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Unger T, de Sousa Ribeiro R, Mokni M, Weikert T, Pohl J, Schwarz A, Held J, Sauerzopf L, Kühnis B, Gavagnin E, Luft A, Gassert R, Lambercy O, Awai Easthope C, Schönhammer J. Upper limb movement quality measures: comparing IMUs and optical motion capture in stroke patients performing a drinking task. Front Digit Health 2024; 6:1359776. [PMID: 38606036 PMCID: PMC11006959 DOI: 10.3389/fdgth.2024.1359776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/13/2024] [Indexed: 04/13/2024] Open
Abstract
Introduction Clinical assessment of upper limb sensorimotor function post-stroke is often constrained by low sensitivity and limited information on movement quality. To address this gap, recent studies proposed a standardized instrumented drinking task, as a representative daily activity combining different components of functional arm use. Although kinematic movement quality measures for this task are well-established, and optical motion capture (OMC) has proven effective in their measurement, its clinical application remains limited. Inertial Measurement Units (IMUs) emerge as a promising low-cost and user-friendly alternative, yet their validity and clinical relevance compared to the gold standard OMC need investigation. Method In this study, we conducted a measurement system comparison between IMUs and OMC, analyzing 15 established movement quality measures in 15 mild and moderate stroke patients performing the drinking task, using five IMUs placed on each wrist, upper arm, and trunk. Results Our findings revealed strong agreement between the systems, with 12 out of 15 measures demonstrating clinical applicability, evidenced by Limits of Agreement (LoA) below the Minimum Clinically Important Differences (MCID) for each measure. Discussion These results are promising, suggesting the clinical applicability of IMUs in quantifying movement quality for mildly and moderately impaired stroke patients performing the drinking task.
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Affiliation(s)
- T. Unger
- DART Lab, Lake Lucerne Institute, Vitznau, Switzerland
- Rehabilitation Engineering Laboratory, ETH Zurich, Zurich, Switzerland
| | | | - M. Mokni
- DART Lab, Lake Lucerne Institute, Vitznau, Switzerland
| | - T. Weikert
- DART Lab, Lake Lucerne Institute, Vitznau, Switzerland
| | - J. Pohl
- DART Lab, Lake Lucerne Institute, Vitznau, Switzerland
| | - A. Schwarz
- Department of Neurology, UCLA, Los Angeles, CA, United States
- California Rehabilitation Institute, Los Angeles, CA, United States
| | - J.P.O. Held
- Ambulante Reha Triemli Zurich, Zurich, Switzerland
| | - L. Sauerzopf
- ZHAW School of Health Sciences, Institute of Occupational Therapy, Winterthur, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - B. Kühnis
- ZHAW School of Management and Law, Institute of Business Information Technology, Winterthur, Switzerland
| | - E. Gavagnin
- ZHAW School of Management and Law, Institute of Business Information Technology, Winterthur, Switzerland
- ZHAW School of Engineering, Centre for Artificial Intelligence, Winterthur, Switzerland
| | - A.R. Luft
- Division of Vascular Neurology and Neurorehabilitation, Department of Neurology and Clinical Neuroscience Center, University of Zurich and University Hospital Zurich, Zurich, Switzerland
- cereneo, Center for Neurology and Rehabilitation, Vitznau, Switzerland
| | - R. Gassert
- Rehabilitation Engineering Laboratory, ETH Zurich, Zurich, Switzerland
| | - O. Lambercy
- Rehabilitation Engineering Laboratory, ETH Zurich, Zurich, Switzerland
| | | | - J.G. Schönhammer
- DART Lab, Lake Lucerne Institute, Vitznau, Switzerland
- Division of Vascular Neurology and Neurorehabilitation, Department of Neurology and Clinical Neuroscience Center, University of Zurich and University Hospital Zurich, Zurich, Switzerland
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Freire B, Silva LY, Espindola KA, da Rocha JRDO, Michaelsen SM. Motion Analysis of the Mug Transportation Task Through Upper Limb Kinematics. J Mot Behav 2024:1-9. [PMID: 38439504 DOI: 10.1080/00222895.2024.2324903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/23/2024] [Indexed: 03/06/2024]
Abstract
The task of transporting objects is a fundamental part of daily living activities. Previous kinematic studies focusing on tasks such as pointing, reach-to-grasp, and drinking have not fully captured the motor behaviors involved in object transportation, including placing a cup on a table or storing items in specific places. Hence, this study aimed to analyze the motor behavior associated with transporting a mug using upper limb kinematic variables. Fifteen healthy adults were instructed to transport an open-handle mug across a table. The kinematic metrics evaluated included object end-error for accuracy, frontal and lateral end-range for precision, movement time, peak velocity, time to peak velocity for control strategy, object path ratio for efficiency, and interjoint coordination. The stability of motor behavior was assessed through a test-retest analysis. The mug transporting task achieved accuracy with a radius <10 mm around the target, a peak velocity of ∼0.4 m/s, a control strategy where acceleration time constituted about 30% of the movement time, and a slightly curved trajectory. The test-retest analysis confirmed stable motor behavior across all kinematic metrics (ICCs > 0.75). Thus, the mug transporting task exhibited unique and stable kinematic characteristics, distinguishing it from non-transport activities and effectively mirroring transporting activities of daily living.
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Affiliation(s)
- Bruno Freire
- Department of Physical Therapy, Santa Catarina State University, Florianópolis, Brazil
| | - Letícia Yolanda Silva
- Department of Physical Therapy, Santa Catarina State University, Florianópolis, Brazil
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Nakatake J, Arakawa H, Tajima T, Miyazaki S, Chosa E. Age- and sex-related differences in upper-body joint and endpoint kinematics during a drinking task in healthy adults. PeerJ 2023; 11:e16571. [PMID: 38144196 PMCID: PMC10740664 DOI: 10.7717/peerj.16571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/13/2023] [Indexed: 12/26/2023] Open
Abstract
Background The objective kinematic assessments of activities of daily living are desired. However, the limited knowledge regarding age- and sex-related differences prevents the adaptation of these measurements to clinical settings and in-home exercises. Therefore, this study aimed to determine the effects of age and sex on joint and endpoint kinematics during a common activity of daily living, specifically, drinking from a glass. Methods In total, 32 healthy adults (18 males and 14 females) aged 22-77 years performed a drinking task comprising reaching for a glass, bringing it forward and sipping, returning it, and placing the hand back to the starting position, which was recorded using a three-dimensional motion-capturing system. A two-way analysis of variance was used to statistically compare joint angles at five different time points and endpoint kinematic variables in the four drinking phases between older and younger age groups and sexes. Results Wrist radial deviation was greater in older adults than in younger participants at all five different time points (F = 5.16-7.34, p ≤ 0.03, η2 = 0.14-0.21). Moreover, lesser shoulder abduction and greater shoulder internal rotation and forearm pronation when moving and returning the hand to the starting position were observed in the female group than in the male group (F = 4.21-20.03, p ≤ 0.0497, η2 = 0.13-0.41). Trunk flexion was lower in the female group than in the male group at all time points (F = 4.25-7.13, p ≤ 0.0485, η2 = 0.12-0.19). Regarding endpoint kinematics, the performance time in the reaching phase was longer in older adults than in younger individuals (F = 4.96, p = 0.03, η2 = 0.14). Furthermore, a shorter time while returning the hand to the starting position was observed in the female group than in the male group (F = 9.55, p < 0.01, η2 = 0.22). Conclusions The joint kinematics of drinking were partially characterized by an age effect, whereas endpoint kinematics were scattered in all drinking phases. Sex-related effects in most upper-body motions and postures may cause rapid motions in females. Therefore, clinicians could use this knowledge for precise assessments and to suggest feasible in-home exercises.
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Affiliation(s)
- Jun Nakatake
- Rehabilitation Unit, University of Miyazaki Hospital, Miyazaki, Miyazaki, Japan
| | - Hideki Arakawa
- Rehabilitation Unit, University of Miyazaki Hospital, Miyazaki, Miyazaki, Japan
| | - Takuya Tajima
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Miyazaki, Japan
| | - Shigeaki Miyazaki
- Rehabilitation Unit, University of Miyazaki Hospital, Miyazaki, Miyazaki, Japan
| | - Etsuo Chosa
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Miyazaki, Japan
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Choi H, Park D, Rha DW, Nam HS, Jo YJ, Kim DY. Kinematic analysis of movement patterns during a reach-and-grasp task in stroke patients. Front Neurol 2023; 14:1225425. [PMID: 37693760 PMCID: PMC10484108 DOI: 10.3389/fneur.2023.1225425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/15/2023] [Indexed: 09/12/2023] Open
Abstract
Background This study aimed to evaluate the kinematic movement patterns during a reach-and-grasp task in post-stroke patients according to the upper extremity impairment severity. Methods Subacute stroke patients (n = 46) and healthy controls (n = 20) were enrolled in this study. Spatiotemporal and kinematic data were obtained through 3D motion analysis during the reach-and-grasp task. Stroke patients were grouped using the Fugl-Meyer Assessment (FMA) scale, and a comparison of the groups was performed. Results The severe group showed a significantly longer movement time, lower peak velocity, and higher number of movement units than the mild group during the reach-and-grasp task (p < 0.05). Characteristic compensatory movement patterns, such as shoulder abduction, thoracic posterior tilting, and upward and external rotation were significantly greater during the forward transporting phase in the severe group than in the mild group (p < 0.05). The FMA score was significantly associated with the movement time during the forward transporting phase, number of movement units during the reaching phase, range of shoulder abduction-adduction and wrist flexion-extension movements during the reaching phase, and range of thoracic internal-external rotation during the backward transporting phase (p < 0.05). Conclusion Post-stroke patients have unique spatiotemporal and kinematic movement patterns during a reach-and grasp-task according to the impairment severity.
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Affiliation(s)
- Hyoseon Choi
- Department of Rehabilitation Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Republic of Korea
- Department of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dongho Park
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, United States
- Institute for Robotics and Intelligent Machines, Georgia Institute of Technology, Atlanta, GA, United States
| | - Dong-Wook Rha
- Department of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyo Suk Nam
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yea Jin Jo
- Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Deog Young Kim
- Department of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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Lustosa L, Silva AEL, Carvalho RDP, Vargas CD. Upper limb joint coordination preserves hand kinematics after a traumatic brachial plexus injury. Front Hum Neurosci 2022; 16:944638. [PMID: 36277047 PMCID: PMC9583840 DOI: 10.3389/fnhum.2022.944638] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 09/07/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundTraumatic brachial plexus injury (TBPI) causes a sensorimotor deficit in upper limb (UL) movements.ObjectiveOur aim was to investigate the arm–forearm coordination of both the injured and uninjured UL of TBPI subjects.MethodsTBPI participants (n = 13) and controls (n = 10) matched in age, gender, and anthropometric characteristics were recruited. Kinematics from the shoulder, elbow, wrist, and index finger markers were collected, while upstanding participants transported a cup to their mouth and returned the UL to a starting position. The UL coordination was measured through the relative phase (RP) between arm and forearm phase angles and analyzed as a function of the hand kinematics.ResultsFor all participants, the hand transport had a shorter time to peak velocity (p < 0.01) compared to the return. Also, for the control and the uninjured TBPI UL, the RP showed a coordination pattern that favored forearm movements in the peak velocity of the transport phase (p < 0.001). TBPI participants' injured UL showed a longer movement duration in comparison to controls (p < 0.05), but no differences in peak velocity, time to peak velocity, and trajectory length, indicating preserved hand kinematics. The RP of the injured UL revealed altered coordination in favor of arm movements compared to controls and the uninjured UL (p < 0.001). Finally, TBPI participants' uninjured UL showed altered control of arm and forearm phase angles during the deceleration of hand movements compared to controls (p < 0.05).ConclusionThese results suggest that UL coordination is reorganized after a TBPI so as to preserve hand kinematics.
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Affiliation(s)
- Luiggi Lustosa
- Laboratório de Neurobiologia do Movimento, Instituto de Biofísica Carlos Chagas Filho – Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Núcleo de Pesquisa em Neurociências e Reabilitação, Instituto de Neurologia Deolindo Couto – Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ana Elisa Lemos Silva
- Núcleo de Pesquisa em Neurociências e Reabilitação, Instituto de Neurologia Deolindo Couto – Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Raquel de Paula Carvalho
- Departamento de Ciências do Movimento Humano, Instituto Saúde e Sociedade, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Claudia D. Vargas
- Laboratório de Neurobiologia do Movimento, Instituto de Biofísica Carlos Chagas Filho – Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Núcleo de Pesquisa em Neurociências e Reabilitação, Instituto de Neurologia Deolindo Couto – Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- *Correspondence: Claudia D. Vargas
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Vocelle AR, Weidig G, Bush TR. Shoulder structure and function: The impact of osteoarthritis and rehabilitation strategies. J Hand Ther 2022; 35:377-387. [PMID: 35918274 DOI: 10.1016/j.jht.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 05/31/2022] [Accepted: 06/20/2022] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Invited review. BACKGROUND Shoulder osteoarthritis can result in significant functional deficits. To improve diagnosis and treatment, we must better understand the impact of osteoarthritis on shoulder biomechanics and the known mechanical benefits of currently available treatments. PURPOSE The purpose of this paper is to present up-to-date data on the effects of osteoarthritis and rehabilitation on the biomechanical parameters contributing to shoulder function. With this goal, we also reviewed the anatomy and the ranges of motion of the shoulder. METHODS A search of electronic databases was conducted. All study designs were included to inform this qualitative, narrative literature review. RESULTS This review describes the biomechanics of the shoulder, the impact of osteoarthritis on shoulder function, and the treatment of shoulder osteoarthritis with an emphasis on rehabilitation. CONCLUSIONS The shoulder is important for the completion of activities of daily living, and osteoarthritis of the shoulder can significantly reduce shoulder motion and arm function. Although shoulder rehabilitation is an integral treatment modality to improve pain and function in shoulder osteoarthritis, few high-quality studies have investigated the effects and benefits of shoulder physical and occupational therapies. To advance the fields of therapy and rehabilitation, future studies investigating the effects of therapy intensity, therapy duration, and the relative benefits of therapy subtypes on shoulder biomechanics and function are necessary.
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Affiliation(s)
- Amber R Vocelle
- Physical Medicine and Rehabilitation Department, E.W. Sparrow Hospital, Lansing, MI, USA; Physical Medicine and Rehabilitation Department, Michigan State University, East Lansing, MI, USA
| | - Garrett Weidig
- Mechanical Engineering Department, Michigan State University, East Lansing, MI, USA
| | - Tamara R Bush
- Mechanical Engineering Department, Michigan State University, East Lansing, MI, USA.
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Kinematic Analysis of Daily Activity of Touching Lateral Shoulder for Normal Subjects. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12042069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Analysis of motion is needed in order to gain a better understanding of upper-limb movements. Biomechanical studies involving measurements of movement analysis are very important so that upper-limb activities can be explained. The purpose of this study was to describe the temporal analysis for different age groups and investigate the relationship between kinematical analysis movements of upper-limb joints in the “touching contra lateral shoulder” activity with different age groups. The activity included hand lifting, resting and returning the hand to the initial position with twenty healthy subjects between 24 and 56 years old (n = 60). The Vicon motion analysis system, which consists of three infrared and high-speed cameras, was used to analyze several kinematical parameters such as movement times, peak velocities and joint angles of the shoulder, elbow and wrist. Descriptive kinematic variables were obtained, and phase definitions were determined. There were significant differences among all age groups for total movement times and angles of the shoulder, elbow and wrist joints. The quality of movement dropped after subjects reached an age of 50. Thus, the analysis that segmented this age group may provide relevant information that will help improve the understanding of the motor system with advancing age.
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Motor Ability Evaluation of the Upper Extremity with Point-To-Point Training Movement Based on End-Effector Robot-Assisted Training System. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:1939844. [PMID: 35126907 PMCID: PMC8816541 DOI: 10.1155/2022/1939844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 10/17/2021] [Accepted: 01/06/2022] [Indexed: 11/18/2022]
Abstract
Assessment is critical during the procedure of stroke rehabilitation. However, traditional assessment methods are time-consuming, laborious, and dependent on the skillfulness of the therapist. Moreover, they cannot distinguish whether the improvement comes from the abnormal compensation or the improvement of upper extremity motor function. To make up for the shortcomings of the traditional methods, this study proposes a novel assessment system, which consisted of a rehabilitation robot and motion capture (MoCAP) system. A 9-degree-of-freedom (DOF) kinematic model is established, which consists of the shoulder girdle, shoulder, elbow, and wrist joints. And seven assessment indices are selected for this assessment system, including a range of motion (ROM), shoulder girdle compensation (SGC), trunk compensation (TC), aiming angle (AA), motion error (ME), motion length ratio (MLR), and useful force (UF). For AA, ME, and MLR, all describe the motor ability of the upper extremity, and a linear model was proposed to map these three indices into one index, called motor control ability (MCA). Then, this system can quantitatively evaluate human upper extremity motor function from joint space kinematics, Cartesian space kinematics, and dynamics. Three healthy participants were invited to verify the effectiveness of this system. The preliminary results show that all participants' handedness performs a little better than the nonhandedness. And the performance of the participants and the change of all the upper limb joints can be directly watched from the trajectory of the hand and joint angles' curve. Therefore, this assessment system can evaluate the human upper limb motor function well. Future studies are planned to recruit elderly volunteers or stroke patients to further verify the effectiveness of this system.
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Sousa ASP, da Silva CIC, Mesquita IA, Silva A, Macedo R, Imatz-Ojanguren E, Hernandez E, Keller T, Moreira J, da Fonseca PFP, Santos R. Optimal multi-field functional electrical stimulation parameters for the "drinking task - reaching phase" and related upper limb kinematics repeatability in post stroke subjects. J Hand Ther 2021; 35:645-654. [PMID: 34253404 DOI: 10.1016/j.jht.2021.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 03/02/2021] [Accepted: 05/06/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND No specific guidelines for the management of functional electrical stimulation (FES) parameters in post stroke patients have been defined yet, despite its frequent use. The purpose of this study is to characterize the optimal FES parameters that assist the reaching phase of drinking task ("drinking task - reaching phase") on post stroke subjects and to analyze the related upper limb (UL) movement quality indicators repeatability. METHODS An observational study with a test and re-test design involving ten post stroke subjects with UL dysfunction was performed. End-point and joint kinematics of contralesional UL were assessed during the "drinking task - reaching phase" with FES through a test and retest design. FES parameters were adjusted to improve UL function according to a consensus between physiotherapists and patients' perspective. FINDINGS It was possible to establish reliable FES parameters that assisted the "drinking task - reaching phase". All FES parameters presented high to very high repeatability and led to moderate to very high repeatability in almost UL movement quality indicators during the "drinking task - reaching phase". INTERPRETATION These findings show that the main characteristics of FES parameters that improves patient perception of change are quite stable, which facilitate its implementation in clinical practice by allowing consistence between intervention sessions.
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Affiliation(s)
- Andreia S P Sousa
- Center for Rehabilitation Research - Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200 - 072, Porto, Portugal.
| | - Cláudia Isabel Costa da Silva
- Center for Rehabilitation Research - Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200 - 072, Porto, Portugal
| | - Inês Albuquerque Mesquita
- Center for Rehabilitation Research - Human Movement System (Re)habilitation Area, Department of Functional Sciences, School of Health, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200 - 072, Porto, Portugal
| | - Augusta Silva
- Center for Rehabilitation Research - Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200 - 072, Porto, Portugal
| | - Rui Macedo
- Center for Rehabilitation Research - Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200 - 072, Porto, Portugal
| | - Eukene Imatz-Ojanguren
- TECNALIA, Basque Research and Technology Alliance (BRTA), Parque Tecnológico de Bizkaia, Astondo Bidea, Edificio 700, E-48160 Derio (Spain)
| | - Erik Hernandez
- TECNALIA, Basque Research and Technology Alliance (BRTA), Parque Tecnológico de San Sebastián, Mikeletegi Pasealekua, 1, E-20009 Donostia-San Sebastián (Spain)
| | - Thierry Keller
- TECNALIA, Basque Research and Technology Alliance (BRTA), Parque Tecnológico de San Sebastián, Mikeletegi Pasealekua, 1, E-20009 Donostia-San Sebastián (Spain)
| | - Juliana Moreira
- Center for Rehabilitation Research - Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200 - 072, Porto, Portugal
| | | | - Rubim Santos
- Center for Rehabilitation Research - Human Movement System (Re)habilitation Area, Department of Physics, School of Health, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200 - 072, Porto, Portugal
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Sousa ASP, Mesquita IA, Costa da Silva CI, Silva A, Macedo R, Imatz-Ojanguren E, Hernandez E, Keller T, Moreira J, Pereira da Fonseca PF, Santos R. Optimal Multifield Functional Electrical Stimulation Parameters for the "Turn on the Light" Task and Related Upper Limb Kinematics Repeatability in Poststroke Subjects. Arch Phys Med Rehabil 2020; 102:1180-1190. [PMID: 33253692 DOI: 10.1016/j.apmr.2020.10.135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 10/16/2020] [Accepted: 10/20/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To characterize the optimal functional electrical stimulation (FES) parameters that assist the turn on the light task (TOTL) on poststroke participants and to analyze the related upper limb (UL) kinematics repeatability. DESIGN Cross-sectional study. SETTING Human movement research center. PARTICIPANTS Poststroke individuals (N=11) with history of a single unilateral stroke that resulted in a motor control dysfunction of the contralesional UL. INTERVENTIONS FES based on surface multifield technology applied to the contralesional wrist and finger extensors during the TOTL. MAIN OUTCOME MEASURES FES outcome metrics (virtual electrodes, stimulation duration, intensity) and kinematic metrics (end-point kinematics [absolute and relative duration, mean and peak velocities, relative instant of peak velocity, index of curvature, number of movement units] and joint kinematics [shoulder, elbow, wrist end position and range of movement]). Outcome measures were assessed 2 times with a 72-hour maximum time interval. CONCLUSION It was possible to establish reliable FES parameters that assisted the TOTL on poststroke participants. These stimulation parameters led to high to very high repeatability in terms of UL kinematics for most of the cases.
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Affiliation(s)
- Andreia S P Sousa
- Center for Rehabilitation Research - Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, Porto, Portugal.
| | - Inês Albuquerque Mesquita
- Center for Rehabilitation Research - Human Movement System (Re)habilitation Area, Department of Functional Sciences, School of Health, Polytechnic of Porto, Porto, Portugal
| | - Cláudia Isabel Costa da Silva
- Center for Rehabilitation Research - Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, Porto, Portugal
| | - Augusta Silva
- Center for Rehabilitation Research - Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, Porto, Portugal
| | - Rui Macedo
- Center for Rehabilitation Research - Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, Porto, Portugal
| | | | - Erik Hernandez
- TECNALIA, Basque Research and Technology Alliance (BRTA) Spain
| | - Thierry Keller
- TECNALIA, Basque Research and Technology Alliance (BRTA) Spain
| | - Juliana Moreira
- Center for Rehabilitation Research - Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, Porto, Portugal
| | | | - Rubim Santos
- Center for Rehabilitation Research - Human Movement System (Re)habilitation Area, Department of Physics, School of Health, Polytechnic of Porto, Porto, Portugal
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Radwan NL, Ibrahim MM, Mahmoud WS. Effect of Wii-habilitation on spatiotemporal parameters and upper limb function post-burn in children. Burns 2020; 47:828-837. [PMID: 33092897 DOI: 10.1016/j.burns.2020.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 09/07/2020] [Accepted: 09/24/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Limb burns can cause different functional disorders that greatly impact one's quality of life. AIM The purpose of the current study was to compare the effect of Nintendo Wii sports intervention, and traditional treatment methods on spatiotemporal parameters and upper limb function post-burn in children. METHODS Thirty children their age ranging from 7-12 years, with dominant side upper limb burn participated in the study.Vicon3-D motion analysis system and Jebsen hand function test were used to evaluate spatiotemporal parameters (movement duration, peak velocity, and time to peak velocity percentage in three functional tasks) and upper limb function respectively. The children were randomly divided into study and control groups. The study group was rehabilitated with Wii training in addition to traditional therapy, while the control group rehabilitated only with the traditional therapy program. For the study group, the games selected were Wii Bowling, Baseball, and Tennis. Both groups were trained for 60 min daily, three times/week for six weeks. The outcomes were measured pre and post the treatment period. RESULTS The whole-time duration and peak velocity improved significantly in the study group across the hand to head task (p = 0.001, p < 0.001, respectively), hand to mouth (p = 0.001), and hand to shoulder (p < 0.001, p = 0.0018, respectively) compared with the control group. The time to peak velocity percentage was enhanced significantly in the study group (p < 0.001) than the control group in all three-measured tasks. Moreover, the Jebsen hand function test improved significantly (p < 0.001) in the study group than in the control group. CONCLUSION Wii-habilitation could be advised as an effective tool in the rehabilitation program of children with post-burn injuries.
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Affiliation(s)
- Nadia L Radwan
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Egypt; Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Kingdom of Saudi Arabia.
| | - Marwa M Ibrahim
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Egypt; Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Kingdom of Saudi Arabia
| | - Waleed S Mahmoud
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Kingdom of Saudi Arabia; Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Bailey CA, Weiss M, Côté JN. Age-Dependent Control of Shoulder Muscles During a Reach-and-Lift Task. J Aging Phys Act 2020; 28:556-566. [PMID: 31825888 DOI: 10.1123/japa.2019-0055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 10/18/2019] [Accepted: 10/29/2019] [Indexed: 10/27/2023]
Abstract
Aging affects fatigability and is a risk factor for incurring a fatigue-related injury in the neck/shoulder region. Age-related changes in the electromyographical features of motor control may be partly responsible. Young (N = 17) and older (N = 13) adults completed a reach-and-lift task at their self-selected speed, before and after a fatiguing task targeting the neck/shoulder. Electromyography amplitude (root mean square), amplitude variability (root mean square coefficient of variation [CV]), functional connectivity (normalized mutual information [NMI]), and functional connectivity variability (NMI CV) were extracted from several muscles and analyzed for effects and interactions of age using general estimating equation models. Root mean square CV and deltoid NMI CV increased from pre- to postfatigue (ps < .05). Upper trapezius-deltoid NMI decreased for young, but increased for older adults, while the opposite response was found for lower trapezius-deltoid NMI (ps < .05). Older adults seem to adapt to fatigue in reach-and-lift movement with a cranial shift in control of the scapula.
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13
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Thrane G, Sunnerhagen KS, Murphy MA. Upper limb kinematics during the first year after stroke: the stroke arm longitudinal study at the University of Gothenburg (SALGOT). J Neuroeng Rehabil 2020; 17:76. [PMID: 32539738 PMCID: PMC7296942 DOI: 10.1186/s12984-020-00705-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 05/28/2020] [Indexed: 12/31/2022] Open
Abstract
Background Reduction of compensation and improved movement quality indicate recovery after stroke. Since clinical measures alone are often inadequate to distinguish between behavioral recovery and compensation, kinematic analysis of functional tasks has been recommended. Objective To quantify longitudinal changes and residual deficits in movement performance and quality during the first year after stroke using kinematic analysis of drinking task. Methods A total of 56 participants with first ever stroke causing upper extremity impairment were extracted from a non-selected stroke unit cohort (Stroke Arm Longitudinal Study at the University of Gothenburg-SALGOT). Participants needed to able to perform the drinking task with the more-affected arm at least on 2 occasions out of 6 (3 days, 10 days, 4 weeks, and 3, 6, and 12 months) during the first year to be included. A cohort of 60 healthy individuals was used as reference. Longitudinal changes were analyzed using linear mixed models. Results Movement time, number of movement units, peak angular velocity of the elbow, peak hand velocity, and trunk displacement improved significantly over the first 3 months with a peak at 6 months. Movement time and peak hand velocity reached levels comparable to healthy at 3 months, but number of movement units, peak elbow angular velocity, trunk displacement, and arm abduction remained different from healthy over the first year after stroke. Conclusions Even when the recovery patterns of kinematics follow the known nonlinear pattern, not all kinematic measures reach the levels in par with healthy controls at one year post stroke. Since the number of movement units, peak angular velocity, trunk displacement, and arm abduction remained impaired over the first year, they might be the most suited measures to distinguish behavioral recovery from compensation strategies. Trial registration ClinicalTrials: NCT01115348. 4 May 2010. Retrospectively registered.
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Affiliation(s)
- Gyrd Thrane
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Postboks 6050 Langnes, 9037, Tromsø, Norway. .,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Rehabilitation Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Katharina Stibrant Sunnerhagen
- Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Rehabilitation Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Margit Alt Murphy
- Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Rehabilitation Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Naghibi SS, Fallah A, Maleki A, Ghassemi F. Elbow angle generation during activities of daily living using a submovement prediction model. BIOLOGICAL CYBERNETICS 2020; 114:389-402. [PMID: 32518963 DOI: 10.1007/s00422-020-00834-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 05/11/2020] [Indexed: 06/11/2023]
Abstract
The present study aimed to develop a realistic model for the generation of human activities of daily living (ADL) movements. The angular profiles of the elbow joint during functional ADL tasks such as eating and drinking were generated by a submovement-based closed-loop model. First, the ADL movements recorded from three human participants were broken down into logical phases, and each phase was decomposed into submovement components. Three separate artificial neural networks were trained to learn the submovement parameters and were then incorporated into a closed-loop model with error correction ability. The model was able to predict angular trajectories of human ADL movements with target access rate = 100%, VAF = 98.9%, and NRMSE = 4.7% relative to the actual trajectories. In addition, the model can be used to provide the desired target for practical trajectory planning in rehabilitation systems such as functional electrical stimulation, robot therapy, brain-computer interface, and prosthetic devices.
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Affiliation(s)
| | - Ali Fallah
- Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran.
| | - Ali Maleki
- Biomedical Engineering Department, Semnan University, Semnan, Iran
| | - Farnaz Ghassemi
- Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran
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Mesquita IA, Fonseca PFPD, Borgonovo-Santos M, Ribeiro E, Pinheiro ARV, Correia MV, Silva C. Comparison of upper limb kinematics in two activities of daily living with different handling requirements. Hum Mov Sci 2020; 72:102632. [PMID: 32452388 DOI: 10.1016/j.humov.2020.102632] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Recently, kinematic analysis of the drinking task (DRINK) has been recommended to assess the quality of upper limb (UL) movement after stroke, but the accomplishment of this task may become difficult for poststroke patients with hand impairment. Therefore, it is necessary to study ADLs that involve a simpler interaction with a daily life target, such as the turning on a light task (LIGHT). As the knowledge of movement performed by healthy adults becomes essential to assess the quality of movement of poststroke patients, the main goal of this article was to compare the kinematic strategies used by healthy adults in LIGHT with those that are used in DRINK. METHODS 63 adults, aged 30 to 69 years old, drank water and turned on a light, using both ULs separately, while seated. The movements of both tasks were captured by a 3D motion capture system. End-point and joint kinematics of reaching and returning phases were analysed. A multifactorial analysis of variance with repeated measures was applied to the kinematic metrics, using age, sex, body mass index and dominance as main factors. RESULTS Mean and peak velocities, index of curvature, shoulder flexion and elbow extension were lower in LIGHT, which suggests that the real hand trajectory was smaller in this task. In LIGHT, reaching was less smooth and returning was smoother than DRINK. The instant of peak velocity was similar in both tasks. There was a minimal anterior trunk displacement in LIGHT, and a greater anterior trunk displacement in DRINK. Age and sex were the main factors which exerted effect on some of the kinematics, especially in LIGHT. CONCLUSION The different target formats and hand contact in DRINK and LIGHT seem to be responsible for differences in velocity profile, efficiency, smoothness, joint angles and trunk displacement. Results suggest that the real hand trajectory was smaller in LIGHT and that interaction with the switch seems to be less demanding than with the glass. Accordingly, LIGHT could be a good option for the assessment of poststroke patients without grasping ability. Age and sex seem to be the main factors to be considered in future studies for a better match between healthy and poststroke adults.
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Affiliation(s)
- Inês Albuquerque Mesquita
- Center for Rehabilitation Research (CIR) (CIR), School of Health of Polytechnic of Porto (ESS-P.Porto), Rua Dr. António Bernardino de Almeida, 400, 4200 - 072 Porto, Portugal; Department of Functional Sciences, School of Health of Polytechnic of Porto (ESS-P.Porto), Rua Dr. António Bernardino de Almeida, 400, 4200 - 072 Porto, Portugal.
| | | | - Márcio Borgonovo-Santos
- LABIOMEP: Porto Biomechanics Laboratory, University of Porto. R. Dr. Plácido da Costa, 4200-450 Porto, Portugal
| | - Edgar Ribeiro
- Center for Rehabilitation Research (CIR) (CIR), School of Health of Polytechnic of Porto (ESS-P.Porto), Rua Dr. António Bernardino de Almeida, 400, 4200 - 072 Porto, Portugal
| | - Ana Rita Vieira Pinheiro
- Center for Rehabilitation Research (CIR) (CIR), School of Health of Polytechnic of Porto (ESS-P.Porto), Rua Dr. António Bernardino de Almeida, 400, 4200 - 072 Porto, Portugal; School of Health Sciences, University of Aveiro, Edifício 30, Agras do Crasto - Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - Miguel Velhote Correia
- Department of Electrical and Computer Engineering, Faculty of Engineering of the University of Porto (FEUP), R. Dr. Roberto Frias, 4200-465 Porto, Portugal; Institute for Systems and Computer Engineering, Technology and Science (INESC TEC), R. Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - Cláudia Silva
- Center for Rehabilitation Research (CIR) (CIR), School of Health of Polytechnic of Porto (ESS-P.Porto), Rua Dr. António Bernardino de Almeida, 400, 4200 - 072 Porto, Portugal; Department of Physiotherapy, School of Health of Polytechnic of Porto (ESS-P.Porto), Rua Dr. António Bernardino de Almeida, 400, 4200 - 072 Porto, Portugal
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16
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Ukita A, Abe M, Kishigami H, Hatta T. Influence of back support shape in wheelchairs offering pelvic support on asymmetrical sitting posture and pressure points during reaching tasks in stroke patients. PLoS One 2020; 15:e0231860. [PMID: 32315353 PMCID: PMC7173851 DOI: 10.1371/journal.pone.0231860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 04/02/2020] [Indexed: 12/25/2022] Open
Abstract
Many poststroke hemiplegic patients have an asymmetrical wheelchair-sitting posture. This study aimed to investigate the impact of different back support shapes on asymmetrical sitting posture and pressure points among poststroke hemiplegic patients during an activities of daily living–related reaching task. This study included 23 poststroke hemiplegic patients who performed tasks that involved the movement of objects using the unaffected upper limb to the affected side while sitting in a conventional wheelchair (C-WC) with a flat back support or a wheelchair providing pelvic and thoracic support (P-WC). Body alignment angles from video images and pressure distribution on supporting surfaces were measured using a two-dimensional motion analysis software (Dartfish) and a pressure mapping system (FSA). Regarding movement performance, although postural asymmetry increased in both wheelchair types, the degree of postural variation was smaller with P-WC use than C-WC use (p < 0.05), with partly reduced postural asymmetry. With P-WC, one-sided ischial asymmetrical pressure was significantly less after the movement (p < 0.05). In conclusion, P-WC’s back support shape contributed to a decrease in postural asymmetry for pelvic girdle support both at rest and during movement. This highlights the importance of a wheelchair back support shape and may help to increase the quality of activities of daily living movement in poststroke hemiplegic patients in wheelchairs.
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Affiliation(s)
- Atsuki Ukita
- Social Medical Corporation Hokuto, Tokachi Rehabilitation Center, Obihiro, Japan
- Tohoku Fukushi University, Sendai, Japan
| | - Masayuki Abe
- Social Medical Corporation Hokuto, Tokachi Rehabilitation Center, Obihiro, Japan
| | | | - Tatsuo Hatta
- Japan Health Care College, Eniwa, Japan
- * E-mail:
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Quantitative Assessment of Motor Function for Patients with a Stroke by an End-Effector Upper Limb Rehabilitation Robot. BIOMED RESEARCH INTERNATIONAL 2020; 2020:5425741. [PMID: 32462001 PMCID: PMC7224306 DOI: 10.1155/2020/5425741] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 01/15/2020] [Accepted: 02/15/2020] [Indexed: 11/17/2022]
Abstract
With the popularization of rehabilitation robots, it is necessary to develop quantitative motor function assessment methods for patients with a stroke. To make the assessment equipment easier to use in clinics and combine the assessment methods with the rehabilitation training process, this paper proposes an anthropomorphic rehabilitation robot based on the basic movement patterns of the upper limb, point-to-point reaching and circle drawing movement. This paper analyzes patients' movement characteristics in aspects of movement range, movement accuracy, and movement smoothness and the output force characteristics by involving 8 patients. Besides, a quantitative assessment method is also proposed based on multivariate fitting methods. It can be concluded that the area of the real trajectory and movement accuracy during circle drawing movement as well as the ratio of force along the sagittal axis in backward point-to-point movement are the unique parameters that are different remarkably between stroke patients and healthy subjects. The fitting function has a high goodness of fit with the Fugl-Meyer scores for the upper limb (R 2 = 0.91, p = 0.015), which demonstrates that the fitting function can be used to assess patients' upper limb movement function. The indicators are recorded during training movement, and the fitting function can calculate the scores immediately, which makes the functional assessment quantitative and timely. Combining the training process and assessment, the quantitative assessment method will farther expand the application of rehabilitation robots.
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18
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Serious Game Platform with Haptic Feedback and EMG Monitoring for Upper Limb Rehabilitation and Smoothness Quantification on Spinal Cord Injury Patients. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10030963] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cervical Spinal Cord injury (SCI) is a neurological disease that produces, as a consequence, impairments of the upper limb function. This paper illustrates a virtual reality platform based on three serious games for upper limb rehabilitation with electromyography monitoring, providing force feedback to the patient. In the rehabilitation process proposed, haptic feedback was provided to the patients to strength the arm muscles by means of the Novint Falcon device. This end-effector device was used to manipulate the serious games. During the therapy performance, the system recorded electromyography signals from the patient’s arm muscles, which may be used to monitor muscle contraction. The work presented a virtual reality system developed for spinal cord-injured patients. Each virtual reality environment could be modified in strength and duration according to the patients’ needs and was implemented for recording quantitative data about the motor performance. The platform was validated as a proof of concept in cervical spinal cord-injured patients. Results showed that this rehabilitation platform could be used for obtaining objective information in relation to motor control characteristics.
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19
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da Silva ESM, Santos GL, Catai AM, Borstad A, Furtado NPD, Aniceto IAV, Russo TL. Effect of aerobic exercise prior to modified constraint-induced movement therapy outcomes in individuals with chronic hemiparesis: a study protocol for a randomized clinical trial. BMC Neurol 2019; 19:196. [PMID: 31416436 PMCID: PMC6694597 DOI: 10.1186/s12883-019-1421-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 07/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recovery of upper limb function in individuals after a stroke remains challenging. Modified constraint-induced movement therapy (m-CIMT) has strong evidence for increasing the use and recovery of sensorimotor function of the paretic upper limb. Recent studies have shown that priming with aerobic exercise prior to task-specific training potentiates upper limb recovery in individuals with stroke. This protocol describes a randomized clinical trial designed to determine whether priming with moderate-high intensity aerobic exercise prior to m-CIMT will improve the manual dexterity of the paretic upper limb in individuals with chronic hemiparesis. METHODS Sixty-two individuals with chronic hemiparesis will be randomized into two groups: Aerobic exercise + m-CIMT or Stretching + m-CIMT. m-CIMT includes 1) restraint of the nonparetic upper limb for 90% of waking hours, 2) intensive task-oriented training of the paretic upper limb for 3 h/day for 10 days and 3) behavior interventions for improving treatment adherence. Aerobic exercise will be conducted on a stationary bicycle at intervals of moderate to high intensity. Participants will be evaluated at baseline, 3, 30, and 90 days postintervention by the following instruments: Motor Activity Log, Nottingham Sensory Assessment, Wolf Motor Function Test, Box and Block Test, Nine-Hole Peg Test, Stroke Specific Quality of Life Scale and three-dimensional kinematics. The data will be tested for normality and homogeneity. Parametric data will be analyzed by two-way ANOVA with repeated measures and Bonferroni's adjustment. For nonparametric data, the Friedman test followed by the Wilcoxon test with Bonferroni's adjustment will be used to compare the ratings for each group. To compare the groups in each assessment, the Mann-Whitney test will be used. DISCUSSION This study will provide valuable information about the effect of motor priming for fine upper limb skill improvement in people with chronic poststroke hemiparesis, bringing new evidence about the association of two therapies commonly used in clinical practice. TRIAL REGISTRATION This trial was retrospectively registered (registration number RBR-83pwm3 ) on 07 May 2018.
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Affiliation(s)
- Erika Shirley Moreira da Silva
- Department of Physiotherapy, Laboratory of Neurological Physiotherapy Research, Federal University of São Carlos (UFSCar), Rodovia Washington Luís, Km 235, São Carlos, SP, 13565-905, Brazil
| | - Gabriela Lopes Santos
- Department of Physiotherapy, Laboratory of Neurological Physiotherapy Research, Federal University of São Carlos (UFSCar), Rodovia Washington Luís, Km 235, São Carlos, SP, 13565-905, Brazil.,Health science Institute, Faculty Alfredo Nasse, Aparecida de Goiânia, Goiás, Brazil
| | - Aparecida Maria Catai
- Department of Physiotherapy, Cardiovascular Physical Therapy Laboratory, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | | | - Natália Pereira Duarte Furtado
- Department of Physiotherapy, Laboratory of Neurological Physiotherapy Research, Federal University of São Carlos (UFSCar), Rodovia Washington Luís, Km 235, São Carlos, SP, 13565-905, Brazil
| | | | - Thiago Luiz Russo
- Department of Physiotherapy, Laboratory of Neurological Physiotherapy Research, Federal University of São Carlos (UFSCar), Rodovia Washington Luís, Km 235, São Carlos, SP, 13565-905, Brazil.
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Valevicius AM, Boser QA, Lavoie EB, Chapman CS, Pilarski PM, Hebert JS, Vette AH. Characterization of normative angular joint kinematics during two functional upper limb tasks. Gait Posture 2019; 69:176-186. [PMID: 30769260 DOI: 10.1016/j.gaitpost.2019.01.037] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 01/18/2019] [Accepted: 01/26/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Optical motion capture is a powerful tool for assessing upper body kinematics, including compensatory movements, in different populations. However, the lack of a standardized protocol with clear functional relevance hinders its clinical acceptance. RESEARCH QUESTION The objective of this study was to use motion capture to: (1) characterize angular joint kinematics in a normative population performing two complex, yet standardized upper limb tasks with clear functional relevance; and (2) assess the protocol's intra-rater reliability. METHODS Twenty non-disabled adults performed the previously developed Pasta Box Task and Cup Transfer Task. The kinematics of the upper body were captured using an optoelectronic motion capture system and rigid plates with reflective markers. Angular joint trajectories, peak angle, range of motion (RoM), and peak angular velocity were extracted for the trunk, shoulder, elbow, forearm, and wrist. Intra-class correlation was used to assess the intra-rater reliability of the kinematic measures. RESULTS Both tasks required minimal trunk motion. Cross-body movements required greater RoM at the trunk, shoulder, and elbow joints compared to movements in front of the body. Reaches to objects further away from the body required greater trunk and elbow joint RoM compared to reaches to objects closer to the body. Transporting the box of pasta required the wrist to maintain an extended position. The two different grasp patterns in the Cup Transfer Task forced the wrist into a flexed and ulnar-deviated position for the near cup, and an extended and radial-deviated position for the far cup. For both tasks, the majority of measures displayed intra-class correlation values above 0.75, indicating good reliability. SIGNIFICANCE Our protocol and functional tasks elicit a degree of movement sensitivity that is not available in current clinical assessments. Our study also provides a comprehensive dataset that can serve as a normative benchmark for quantifying movement compensations following impairment.
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Affiliation(s)
- Aïda M Valevicius
- Department of Biomedical Engineering, University of Alberta, 1098 Research Transition Facility, Edmonton, Alberta T6G 2V2, Canada
| | - Quinn A Boser
- Department of Biomedical Engineering, University of Alberta, 1098 Research Transition Facility, Edmonton, Alberta T6G 2V2, Canada
| | - Ewen B Lavoie
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, 3-100 University Hall, Van Vliet Complex, Edmonton, Alberta T6G 2H9, Canada
| | - Craig S Chapman
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, 3-100 University Hall, Van Vliet Complex, Edmonton, Alberta T6G 2H9, Canada
| | - Patrick M Pilarski
- Division of Physical Medicine and Rehabilitation, Faculty of Medicine and Dentistry, University of Alberta, Walter C Mackenzie Health Sciences Centre, 8440 112 Street NW, Edmonton, Alberta T6G 2R7, Canada
| | - Jacqueline S Hebert
- Department of Biomedical Engineering, University of Alberta, 1098 Research Transition Facility, Edmonton, Alberta T6G 2V2, Canada; Division of Physical Medicine and Rehabilitation, Faculty of Medicine and Dentistry, University of Alberta, Walter C Mackenzie Health Sciences Centre, 8440 112 Street NW, Edmonton, Alberta T6G 2R7, Canada; Glenrose Rehabilitation Hospital, Alberta Health Services, 10230 111 Avenue NW, Edmonton, Alberta T5G 0B7, Canada
| | - Albert H Vette
- Department of Biomedical Engineering, University of Alberta, 1098 Research Transition Facility, Edmonton, Alberta T6G 2V2, Canada; Glenrose Rehabilitation Hospital, Alberta Health Services, 10230 111 Avenue NW, Edmonton, Alberta T5G 0B7, Canada; Department of Mechanical Engineering, University of Alberta, Donadeo Innovation Centre for Engineering, 9211 116 Street NW, Edmonton, Alberta T6G 1H9, Canada.
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Cacho EWA, Cacho RDO, Ortolan RL, Lima NMFV, Silva Filho EMD, Cliquet Jr A. REACH AND PALMAR GRASP IN TETRAPLEGICS WITH NEUROMUSCULAR ELECTRICAL STIMULATION. REV BRAS MED ESPORTE 2018. [DOI: 10.1590/1517-869220182406180392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: To evaluate the movement strategies of quadriplegics, assisted by neuromuscular electrical stimulation, on reach and palmar grasp using objects of different weights. Methods: It was a prospective clinical trial. Four chronic quadriplegics (C5-C6), with injuries of traumatic origin, were recruited and all of them had their reach and palmar grasp movement captured by four infrared cameras and six retro-reflective markers attached to the trunk and right arm, assisted or not by neuromuscular electrical stimulation to the triceps, extensor carpi radialis longus, extensor digitorum communis, flexor digitorum superficialis, opponens pollicis and lumbricals. It was measured by a Neurological and Functional Classification of Spinal Cord Injuries of the American Spinal Injury Association, Functional Independence Measure and kinematic variables. Results: The patients were able to reach and execute palmar grasp in all cylinders using the stimulation sequences assisted by neuromuscular electrical stimulation. The quadriplegics produced lower peak velocity, a shorter time of movement and reduction in movement segmentation, when assisted by neuromuscular electrical stimulation. Conclusion: This study showed that reach and palmar grasp movement assisted by neuromuscular electrical stimulation was able to produce motor patterns more similar to healthy subjects. Level of evidence IV; Case series.
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Affiliation(s)
| | | | | | | | | | - Alberto Cliquet Jr
- Universidade Estadual de Campinas, Brazil; Universidade de São Paulo, Brazil
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22
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Thrane G, Alt Murphy M, Sunnerhagen KS. Recovery of kinematic arm function in well-performing people with subacute stroke: a longitudinal cohort study. J Neuroeng Rehabil 2018; 15:67. [PMID: 30021596 PMCID: PMC6052713 DOI: 10.1186/s12984-018-0409-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 06/29/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Most motor function improvements in people who have experienced strokes occur within the first 3 months. However, individuals showing complete or nearly complete arm function recovery, as assessed using clinical scales, still show certain movement kinematic deficits at 3 months, post-stroke. This study evaluated the changes in upper extremity kinematics, in individuals demonstrating minor clinical motor impairments, 3-12 months post-stroke, and also examined the association between kinematics and the subjects's self-perceived hand abilities during the chronic stage, 12 months post-stroke. METHODS Forty-two subjects recovering from strokes and having Fugl-Meyer upper extremity motor assessment scores ≥60 were included from the Stroke Arm Longitudinal Study at the University of Gothenburg (SALGOT). Kinematic analyses of a drinking task, performed 3, 6, and 12 months post-stroke, were compared with kinematic analyses performed in 35 healthy controls. The Stroke Impact Scale-Hand domain was evaluated at the 12-month follow-up. RESULTS There were no significant changes in kinematic performance between 3 and 12 months, post-stroke. The patients recovering from stroke showed lower peak elbow extension velocities, and increased shoulder abduction and trunk displacement during drinking than did healthy controls, at all time points. At 12 months, post-stroke, better self-perceived arm functions correlated with improved trunk displacements, movement times, movement units, and time to peak velocity percentages. CONCLUSION Kinematic movement deficits, observed at 3 months post-stroke, remained unchanged at 12 months. Movement kinematics were associated with the patient's self-perceived ability to use their more affected hand. TRIAL REGISTRATION ClinicalTrials: NCT01115348 .
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Affiliation(s)
- Gyrd Thrane
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Institute of Neuroscience and Physiology, Rehabilitation Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Margit Alt Murphy
- Institute of Neuroscience and Physiology, Rehabilitation Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Katharina Stibrant Sunnerhagen
- Institute of Neuroscience and Physiology, Rehabilitation Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Center for Person-Centered Care (GPCC), University of Gothenburg, Gothenburg, Sweden
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Silva CF, Pereira S, Silva CC, Ferreira S, Oliveira N, Santos R. Anticipatory postural adjustments in the shoulder girdle in the reach movement performed in standing by post-stroke subjects. Somatosens Mot Res 2018; 35:124-130. [DOI: 10.1080/08990220.2018.1484354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Cláudia F. Silva
- Pysiotherapist graduate at the School of Health, Polytechnic Institute of Porto, Porto, Portugal
| | - Soraia Pereira
- Department of Physiotherapy, School of Health, Polytechnic Institute of Porto, Porto, Portugal
| | - Cláudia C. Silva
- Department of Physiotherapy, School of Health, Polytechnic Institute of Porto, Porto, Portugal
| | - Sílvia Ferreira
- Pysiotherapist graduate at the School of Health, Polytechnic Institute of Porto, Porto, Portugal
| | - Nuno Oliveira
- Department of Physics, School of Health, Polytechnic Institute of Porto, Porto, Portugal
| | - Rubim Santos
- Department of Physics and Activity and Human Movement Study Center (CEMAH), School of Health, Polytechnic Institute of Porto, Porto, Portugal
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Valevicius AM, Boser QA, Lavoie EB, Murgatroyd GS, Pilarski PM, Chapman CS, Vette AH, Hebert JS. Characterization of normative hand movements during two functional upper limb tasks. PLoS One 2018; 13:e0199549. [PMID: 29928022 PMCID: PMC6013217 DOI: 10.1371/journal.pone.0199549] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 06/08/2018] [Indexed: 11/18/2022] Open
Abstract
Background Dexterous hand function is crucial for completing activities of daily living (ADLs), which typically require precise hand-object interactions. Kinematic analyses of hand trajectory, hand velocity, and grip aperture provide valuable mechanistic insights into task performance, but there is a need for standardized tasks representative of ADLs that are amenable to motion capture and show consistent performance in non-disabled individuals. Our objective was to develop two standardized functional upper limb tasks and to quantitatively characterize the kinematics of normative hand movement. Methods Twenty non-disabled participants were recruited to perform two tasks: the Pasta Box Task and Cup Transfer Task. A 12-camera motion capture system was used to collect kinematic data from which hand movement and grip aperture measures were calculated. Measures reported for reach-grasp and transport-release segments were hand distance travelled, hand trajectory variability, movement time, peak and percent-to-peak hand velocity, number of movement units, peak and percent-to-peak grip aperture, and percent-to-peak hand deceleration. A between-session repeatability analysis was conducted on 10 participants. Results Movement times were longer for transport-release compared to reach-grasp for every movement. Hand and grip aperture measures had low variability, with 55 out of 63 measures showing good repeatability (ICC > 0.75). Cross-body movements in the Pasta Box Task had longer movement times and reduced percent-to-peak hand velocity values. The Cup Transfer Task showed decoupling of peak grip aperture and peak hand deceleration for all movements. Movements requiring the clearing of an obstacle while transporting an object displayed a double velocity peak and typically a longer deceleration phase. Discussion Normative hand kinematics for two standardized functional tasks challenging various aspects of hand-object interactions important for ADLs showed excellent repeatability. The consistency in normative task performance across a variety of task demands shows promise as a potential outcome assessment for populations with upper limb impairment.
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Affiliation(s)
- Aïda M. Valevicius
- Department of Biomedical Engineering, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Quinn A. Boser
- Department of Biomedical Engineering, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Ewen B. Lavoie
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Glyn S. Murgatroyd
- Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, Alberta, Canada
| | - Patrick M. Pilarski
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Craig S. Chapman
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Albert H. Vette
- Department of Biomedical Engineering, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, Alberta, Canada
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Jacqueline S. Hebert
- Department of Biomedical Engineering, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, Alberta, Canada
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- * E-mail:
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Thrane G, Sunnerhagen KS, Persson HC, Opheim A, Alt Murphy M. Kinematic upper extremity performance in people with near or fully recovered sensorimotor function after stroke. Physiother Theory Pract 2018; 35:822-832. [PMID: 29658813 DOI: 10.1080/09593985.2018.1458929] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Background: Clinical scales for upper extremity motor function may not capture improvement among higher functioning people with stroke. Objective: To describe upper extremity kinematics in people with stroke who score within the upper 10% of the Fugl-Meyer Assessment (FMA-UE) and explore the ceiling effects of the FMA-UE. Design: A cross-sectional study design was used. Participants: People with stroke were included from the Stroke Arm Longitudinal Study at University of Gothenburg together with 30 healthy controls. The first analysis included participants who achieved FMA-UE score > 60 within the first year of stroke (assessed at 3 days, 2 weeks, 4 weeks, 3 months, or 12 months post stroke). The second analysis included participants with submaximal FMA-UE (60-65 points, n = 24) or maximal FMA-UE score (66 points, n = 21) at 3 months post stroke. Measurements: The kinematic analysis of a standardized drinking task included movement time, velocity and strategy, joint angles of the elbow, and shoulder and trunk displacement. Results: The high FMA-UE stroke group showed deficits in seven of eight kinematic variables. The submaximal FMA-UE stroke group was slower, had lower tangential and angular peak velocity, and used more trunk displacement than the controls. In addition, the maximal FMA-UE stroke group showed larger trunk displacement and arm abduction during drinking and lower peak angular velocity of the elbow. Conclusions: Participants with near or fully recovered sensorimotor function after stroke still show deficits in movement kinematics; however, the FMA-UE may not be able to detect these impairments.
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Affiliation(s)
- Gyrd Thrane
- a Department of Health and Care Sciences , UiT The Arctic University of Norway , Tromsø , Norway.,b Institute of Neuroscience and Physiology, Rehabilitation Medicine, Sahlgrenska Academy , University of Gothenburg , Gothenburg , Sweden
| | - Katharina S Sunnerhagen
- b Institute of Neuroscience and Physiology, Rehabilitation Medicine, Sahlgrenska Academy , University of Gothenburg , Gothenburg , Sweden
| | - Hanna C Persson
- b Institute of Neuroscience and Physiology, Rehabilitation Medicine, Sahlgrenska Academy , University of Gothenburg , Gothenburg , Sweden
| | - Arve Opheim
- b Institute of Neuroscience and Physiology, Rehabilitation Medicine, Sahlgrenska Academy , University of Gothenburg , Gothenburg , Sweden.,c Research Department , Sunnaas Rehabilitation Hospital , Nesoddtangen , Norway
| | - Margit Alt Murphy
- b Institute of Neuroscience and Physiology, Rehabilitation Medicine, Sahlgrenska Academy , University of Gothenburg , Gothenburg , Sweden
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Alt Murphy M, Murphy S, Persson HC, Bergström UB, Sunnerhagen KS. Kinematic Analysis Using 3D Motion Capture of Drinking Task in People With and Without Upper-extremity Impairments. J Vis Exp 2018. [PMID: 29658937 DOI: 10.3791/57228] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Kinematic analysis is a powerful method for objective assessment of upper extremity movements in a three-dimensional (3D) space. Three-dimensional motion capture with an optoelectronic camera system is considered as golden standard for kinematic movement analysis and is increasingly used as outcome measure to evaluate the movement performance and quality after an injury or disease involving upper extremity movements. This article describes a standardized protocol for kinematic analysis of drinking task applied in individuals with upper extremity impairments after stroke. The drinking task incorporates reaching, grasping and lifting a cup from a table to take a drink, placing the cup back, and moving the hand back to the edge of the table. The sitting position is standardized to the individual's body size and the task is performed in a comfortable self-paced speed and compensatory movements are not constrained. The intention is to keep the task natural and close to a real-life situation to improve the ecological validity of the protocol. A 5-camera motion capture system is used to gather 3D coordinate positions from 9 retroreflective markers positioned on anatomical landmarks of the arm, trunk, and face. A simple single marker placement is used to ensure the feasibility of the protocol in clinical settings. Custom-made Matlab software provides automated and fast analyses of movement data. Temporal kinematics of movement time, velocity, peak velocity, time of peak velocity, and smoothness (number of movement units) along with spatial angular kinematics of shoulder and elbow joint as well as trunk movements are calculated. The drinking task is a valid assessment for individuals with moderate and mild upper extremity impairment. The construct, discriminative and concurrent validity along with responsiveness (sensitivity to change) of the kinematic variables obtained from the drinking task have been established.
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Affiliation(s)
- Margit Alt Murphy
- Institution of Neuroscience and Physiology, Rehabilitation Medicine, Sahlgrenska Academy, University of Gothenburg; Departement of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital;
| | | | - Hanna C Persson
- Institution of Neuroscience and Physiology, Rehabilitation Medicine, Sahlgrenska Academy, University of Gothenburg; Departement of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital
| | - Ulla-Britt Bergström
- Departement of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital
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27
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Distal upper limb kinematics during functional everyday tasks. Gait Posture 2018; 61:135-140. [PMID: 29346082 DOI: 10.1016/j.gaitpost.2018.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 12/14/2017] [Accepted: 01/09/2018] [Indexed: 02/02/2023]
Abstract
Quantitative characterisation of upper limb motion allows the evaluation of the effect of pathology on functional task performance, potentially directing rehabilitation strategies. Movement patterns of the distal upper limb in healthy adults during functional tasks have not been extensively characterised. During five loaded functional tasks (drinking from a glass, pouring from a kettle, turning a handle, lifting a bag to a shelf, turning a key) the movement patterns were characterised using three-dimensional motion analysis with a minimal marker set in 16 healthy adults (10 M,6F, 27 (IQR:25-43)years). Joint angles reported include flexion/extension at the elbow and wrist, forearm supination/pronation and digits 2-5 metacarpophalangeal (MCP) joint flexion/extension. Additionally for the thumb the angle between the metacarpal of the thumb and the 2nd digit (Thumb base), the thumb MCP (Thumb MCP) and interphalangeal (Thumb IP) joint angles are presented. Durations of activities performed at self-selected comfortable speeds (3.36 (IQR:3.07,3.66)s turning a key to 6.20 (IQR:5.44,6.38)s drinking from a glass) are reported. The maximum joint angles used (median of participants' maxima) were 141° of elbow flexion, 116° forearm supination, 36° wrist extension, 56° Thumb base, 14° Thumb MCP flexion, 18° Thumb IP flexion, 85° MCP2-5 flexion. The tasks of drinking from a glass, lifting a bag to a shelf and turning a key appeared to have the least variation in performance, suggesting that these activities are better suited to be selected as standardized tasks for assessing the impact of pathology on movement than pouring from a kettle and turning a handle.
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Use of optical motion capture for the analysis of normative upper body kinematics during functional upper limb tasks: A systematic review. J Electromyogr Kinesiol 2018. [PMID: 29533202 DOI: 10.1016/j.jelekin.2018.02.011] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Quantifying three-dimensional upper body kinematics can be a valuable method for assessing upper limb function. Considering that kinematic model characteristics, performed tasks, and reported outcomes are not consistently standardized and exhibit significant variability across studies, the purpose of this review was to evaluate the literature investigating upper body kinematics in non-disabled individuals via optical motion capture. Specific objectives were to report on the kinematic model characteristics, performed functional tasks, and kinematic outcomes, and to assess whether kinematic protocols were assessed for validity and reliability. Five databases were searched. Studies using anatomical and/or cluster marker sets, along with optical motion capture, and presenting normative data on upper body kinematics were eligible for review. Information extracted included model characteristics, performed functional tasks, kinematic outcomes, and validity or reliability testing. 804 publication records were screened and 20 reviewed based on the selection criteria. Thirteen studies described their kinematic protocols adequately for reproducibility, and 8 studies followed International Society of Biomechanics standards for quantifying upper body kinematics. Six studies assessed their protocols for validity or reliability. While a substantial number of studies have adequately reported their protocols, more systematic work is needed to evaluate the validity and reliability of existing protocols.
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Kinematic Outcome Measures using Target-Reaching Arm Movement in Stroke. Ann Biomed Eng 2017; 45:2794-2803. [PMID: 28884207 DOI: 10.1007/s10439-017-1912-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 08/29/2017] [Indexed: 10/18/2022]
Abstract
This study aimed to quantitatively investigate upper extremity motor performance and disclose the abnormality of motor control induced by stroke. Ten patients and ten healthy subjects were instructed to perform target-reaching tasks at nine difficulty levels, and coordinates of the shoulder, elbow and tip of the index finger were recorded. Age-matched control performed significantly better than patients, as indicated by lower movement time (MT) and normalized jerk score (NJS) and higher peak velocity (V peak), percentage time to peak velocity (PTPV), fuzzy approximate entropy (fApEn) and relative joint angles correlation (RJAC); also, significant effects of difficulty on all parameters except RJAC and fApEn, were observed in two groups. There were significant correlations between PTPV and Fugl-Meyer assessment for upper extremity (FMA-UE) and between RJAC and FMA-UE at certain difficulty levels. The stroke-related differences could be explained by the increase in intrinsic neuromotor noise, and the difficulty-related differences may be related to extrinsic neuromotor noise. The increase in either noises could result in a degradation in motor control. The significant linear relationships between some kinematic parameters and the clinical score suggested that the kinematic parameters could be applied as quantitative outcome measures in the clinic in the future.
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The role of perspective in discriminating between social and non-social intentions from reach-to-grasp kinematics. PSYCHOLOGICAL RESEARCH 2017; 82:915-928. [PMID: 28444467 DOI: 10.1007/s00426-017-0868-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 04/18/2017] [Indexed: 10/19/2022]
Abstract
Making correct inferences regarding social and individual intentions may be crucial for successful interactions, especially when we are required to discriminate between cooperative and competitive behaviors. The results of previous studies indicate that reach-to-grasp kinematic parameters may be used to infer the social or individual outcome of a movement. However, the majority of the studies investigated this ability by presenting reach-to-grasp movements from a third-person perspective only. The aim of the present study was to assess whether the ability to recognize the intent associated to a reach-to-grasp movement varies as a function of perspective by manipulating the perspective of observation (second- and third-perspective) within participants. To this end, we presented participants with video clips of models performing a reach-to-grasp movement with different intents. The video clips were recorded both from a lateral view (third-person perspective) and from a frontal view (second-person perspective). After viewing the clips, in two subsequent tasks participants were asked to distinguish between social and non-social intentions by observing the initial phase of the same action recorded from the two different views. Results showed that, when a fast-speed movement was presented from a lateral view, participants were able to predict its social intention. In contrast, when the same movement was observed from a frontal view, performance was impaired. These results indicate that the ability to detect social intentions from motor cues can be biased by the visual perspective of the observer, specifically for fast-speed movements.
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31
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Gulde P, Hughes CML, Hermsdörfer J. Effects of Stroke on Ipsilesional End-Effector Kinematics in a Multi-Step Activity of Daily Living. Front Hum Neurosci 2017; 11:42. [PMID: 28223927 PMCID: PMC5293874 DOI: 10.3389/fnhum.2017.00042] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 01/19/2017] [Indexed: 11/13/2022] Open
Abstract
Background: Stroke frequently impairs activities of daily living (ADL) and deteriorates the function of the contra- as well as the ipsilesional limbs. In order to analyze alterations of higher motor control unaffected by paresis or sensory loss, the kinematics of ipsilesional upper limb movements in patients with stroke has previously been analyzed during prehensile movements and simple tool use actions. By contrast, motion recording of multi-step ADL is rare and patient-control comparisons for movement kinematics are largely lacking. Especially in clinical research, objective quantification of complex externally valid tasks can improve the assessment of neurological impairments. Methods: In this preliminary study we employed three-dimensional motion recording and applied kinematic analysis in a multi-step ADL (tea-making). The trials were examined with respect to errors and sub-action structure, durations, path lengths (PLs), peak velocities, relative activity (RA) and smoothness. In order to check for specific burdens the sub-actions of the task were extracted and compared. To examine the feasibility of the approach, we determined the behavioral and kinematic metrics of the (ipsilesional) unimanual performance of seven chronic stroke patients (64a ± 11a, 3 with right/4 with left brain damage (LBD), 2 with signs of apraxia, variable severity of paresis) and compared the results with data of 14 neurologically healthy age-matched control participants (70a ± 7a). Results: T-tests revealed that while the quantity and structure of sub-actions of the task were similar. The analysis of end-effector kinematics was able to detect clear group differences in the associated parameters. Specifically, trial duration (TD) was increased (Cohen's d = 1.77); the RA (Cohen's d = 1.72) and the parameters of peak velocities (Cohen's d = 1.49/1.97) were decreased in the patient group. Analysis of the task's sub-actions repeated measures analysis of variance (rmANOVA) revealed no impact of the different demands of the sub-actions on the relative performance of the patient group. Conclusion: The analyses revealed kinematic peculiarities in the performance with the ipsilesional hand. These deficits apparently arose from the cognitive demands like sequencing rather than motor constraints. End-effector kinematics proved as a sensitive method to detect and quantify aspects of disturbed multi-step ADL performance after stroke. If standardized, the examination and the analysis are quick and deliver objective data supporting clinical research.
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Affiliation(s)
- Philipp Gulde
- Institute of Movement Science, Department of Sport and Health Sciences, Technical University of Munich Munich, Germany
| | | | - Joachim Hermsdörfer
- Institute of Movement Science, Department of Sport and Health Sciences, Technical University of Munich Munich, Germany
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32
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Bustrén EL, Sunnerhagen KS, Alt Murphy M. Movement Kinematics of the Ipsilesional Upper Extremity in Persons With Moderate or Mild Stroke. Neurorehabil Neural Repair 2017; 31:376-386. [PMID: 28107802 DOI: 10.1177/1545968316688798] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND An increasing number of studies have indicated that the ipsilesional arm may be impaired after stroke. There is, however, a lack of knowledge whether ipsilesional deficits influence movement performance during purposeful daily tasks. OBJECTIVE The aim of this study was to investigate whether, and to what extent, movement impairments are present while performing an ipsilesional upper extremity task during the first 3 months after stroke. METHODS Movement kinematics describing movement time, smoothness, velocity, strategy, and pattern were captured during a standardized drinking task in 40 persons with first-ever stroke and 20 controls. Kinematics were measured early and at 3 months poststroke, and sensorimotor impairment was assessed with Fugl-Meyer Assessment in stroke. RESULTS Half of the ipsilesional kinematics showed significant deficits early after stroke compared to controls, and the stroke severity had a significant impact on the kinematics. Movements of the ipsilesional arm were slower, less smooth, demonstrated prolonged relative time in deceleration, and increased arm abduction during drinking. Kinematics improved over time and reached a level comparable with controls at 3 months, except for angular velocity of the elbow and deceleration time in reaching for those with more severe motor impairment. CONCLUSIONS This study demonstrates that movements of the ipsilesional arm, during a purposeful daily task, are impaired after stroke. These deficits are more prominent early after stroke and when the motor impairment is more severe. In clinical studies and praxis, the use of less-affected arm as a reference may underestimate the level of impairment and extent of recovery.
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Affiliation(s)
- Eva-Lena Bustrén
- 1 Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,2 Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Margit Alt Murphy
- 1 Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,2 Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
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de los Reyes-Guzmán A, Dimbwadyo-Terrer I, Pérez-Nombela S, Monasterio-Huelin F, Torricelli D, Pons JL, Gil-Agudo A. Novel kinematic indices for quantifying upper limb ability and dexterity after cervical spinal cord injury. Med Biol Eng Comput 2016; 55:833-844. [DOI: 10.1007/s11517-016-1555-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 07/30/2016] [Indexed: 12/17/2022]
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Santos GL, García-Salazar LF, Souza MB, Oliveira AB, Camargo PR, Russo TL. Torque steadiness and muscle activation are bilaterally impaired during shoulder abduction and flexion in chronic post-stroke subjects. J Electromyogr Kinesiol 2016; 30:151-60. [PMID: 27451360 DOI: 10.1016/j.jelekin.2016.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 06/30/2016] [Accepted: 07/05/2016] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To characterize sensorimotor control and muscle activation in the shoulder of chronic hemiparetic during abduction and flexion in maximal and submaximal isometric contractions. Furthermore, to correlate submaximal sensorimotor control with motor impairment and degree of shoulder subluxation. METHODS Thirteen chronic hemiparetic post-stroke age-gender matched with healthy were included. Isometric torques were assessed using a dynamometer. Electromyographic activity of the anterior and middle deltoid, upper trapezius, pectoralis major and serratus anterior muscles were collected. Variables were calculated for torque: peak, time to target, standard deviation (SD), coefficient of variation (CV), and standard error (RMSE); for muscle activity: maximum and minimum values, range and coefficient of activation. Motor impairment was determined by Fugl-Meyer and shoulder subluxation was measured with a caliper. RESULTS Paretic and non-paretic limbs reduced peak and muscle activation during maximal isometric contraction. Paretic limb generated lower force when compared with non-paretic and control. Paretic and non-paretic presented higher values of SD, CV, RMSE, and CV for prime mover muscles and minimum values for all muscles during steadiness. No correlation was found between sensorimotor control, motor impairment and shoulder subluxation. CONCLUSION Chronic hemiparetic presented bilateral deficits in sensorimotor and muscle control during maximal and submaximal shoulder abduction and flexion.
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Affiliation(s)
- Gabriela Lopes Santos
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
| | - Luisa Fernanda García-Salazar
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil; Physical Therapy Program, School of Medicine and Health Science, University of Rosario, Bogotá, D.C., Colombia
| | - Matheus Bragança Souza
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Ana Beatriz Oliveira
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Paula Rezende Camargo
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Thiago Luiz Russo
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
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De los Reyes-Guzmán A, Dimbwadyo-Terrer I, Pérez-Nombela S, Monasterio-Huelin F, Torricelli D, Pons JL, Gil-Agudo A. Novel kinematic indices for quantifying movement agility and smoothness after cervical Spinal Cord Injury. NeuroRehabilitation 2016; 38:199-209. [PMID: 26923358 DOI: 10.3233/nre-161311] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND After cervical Spinal Cord Injury (SCI), upper limb movements made by patients have a lack of smoothness and a hand velocity profile characterized by a high number of velocity peaks. OBJECTIVE The aim of the present paper is to propose three novel kinematic indices for quantifying movement agility and smoothness, and to analyze their discriminative capability between healthy and pathological people. METHODS 18 people, healthy and two groups of patients with cervical SCI, participated in the study. Kinematic indices in relation to movement agility and smoothness were computed from hand trajectories and velocity profiles during the performance of the ADL of drinking from a glass. RESULTS The proposed indices discriminated between healthy and SCI people. The results are greater in healthy than SCI people. Both smoothness indices detected significant differences between healthy and both SCI groups. Moreover, the Agility index showed capacity for discriminating between both patients groups. CONCLUSIONS The main contribution of this research consists on the proposal of kinematic indices from experimental data, whose results are dimensionless and relative to a pattern of healthy subjects. We hope that kinematic indices proposed are a step toward the standardization of the quantitative assessment of movement characteristics and functional impairments.
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Affiliation(s)
- Ana De los Reyes-Guzmán
- Department of Biomechanics and Technical Aids. National Hospital for Spinal Cord Injury (SESCAM), Finca La Peraleda, Toledo, Spain
| | - Iris Dimbwadyo-Terrer
- Occupational Thinks Research Group, Centro Superior de Estudios La Salle (UAM), C/La Salle, Madrid, Spain
| | - Soraya Pérez-Nombela
- Department of Biomechanics and Technical Aids. National Hospital for Spinal Cord Injury (SESCAM), Finca La Peraleda, Toledo, Spain
| | - Félix Monasterio-Huelin
- Department of Special Technologies Applied to Telecommunication. Higher Technical School of Telecommunications Engineering, Technical University of Madrid, University City, Madrid, Spain
| | - Diego Torricelli
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), C/Doctor Arce, Madrid, Spain
| | - José Luis Pons
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), C/Doctor Arce, Madrid, Spain
| | - Angel Gil-Agudo
- Department of Biomechanics and Technical Aids. National Hospital for Spinal Cord Injury (SESCAM), Finca La Peraleda, Toledo, Spain
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Dimbwadyo-Terrer I, Gil-Agudo A, Segura-Fragoso A, de los Reyes-Guzmán A, Trincado-Alonso F, Piazza S, Polonio-López B. Effectiveness of the Virtual Reality System Toyra on Upper Limb Function in People with Tetraplegia: A Pilot Randomized Clinical Trial. BIOMED RESEARCH INTERNATIONAL 2016; 2016:6397828. [PMID: 26885511 PMCID: PMC4739467 DOI: 10.1155/2016/6397828] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 12/20/2015] [Accepted: 12/21/2015] [Indexed: 12/04/2022]
Abstract
The aim of this study was to investigate the effects of a virtual reality program combined with conventional therapy in upper limb function in people with tetraplegia and to provide data about patients' satisfaction with the virtual reality system. Thirty-one people with subacute complete cervical tetraplegia participated in the study. Experimental group received 15 sessions with Toyra(®) virtual reality system for 5 weeks, 30 minutes/day, 3 days/week in addition to conventional therapy, while control group only received conventional therapy. All patients were assessed at baseline, after intervention, and at three-month follow-up with a battery of clinical, functional, and satisfaction scales. Control group showed significant improvements in the manual muscle test (p = 0,043, partial η (2) = 0,22) in the follow-up evaluation. Both groups demonstrated clinical, but nonsignificant, changes to their arm function in 4 of the 5 scales used. All patients showed a high level of satisfaction with the virtual reality system. This study showed that virtual reality added to conventional therapy produces similar results in upper limb function compared to only conventional therapy. Moreover, the gaming aspects incorporated in conventional rehabilitation appear to produce high motivation during execution of the assigned tasks. This trial is registered with EudraCT number 2015-002157-35.
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Affiliation(s)
- I. Dimbwadyo-Terrer
- Occupational Thinks Research Group, Centro Superior de Estudios Universitarios La Salle (UAM), C/La Salle 10, 28023 Madrid, Spain
| | - A. Gil-Agudo
- Biomechanics and Technical Aids Department, National Hospital for Spinal Cord Injury, Finca la Peraleda s/n, 45071 Toledo, Spain
| | - A. Segura-Fragoso
- Health Sciences Institute, Avenida de Madrid s/n, Talavera de la Reina, 45600 Toledo, Spain
| | - A. de los Reyes-Guzmán
- Biomechanics and Technical Aids Department, National Hospital for Spinal Cord Injury, Finca la Peraleda s/n, 45071 Toledo, Spain
| | - F. Trincado-Alonso
- Biomechanics and Technical Aids Department, National Hospital for Spinal Cord Injury, Finca la Peraleda s/n, 45071 Toledo, Spain
| | - S. Piazza
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Avenida Doctor Arce 37, 28002 Madrid, Spain
| | - B. Polonio-López
- Nursing, Physiotherapy and Occupational Therapy Department, University of Castilla La Mancha, Avenida Real Fábrica de Sedas s/n, Talavera de la Reina, 45600 Toledo, Spain
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Reader AT, Holmes NP. Video stimuli reduce object-directed imitation accuracy: a novel two-person motion-tracking approach. Front Psychol 2015; 6:644. [PMID: 26042073 PMCID: PMC4436526 DOI: 10.3389/fpsyg.2015.00644] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 05/02/2015] [Indexed: 11/20/2022] Open
Abstract
Imitation is an important form of social behavior, and research has aimed to discover and explain the neural and kinematic aspects of imitation. However, much of this research has featured single participants imitating in response to pre-recorded video stimuli. This is in spite of findings that show reduced neural activation to video vs. real life movement stimuli, particularly in the motor cortex. We investigated the degree to which video stimuli may affect the imitation process using a novel motion tracking paradigm with high spatial and temporal resolution. We recorded 14 positions on the hands, arms, and heads of two individuals in an imitation experiment. One individual freely moved within given parameters (moving balls across a series of pegs) and a second participant imitated. This task was performed with either simple (one ball) or complex (three balls) movement difficulty, and either face-to-face or via a live video projection. After an exploratory analysis, three dependent variables were chosen for examination: 3D grip position, joint angles in the arm, and grip aperture. A cross-correlation and multivariate analysis revealed that object-directed imitation task accuracy (as represented by grip position) was reduced in video compared to face-to-face feedback, and in complex compared to simple difficulty. This was most prevalent in the left-right and forward-back motions, relevant to the imitator sitting face-to-face with the actor or with a live projected video of the same actor. The results suggest that for tasks which require object-directed imitation, video stimuli may not be an ecologically valid way to present task materials. However, no similar effects were found in the joint angle and grip aperture variables, suggesting that there are limits to the influence of video stimuli on imitation. The implications of these results are discussed with regards to previous findings, and with suggestions for future experimentation.
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Affiliation(s)
- Arran T Reader
- School of Psychology and Clinical Language Sciences, University of Reading Reading, UK
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Concurrent and Predictive Validity of Arm Kinematics With and Without a Trunk Restraint During a Reaching Task in Individuals With Stroke. Arch Phys Med Rehabil 2015; 96:1666-75. [PMID: 25940684 DOI: 10.1016/j.apmr.2015.04.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 04/18/2015] [Accepted: 04/21/2015] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To examine the concurrent and predictive validity of measurements of kinematic variables during reaching tasks with and without a trunk constraint in individuals with stroke. DESIGN Randomized controlled trials. SETTINGS Hospitals and a laboratory. PARTICIPANTS Individuals with stroke (N=95) enrolled in previous and ongoing clinical trials. INTERVENTIONS Upper limb training protocols were 90 to 120 minutes of intervention every weekday for 3 to 4 weeks. MAIN OUTCOME MEASURES Functional capacity was assessed using the Action Research Arm Test and motor impairment using the Fugl-Meyer Assessment for the Upper Extremity. Movement kinematics were measured during a reaching task with and without a trunk constraint. We derived 5 endpoint control variables and 3 joint recruitment variables for estimating concurrent and predictive validity. RESULTS The adjusted R(2) values for the constraint tasks ranged from .24 to .38 and for the unconstraint tasks from .29 to .40. Movement time was the most prominent kinematic variable for the Fugl-Meyer Assessment for the Upper Extremity before and after the intervention (P<.05). For the Action Research Arm Test, movement time and endpoint displacement were the most significant variables before and after the intervention, respectively (P<.05). CONCLUSIONS Measuring kinematic performance during an unconstrained task is appropriate and possibly sufficient to represent motor impairment and functional capacity of individuals with stroke. Movement time is the dominant variable associated with motor impairment and functional capacity, and endpoint displacement is unique in reflecting functional capacity of individuals with stroke.
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Lee JA, Hwang PW, Kim EJ. Upper extremity muscle activation during drinking from a glass in subjects with chronic stroke. J Phys Ther Sci 2015; 27:701-3. [PMID: 25931712 PMCID: PMC4395696 DOI: 10.1589/jpts.27.701] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 10/21/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to compare the muscle activities of upper
extremities during a drinking task between the stroke-affected and less-affected sides.
[Subjects] Eight stroke patients (8 men; age 45.3 years; stroke duration 21.9 months)
participated in this study. [Methods] Electromyography (EMG) was used to measure nine
muscle activities of the upper extremity. The drinking task was divided into 5 phases.
[Results] Analysis of the EMG data showed that the percentage of maximum voluntary
isometric contraction (%MVIC) across all phases of drinking differed between the affected
and less-affected sides. Participants used relatively higher levels of %MVIC in the
anterior deltoid, flexor muscles, brachioradialis, and infraspinatus on the stoke-affected
side. [Conclusion] The difference in muscle activation across all phases of the drinking
movement allowed us to determine how upper extremity muscle activation may influence
drinking performance on the stroke-affected and less-affected sides.
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Affiliation(s)
- Jung Ah Lee
- Department of Motor and Cognitive Rehabilitation, Korea National Rehabilitation Research Institute, Republic of Korea
| | - Pil Woo Hwang
- Department of Motor and Cognitive Rehabilitation, Korea National Rehabilitation Research Institute, Republic of Korea
| | - Eun Joo Kim
- Department of Rehabilitation Medicine, Korea National Rehabilitation Hospital, Republic of Korea
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Royo Sánchez AC, Aguilar Martín JJ, Santolaria Mazo J. Development of a new calibration procedure and its experimental validation applied to a human motion capture system. J Biomech Eng 2014; 136:124502. [PMID: 25203903 DOI: 10.1115/1.4028523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 09/11/2014] [Indexed: 11/08/2022]
Abstract
Motion capture systems are often used for checking and analyzing human motion in biomechanical applications. It is important, in this context, that the systems provide the best possible accuracy. Among existing capture systems, optical systems are those with the highest accuracy. In this paper, the development of a new calibration procedure for optical human motion capture systems is presented. The performance and effectiveness of that new calibration procedure are also checked by experimental validation. The new calibration procedure consists of two stages. In the first stage, initial estimators of intrinsic and extrinsic parameters are sought. The camera calibration method used in this stage is the one proposed by Tsai. These parameters are determined from the camera characteristics, the spatial position of the camera, and the center of the capture volume. In the second stage, a simultaneous nonlinear optimization of all parameters is performed to identify the optimal values, which minimize the objective function. The objective function, in this case, minimizes two errors. The first error is the distance error between two markers placed in a wand. The second error is the error of position and orientation of the retroreflective markers of a static calibration object. The real co-ordinates of the two objects are calibrated in a co-ordinate measuring machine (CMM). The OrthoBio system is used to validate the new calibration procedure. Results are 90% lower than those from the previous calibration software and broadly comparable with results from a similarly configured Vicon system.
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Gil-Agudo A, de Los Reyes-Guzmán A, Dimbwadyo-Terrer I, Peñasco-Martín B, Bernal-Sahún A, López-Monteagudo P, Del Ama-Espinosa A, Pons JL. A novel motion tracking system for evaluation of functional rehabilitation of the upper limbs. Neural Regen Res 2014; 8:1773-82. [PMID: 25206474 PMCID: PMC4145958 DOI: 10.3969/j.issn.1673-5374.2013.19.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 05/10/2013] [Indexed: 11/18/2022] Open
Abstract
Upper limb function impairment is one of the most common sequelae of central nervous system injury, especially in stroke patients and when spinal cord injury produces tetraplegia. Conventional assessment methods cannot provide objective evaluation of patient performance and the tiveness of therapies. The most common assessment tools are based on rating scales, which are inefficient when measuring small changes and can yield subjective bias. In this study, we designed an inertial sensor-based monitoring system composed of five sensors to measure and analyze the complex movements of the upper limbs, which are common in activities of daily living. We developed a kinematic model with nine degrees of freedom to analyze upper limb and head movements in three dimensions. This system was then validated using a commercial optoelectronic system. These findings suggest that an inertial sensor-based motion tracking system can be used in patients who have upper limb impairment through data integration with a virtual reality-based neuroretation system.
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Affiliation(s)
- Angel Gil-Agudo
- Department of Biomechanics and Technical Aids, National Hospital for Spinal Cord Injury, Toledo, Spain
| | - Ana de Los Reyes-Guzmán
- Department of Biomechanics and Technical Aids, National Hospital for Spinal Cord Injury, Toledo, Spain
| | - Iris Dimbwadyo-Terrer
- Department of Biomechanics and Technical Aids, National Hospital for Spinal Cord Injury, Toledo, Spain
| | - Benito Peñasco-Martín
- Department of Biomechanics and Technical Aids, National Hospital for Spinal Cord Injury, Toledo, Spain
| | | | | | - Antonio Del Ama-Espinosa
- Department of Biomechanics and Technical Aids, National Hospital for Spinal Cord Injury, Toledo, Spain
| | - José Luis Pons
- Bioengineering Group, Spanish National Research Council (CSIC), Arganda del Rey, Madrid, Spain
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de los Reyes-Guzmán A, Dimbwadyo-Terrer I, Trincado-Alonso F, Monasterio-Huelin F, Torricelli D, Gil-Agudo A. Quantitative assessment based on kinematic measures of functional impairments during upper extremity movements: A review. Clin Biomech (Bristol, Avon) 2014; 29:719-27. [PMID: 25017296 DOI: 10.1016/j.clinbiomech.2014.06.013] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 05/14/2014] [Accepted: 06/10/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Quantitative measures of human movement quality are important for discriminating healthy and pathological conditions and for expressing the outcomes and clinically important changes in subjects' functional state. However the most frequently used instruments for the upper extremity functional assessment are clinical scales, that previously have been standardized and validated, but have a high subjective component depending on the observer who scores the test. But they are not enough to assess motor strategies used during movements, and their use in combination with other more objective measures is necessary. The objective of the present review is to provide an overview on objective metrics found in literature with the aim of quantifying the upper extremity performance during functional tasks, regardless of the equipment or system used for registering kinematic data. METHODS A search in Medline, Google Scholar and IEEE Xplore databases was performed following a combination of a series of keywords. The full scientific papers that fulfilled the inclusion criteria were included in the review. FINDINGS A set of kinematic metrics was found in literature in relation to joint displacements, analysis of hand trajectories and velocity profiles. These metrics were classified into different categories according to the movement characteristic that was being measured. INTERPRETATION These kinematic metrics provide the starting point for a proposed objective metrics for the functional assessment of the upper extremity in people with movement disorders as a consequence of neurological injuries. Potential areas of future and further research are presented in the Discussion section.
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Affiliation(s)
- Ana de los Reyes-Guzmán
- Biomechanics and Technical Aids Department, National Hospital for Spinal Cord Injury (SESCAM), Toledo, Spain.
| | - Iris Dimbwadyo-Terrer
- Biomechanics and Technical Aids Department, National Hospital for Spinal Cord Injury (SESCAM), Toledo, Spain
| | - Fernando Trincado-Alonso
- Biomechanics and Technical Aids Department, National Hospital for Spinal Cord Injury (SESCAM), Toledo, Spain
| | - Félix Monasterio-Huelin
- Special Technologies Applied to Telecommunication Department, Higher Technical School of Telecommunications Engineering, Technical University of Madrid (UPM), Avenida Complutense, 30, University City, 28040 Madrid, Spain
| | - Diego Torricelli
- Bioengineering Group, Centre of Automatics and Robotics, Spanish National Research Council (CSIC), Ctra. Campo Real, Km 0.2, Arganda del Rey, 28500 Madrid, Spain
| | - Angel Gil-Agudo
- Biomechanics and Technical Aids Department, National Hospital for Spinal Cord Injury (SESCAM), Toledo, Spain
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Li KY, Wu YH. Clinical evaluation of motion and position sense in the upper extremities of the elderly using motion analysis system. Clin Interv Aging 2014; 9:1123-31. [PMID: 25075181 PMCID: PMC4106968 DOI: 10.2147/cia.s62037] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The purpose of this study was to measure kinesthetic accuracy in healthy older adults by using arm position and motion matching tests. We investigated the effect of task type, joint angle, and matching arm results on kinesthetic accuracy in the upper extremities of 17 healthy right-handed older adults. Blinded subjects were asked to match positions and motions at four reference joint angles: 1) shoulder flexion, 0°–60°; 2) elbow flexion, 90°–135°; 3) wrist extension, 0°–50° in the sagittal plane; and 4) shoulder abduction, 0°–60° in the frontal plane. The absolute difference in angular displacement between the reference and matching arms was calculated to determine kinesthetic accuracy. Results showed that subjects were more accurate at matching motion than position tasks (P=0.03). Shoulder and elbow joints were more sensitive than wrist joints in perceiving passive positions and motions (P<0.05). The effect of the matching arm was found only when matching the joint angles of shoulder abduction and wrist extension (P<0.01). These results are comparable to findings of other studies that used machine-generated kinesthetic stimuli. The manual measurement of kinesthetic accuracy could be effective as a preliminary screening tool for therapists in clinical settings.
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Affiliation(s)
- Kuan-yi Li
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Healthy Aging Research Center, Chang Gung University, Kwei-shan, Tao-Yuan, Taiwan
| | - Yi-hui Wu
- Department of Rehabilitation, Taoyuan Chang Gung Memorial Hospital, Kwei-shan, Tao-Yuan, Taiwan
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Kinematic metrics based on the virtual reality system Toyra as an assessment of the upper limb rehabilitation in people with spinal cord injury. BIOMED RESEARCH INTERNATIONAL 2014; 2014:904985. [PMID: 24895627 PMCID: PMC4017839 DOI: 10.1155/2014/904985] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 02/11/2014] [Accepted: 02/20/2014] [Indexed: 11/18/2022]
Abstract
The aim of this study was to develop new strategies based on virtual reality that can provide additional information to clinicians for the rehabilitation assessment. Virtual reality system Toyra has been used to record kinematic information of 15 patients with cervical spinal cord injury (SCI) while performing evaluation sessions using the mentioned system. Positive correlation, with a moderate and very strong association, has been found between clinical scales and kinematic data, considering only the subscales more closely related to the upper limb function. A set of metrics was defined combining these kinematic data to obtain parameters of reaching amplitude, joint amplitude, agility, accuracy, and repeatability during the evaluation sessions of the virtual reality system Toyra. Strong and moderate correlations have been also found between the metrics reaching and joint amplitude and the clinical scales.
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Kim K, Song WK, Lee J, Lee HY, Park DS, Ko BW, Kim J. Kinematic analysis of upper extremity movement during drinking in hemiplegic subjects. Clin Biomech (Bristol, Avon) 2014; 29:248-56. [PMID: 24451064 DOI: 10.1016/j.clinbiomech.2013.12.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 11/12/2013] [Accepted: 12/16/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND It is necessary to analyze the kinematic properties of a paralyzed extremity to quantitatively determine the degree of impairment of hemiplegic people during functional activities of daily living (ADL) such as a drinking task. This study aimed to identify the kinematic differences between 16 hemiplegic and 32 able-bodied participants in relation to the task phases when drinking with a cup and the kinematic strategy used during motion with respect to the gravity direction. METHODS The subjects performed a drinking task that was divided into five phases according to Murphy's phase definition: reaching, forward transport, drinking, backward transport, and returning. We found that the groups differed in terms of the movement times and the joint angles and angular velocities of the shoulder, elbow, and wrist joints. FINDINGS Compared to the control group, the hemiplegic participants had a larger shoulder abduction angle of at most 17.1° during all the phases, a larger shoulder flexion angle of 7.6° during the reaching phase, and a smaller shoulder flexion angle of 6.4° during the backward transporting phase. Because of these shoulder joint patterns, a smaller elbow pronation peak angle of at most 13.1° and a larger wrist extension peak angle of 12.0° were found in the motions of the hemiplegic participants, as compensation to complete the drinking task. The movement in the gravity direction during the backward transporting phase resulted in a 15.9% larger peak angular velocity for elbow extension in the hemiplegic participants compared to that of the control group. INTERPRETATION These quantitative kinematic patterns help provide an understanding of the movements of an affected extremity and can be useful in designing rehabilitation robots to assist hemiplegic people with ADL.
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Affiliation(s)
- Kyung Kim
- Department of Rehabilitative & Assistive Technology, Korea National Rehabilitation Center, 58 Samgaksan-ro, Gangbuk-gu, Seoul 142-070, Republic of Korea
| | - Won-Kyung Song
- Department of Rehabilitative & Assistive Technology, Korea National Rehabilitation Center, 58 Samgaksan-ro, Gangbuk-gu, Seoul 142-070, Republic of Korea.
| | - Jeongsu Lee
- Department of Rehabilitative & Assistive Technology, Korea National Rehabilitation Center, 58 Samgaksan-ro, Gangbuk-gu, Seoul 142-070, Republic of Korea
| | - Hwi-Young Lee
- Department of Rehabilitative & Assistive Technology, Korea National Rehabilitation Center, 58 Samgaksan-ro, Gangbuk-gu, Seoul 142-070, Republic of Korea
| | - Dae Sung Park
- Department of Physical Therapy, Konyang University, Gwanjeodong-ro, Seo-gu, Daejeon, 302-718, Republic of Korea
| | - Byung-Woo Ko
- Department of Rehabilitative & Assistive Technology, Korea National Rehabilitation Center, 58 Samgaksan-ro, Gangbuk-gu, Seoul 142-070, Republic of Korea
| | - Jongbae Kim
- Department of Rehabilitative & Assistive Technology, Korea National Rehabilitation Center, 58 Samgaksan-ro, Gangbuk-gu, Seoul 142-070, Republic of Korea
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Abd El-Kafy EM, Elshemy SA, Alghamdi MS. Effect of constraint-induced therapy on upper limb functions: a randomized control trial. Scand J Occup Ther 2013; 21:11-23. [PMID: 24325594 DOI: 10.3109/11038128.2013.837505] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS Children with congenital hemiparesis have unilateral upper extremity involvement, limiting their ability in unilateral or bilateral manual tasks, thus negatively influencing their participation in daily activities. Constraint-induced movement therapy (CIMT) has been shown to be promising for improving upper-limb functions in children with cerebral palsy. Clinical assessments may be needed to quantify and qualify changes in children's performance following its application. METHODS This study investigated the effectiveness of a child-friendly form of CIMT to improve upper extremity functional performance. Thirty congenitally hemiparetic children aged 4-8 years were randomly assigned to receive either a CIMT program (study group) or a conventional non-structured therapy program (control group). The programs were applied for both groups for six hours daily, five days weekly for four successive weeks. The Pediatric Arm Function Test, Quality of Upper Extremity Skills Test, and isokinetic muscular performances of shoulder flexors, extensors, and abductors expressed as peak torque were used to evaluate immediate and long-lasting efficacy of CIMT. RESULTS The results showed improvement in the involved upper extremity performances in different evaluated tasks immediately post-CIMT program application compared with the control group. These improvements continued three months later. CONCLUSION Pediatric CIMT with shaping produced considerable and sustained improvement in the involved upper extremity movements and functions in children with congenital hemiparesis.
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Affiliation(s)
- Ehab Mohamed Abd El-Kafy
- Department of Physical Therapy for Disturbances of Growth and Developmental Disorders in Children and its Surgery, Faculty of Physical Therapy, Cairo University , Giza , Egypt
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Alt Murphy M, Willén C, Sunnerhagen KS. Responsiveness of Upper Extremity Kinematic Measures and Clinical Improvement During the First Three Months After Stroke. Neurorehabil Neural Repair 2013; 27:844-53. [DOI: 10.1177/1545968313491008] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Kinematic movement analysis is increasingly used as an outcome measure in evaluation of upper extremity function after stroke. Little is known, however, about what observed longitudinal changes in kinematics mean in the context of an individual’s functioning. In this study, the responsiveness and expected change in kinematic measures associated with clinically meaningful improvement in the upper extremity were evaluated. Methods. Kinematic movement analysis of a drinking task and Action Research Arm Test (ARAT) were performed early (9 days poststroke) and at 3 months after stroke in 51 subjects. The receiver-operating characteristic curve and linear regression analyses were used to evaluate responsiveness of kinematic parameters. Results. Movement time, smoothness, and trunk displacement discriminated those subjects demonstrating clinically meaningful improvements. Significant associations of 31% to 36% were found between the change in ARAT and kinematic measures. A real clinical improvement in kinematics lies in the range of 2.5 to 5 seconds, 3 to 7 units, and 2 to 5 cm in movement time, smoothness, and trunk displacement, respectively. Conclusions. All kinematic measures reported in this study are responsive measures for capturing improvements in the upper extremity during the first 3 months after stroke. Approximate estimates for the expected change in kinematics associated with clinically meaningful improvement in upper extremity activity capacity illustrate the usefulness of the linear regression analysis for assessing responsiveness. This knowledge facilitates the selection of kinematic measures for clinical and movement analysis research as well as for technology-based devices.
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Molina Rueda F, Rivas Montero F, Pérez de Heredia Torres M, Alguacil Diego I, Molero Sánchez A, Miangolarra Page J. Movement analysis of upper extremity hemiparesis in patients with cerebrovascular disease: A pilot study. NEUROLOGÍA (ENGLISH EDITION) 2012. [DOI: 10.1016/j.nrleng.2012.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Alt Murphy M, Willén C, Sunnerhagen KS. Movement Kinematics During a Drinking Task Are Associated With the Activity Capacity Level After Stroke. Neurorehabil Neural Repair 2012; 26:1106-15. [PMID: 22647879 DOI: 10.1177/1545968312448234] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. Kinematic analysis is a powerful method for an objective assessment of movements and is increasingly used as an outcome measure after stroke. Little is known about how the actual movement performance measured with kinematics is related to the common traditional assessment scales. The aim of this study was to determine the relationships between movement kinematics from a drinking task and the impairment or activity limitation level after stroke. Methods. Kinematic analysis of movement performance in a drinking task was used to measure movement time, smoothness, and angular velocity of elbow and trunk displacement (TD) in 30 individuals with stroke. Sensorimotor impairment was assessed with the Fugl-Meyer Assessment (FMA), activity capacity limitation with the Action Research Arm Test (ARAT), and self-perceived activity difficulties with the ABILHAND questionnaire. Results. Backward multiple regression revealed that the movement smoothness (similarly to movement time) and TD together explain 67% of the total variance in ARAT. Both variables uniquely contributed 37% and 11%, respectively. The TD alone explained 20% of the variance in the FMA, and movement smoothness explained 6% of the variance in the ABILHAND. Conclusions. The kinematic movement performance measures obtained during a drinking task are more strongly associated with activity capacity than with impairment. The movement smoothness and time, possibly together with compensatory movement of the trunk, are valid measures of activity capacity and can be considered as key variables in the evaluation of upper-extremity function after stroke. This increased knowledge is of great value for better interpretation and application of kinematic data in clinical studies.
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Molina Rueda F, Rivas Montero FM, Pérez de Heredia Torres M, Alguacil Diego IM, Molero Sánchez A, Miangolarra Page JC. [Movement analysis of upper extremity hemiparesis in patients with cerebrovascular disease: a pilot study]. Neurologia 2012; 27:343-7. [PMID: 22341987 DOI: 10.1016/j.nrl.2011.12.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Revised: 11/14/2011] [Accepted: 12/20/2011] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION As a result of neurophysiological injury, stroke patients have mobility limitations, mainly on the side of the body contralateral to the lesioned hemisphere. The purpose of this study is to quantify motor compensation strategies in stroke patients during the activity of drinking water from a glass. MATERIAL AND METHODS Four male patient with cerebrovascular disease and four right-handed, healthy male control subjects. The motion analysis was conducted using the Vicon Motion System(®) and surface electromyography equipment ZeroWire Aurion(®). We analysed elbow, shoulder and trunk joint movements and performed a qualitative analysis of the sequence of muscle activation. RESULTS Trunk, shoulder and elbow movements measured in the stroke patient along the sagittal plane decreased during the drinking from a glass activity, while the movements in the shoulder in the coronal plane and trunk increased. As for the sequence of muscle activation, anterior, middle and posterior deltoid all contracted in the patient group during the task, while the upper trapezius activation remained throughout the activity. CONCLUSIONS Quantitative analysis of movement provides quantitative information on compensation strategies used by stroke patients, and is therefore, clinically relevant.
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Affiliation(s)
- F Molina Rueda
- Grupo de Investigación del Laboratorio de Análisis del Movimiento, Biomecánica, Ergonomía y Control Motor (LAMBECOM), Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, España.
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