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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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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.
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Markstrom, J. L., Liebermann, D. G., Schelin, L., & Hager, C. K. (2022). Atypical Lower Limb Mechanics During Weight Acceptance of Stair Descent at Different Time Frames After Anterior Cruciate Ligament Reconstruction. Am J Sports Med, , 1–9.
Abstract: BACKGROUND: An anterior cruciate ligament (ACL) rupture may result in poor sensorimotor knee control and, consequentially, adapted movement strategies to help maintain knee stability. Whether patients display atypical lower limb mechanics during weight acceptance of stair descent at different time frames after ACL reconstruction (ACLR) is unknown. PURPOSE: To compare the presence of atypical lower limb mechanics during the weight acceptance phase of stair descent among athletes at early, middle, and late time frames after unilateral ACLR. STUDY DESIGN: Controlled laboratory study. METHODS: A total of 49 athletes with ACLR were classified into 3 groups according to time after ACLR-early (<6 months; n = 17), middle (6-18 months; n = 16), and late (>18 months; n = 16)-and compared with asymptomatic athletes (control; n = 18). Sagittal plane hip, knee, and ankle angles; angular velocities; moments; and powers were compared between the ACLR groups' injured and noninjured legs and the control group as well as between legs within groups using functional data analysis methods. RESULTS: All 3 ACLR groups showed greater knee flexion angles and moments than the control group for injured and noninjured legs. For the other outcomes, the early group had, compared with the control group, less hip power absorption, more knee power absorption, lower ankle plantarflexion angle, lower ankle dorsiflexion moment, and less ankle power absorption for the injured leg and more knee power absorption and higher vertical ground reaction force for the noninjured leg. In addition, the late group showed differences from the control group for the injured leg revealing more knee power absorption and lower ankle plantarflexion angle. Only the early group took a longer time than the control group to complete weight acceptance and demonstrated asymmetry for multiple outcomes. CONCLUSION: Athletes with different time frames after ACLR revealed atypically large knee angles and moments during weight acceptance of stair descent for both the injured and the noninjured legs. These findings may express a chronically adapted strategy to increase knee control. In contrast, atypical hip and ankle mechanics seem restricted to an early time frame after ACLR. CLINICAL RELEVANCE: Rehabilitation after ACLR should include early training in controlling weight acceptance. Including a control group is essential when evaluating movement patterns after ACLR because both legs may be affected.
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Liebermann, D. G. (2008). Biomechanical aspects of motor control in human landing. In R. Bartlett, & Y. Hong (Eds.), Routledge Handbook of Biomechanics and Human Movement Science. Routledge Ltd.
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Falk, B., Eliakim, A., Dotan, R., Liebermann, D. G., Regev, R., & Bar-Or, O. (1997). Birth weight and physical ability in 5- to 8-yr-old healthy children born prematurely. Med Sci Sports Exerc, 29(9), 1124–1130.
Abstract: Recent advances in perinatal care have resulted in increased survival rates of extremely small and immature newborns. This has resulted in some neurodevelopmental impairment. The purpose of this study was to quantitatively evaluate and compare neuromuscular performance in children born prematurely at various levels of subnormal birth weight (BW). Subjects were 5- to 8-yr-old children born prematurely at different levels of subnormal BW (535-1760 g, N = 22, PM), and age-matched controls born at full term (> 2500 g, N = 15, CON). None of the subjects had any clinically defined neuromuscular disabilities. Body mass (BM) of PM was lower than that of CON (18.3 +/- 2.7 vs 21.7 +/- 3.8 kg) with no difference in height or sum of 4 skinfolds. Peak mechanical power output determined with a 15-s modified Wingate Anaerobic Test and corrected for BM was lower (P = 0.07) in PM than in CON (5.11 +/- 1.07 vs 5.94 +/- 1.00 W.kg-1). This was especially noticeable in children born at extremely low BW (ELBW, < 1000 g, 4.49 +/- 1.04 W.kg-1, P < 0.01). Peak power, determined in a force-plate vertical jump, corrected for BM was lower in PM vs CON (25.5 +/- 5.4 vs 30.8 +/- 5.2 W.kg-1, respectively P = 0.01), especially in the ELBW group (20.0 +/- 5.5 W.kg-1). Similarly, the elapsed time between peak velocity and actual jump take-off was longer in PM than in CON (41.2 +/- 9.4 vs 35.8 +/- 5.8 ms, respectively, P = 0.04). No differences were observed in peak force. The results suggest that performance deficiencies of prematurely-born children may be a result of inferior inter-muscular coordination. The precise neuromotor factors responsible for this should be identified by future research.
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