate needs of common ADLs.
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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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Merdler, T., Liebermann, D. G., Levin, M. F., & Berman, S. (2013). Arm-plane representation of shoulder compensation during pointing movements in patients with stroke. J Electromyogr Kinesiol, 23(4), 938–947.
Abstract: Improvements in functional motor activities are often accompanied by motor compensations to overcome persistent motor impairment in the upper limb. Kinematic analysis is used to objectively quantify movement patterns including common motor compensations such as excessive trunk displacement during reaching. However, a common motor compensation to assist reaching, shoulder abduction, is not adequately characterized by current motion analysis approaches. We apply the arm-plane representation that accounts for the co-variation between movements of the whole arm, and investigate its ability to identify and quantify compensatory arm movements in stroke subjects when making forward arm reaches. This method has not been previously applied to the analysis of motion deficits. Sixteen adults with right post-stroke hemiparesis and eight healthy age-matched controls reached in three target directions (14 trials/target; sampling rate: 100Hz). Arm-plane movement was validated against endpoint, joint, and trunk kinematics and compared between groups. In stroke subjects, arm-plane measures were correlated with arm impairment (Fugl-Meyer Assessment) and ability (Box and Blocks) scores and were more sensitive than clinical measures to detect mild motor impairment. Arm-plane motion analysis provides new information about motor compensations involving the co-variation of shoulder and elbow movements that may help to understand the underlying motor deficits in patients with stroke.
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Krasovsky, T., Weiss, P. L., Zuckerman, O., Bar, A., Keren-Capelovitch, T., & Friedman, J. (2020). DataSpoon: Validation of an Instrumented Spoon for Assessment of Self-Feeding. Sensors (Basel), 20(7).
Abstract: Clinically feasible assessment of self-feeding is important for adults and children with motor impairments such as stroke or cerebral palsy. However, no validated assessment tool for self-feeding kinematics exists. This work presents an initial validation of an instrumented spoon (DataSpoon) developed as an evaluation tool for self-feeding kinematics. Ten young, healthy adults (three male; age 27.2 +/- 6.6 years) used DataSpoon at three movement speeds (slow, comfortable, fast) and with three different grips: “natural”, power and rotated power grip. Movement kinematics were recorded concurrently using DataSpoon and a magnetic motion capture system (trakSTAR). Eating events were automatically identified for both systems and kinematic measures were extracted from yaw, pitch and roll (YPR) data as well as from acceleration and tangential velocity profiles. Two-way, mixed model Intraclass correlation coefficients (ICC) and 95% limits of agreement (LOA) were computed to determine agreement between the systems for each kinematic variable. Most variables demonstrated fair to excellent agreement. Agreement for measures of duration, pitch and roll exceeded 0.8 (excellent agreement) for >80% of speed and grip conditions, whereas lower agreement (ICC < 0.46) was measured for tangential velocity and acceleration. A bias of 0.01-0.07 s (95% LOA [-0.54, 0.53] to [-0.63, 0.48]) was calculated for measures of duration. DataSpoon enables automatic detection of self-feeding using simple, affordable movement sensors. Using movement kinematics, variables associated with self-feeding can be identified and aid clinical reasoning for adults and children with motor impairments.
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