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Relationship Between Spasticity and Upper-Limb Movement Disorders in Individuals With Subacute Stroke Using Stochastic Spatiotemporal Modeling
Davidowitz
I
author
Parmet
Y
author
Frenkel-Toledo
S
author
Banina
M
C
author
Soroker
N
author
Solomon
J
M
author
Liebermann
D
G
author
Levin
M
F
author
Berman
S
author
2019
English
BACKGROUND: Spasticity is common in patients with stroke, yet current quantification methods are insufficient for determining the relationship between spasticity and voluntary movement deficits. This is partly a result of the effects of spasticity on spatiotemporal characteristics of movement and the variability of voluntary movement. These can be captured by Gaussian mixture models (GMMs). OBJECTIVES: To determine the influence of spasticity on upper-limb voluntary motion, as assessed by the bidirectional Kullback-Liebler divergence (BKLD) between motion GMMs. METHODS: A total of 16 individuals with subacute stroke and 13 healthy aged-equivalent controls reached to grasp 4 targets (near-center, contralateral, far-center, and ipsilateral). Two-dimensional GMMs (angle and time) were estimated for elbow extension motion. BKLD was computed for each individual and target, within the control group and between the control and stroke groups. Movement time, final elbow angle, average elbow velocity, and velocity smoothness were computed. RESULTS: Between-group BKLDs were much larger than within control-group BKLDs. Between-group BKLDs for the near-center target were lower than those for the far-center and contralateral targets, but similar to that for the ipsilateral target. For those with stroke, the final angle was lower for the near-center target, and the average velocity was higher. Velocity smoothness was lower for the near-center than for the ipsilateral target. Elbow flexor and extensor passive muscle resistance (Modified Ashworth Scale) strongly explained BKLD values. CONCLUSIONS: Results support the view that individuals with poststroke spasticity have a velocity-dependent reduction in active elbow joint range and that BKLD can be used as an objective measure of the effects of spasticity on reaching kinematics.
Gaussian mixture model
Kullback-Liebler divergence
spasticity
stroke
upper-limb kinematics
PMID:30744528
exported from refbase (https://refbase.nfshost.com/show.php?record=93), last updated on Tue, 19 Feb 2019 14:09:03 +0000
text
http://www.ncbi.nlm.nih.gov/pubmed/30744528
http://www.ncbi.nlm.nih.gov/pubmed/30744528
10.1177/1545968319826050
30744528
Davidowitz_etal2019
Neurorehabilitation and Neural Repair
Neurorehabil Neural Repair
2019
continuing
periodical
academic journal
33
2
141
152
1545-9683
1