The concept of “normal” movement and its consequences for therapy

1996 ◽  
Vol 19 (1) ◽  
pp. 79-79
Author(s):  
Jürgen Konczak ◽  
Johannes Dichgans

AbstractThe guideline for therapy should be the improvement of the individual's functionality, not the acquisition of the ill-defined “goldstandard” of normal movement. However, Latash & Anson's suggestion that only primary causes of dysfunction should be treated is problematic for two reasons: First, the distinction between genuine and adaptive changes in motor performance is not always possible, and second, adaptive changes do not necessarily improve motor function, but may actually be detrimental to the system's performance.

2000 ◽  
Vol 42 (4) ◽  
pp. 220-227 ◽  
Author(s):  
U M Fietzek ◽  
F Heinen ◽  
S Berweck ◽  
S Maute ◽  
A Hufschmidt ◽  
...  

2021 ◽  
Author(s):  
Karen Otte ◽  
Tobias Ellermeyer ◽  
Masahide Suzuki ◽  
Hanna M. Röhling ◽  
Ryota Kuroiwa ◽  
...  

Abstract Background Quantification of motor performance has a promising role in personalized medicine by diagnosing and monitoring, e.g. neurodegenerative diseases or health problems related to aging. New motion assessment technologies can evolve into patient-centered eHealth applications on a global scale to support personalized healthcare as well as treatment of disease. However, uncertainty remains on the limits of generalizability of such data, which is relevant specifically for preventive or predictive applications, using normative datasets to screen for incipient disease manifestations or indicators of individual risks. Objective This study explored differences between healthy German and Japanese adults in the performance of a short set of six motor tests. Methods Six motor tasks related to gait and balance were recorded with a validated 3D camera system. Twenty-five healthy adults from Chiba, Japan, participated in this study and were matched for age, sex, and BMI to a sample of 25 healthy adults from Berlin, Germany. Recordings used the same technical setup and standard instructions and were supervised by the same experienced operator. Differences in motor performance were analyzed using multiple linear regressions models, adjusted for differences in body stature. Results From 23 presented parameters, five showed group-related differences after adjustment for height and weight (R2 between .19 and .46, p<.05). Japanese adults transitioned faster between sitting and standing and used a smaller range of hand motion. In stepping-in-place, cadence was similar in both groups, but Japanese adults showed higher knee movement amplitudes. Body height was identified as relevant confounder (standardized beta >.5) for performance of short comfortable and maximum speed walks. For results of posturography, regression models did not reveal effects of group or body stature. Conclusions Our results support the existence of a population-specific bias in motor function patterns in young healthy adults. This needs to be considered when motor function is assessed and used for clinical decisions, especially for personalized predictive and preventive medical purposes. The bias affected only the performance of specific items and parameters and is not fully explained by population-specific ethnic differences in body stature. It may be partially explained as cultural bias related to motor habits. Observed effects were small but are expected to be larger in a non-controlled cross-cultural application of motion assessment technologies with relevance for related algorithms that are being developed and used for data processing. In sum, the interpretation of individual data should be related to appropriate population-specific or even better personalized normative values to yield its full potential and avoid misinterpretation.


2006 ◽  
Vol 23 (4) ◽  
pp. 339-355 ◽  
Author(s):  
Miriam Getz ◽  
Yeshayahu Hutzler ◽  
Adri Vermeer

The purpose of this study was to investigate the relationship between motor performance in the aquatic setting as measured by the Aquatic Independence Measure (AIM) to motor performance on land as measured by the Gross Motor Function Measure (GMFM) and the Pediatric Evaluation of Disability Inventory (PEDI). Fourty- nine children with neuro-motor impairments ages 3 to 7 participated in the study. Pearson correlations were applied to determine the relationships between the AIM and the GMFM, PEDI, and Gross Motor Function Classification System (GMFCS). Significant correlations were found between the total AIM and GMFM scores (r = 69, p < .01) and PEDI self-care sub-scale (r = .79, p < .01) as well as the PEDI mobility sub-scale scores (r = .35, p < .05). The water adjustment sub-scale as measured by the AIM showed the strongest relationship to motor performance on land as measured by the GMFM and PEDI in our sample of 49 children.


2019 ◽  
Vol 51 (Supplement) ◽  
pp. 346
Author(s):  
Angela L. Ridgel ◽  
Jin Hyun Kim ◽  
Peter Gates ◽  
Robert Melczak ◽  
Fred Discenzo ◽  
...  

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Matthew J Durand ◽  
Spencer A Murphy ◽  
Brian D Schmit ◽  
David D Gutterman ◽  
Allison S Hyngstrom

Introduction: Individuals living with chronic stroke have weakness and increased neuromuscular fatigue in the paretic leg, which can limit walking ability and endurance. In cardiac and healthy populations, ischemic preconditioning (IPC) is a widely studied, effective, non-invasive stimulus which not only improves vascular function, but also motor performance. IPC occurs when the tissue of interest is exposed to repeated, short bouts of ischemia, which can improve motor function by enhancing vascular, neural and muscle function. IPC has not been tested as a method to improve motor function in individuals post-stroke. Hypothesis: Two weeks of IPC training on the paretic leg will improve leg strength and time-to-task failure (TTF) during a fatiguing muscle contraction. Methods: A feasibility study of 4 individuals (3 female, 1 male) with chronic stroke (20 ± 4 years) was conducted. A Biodex dynamometer was used to assess paretic leg knee extensor maximal voluntary contraction (MVC). To assess muscle fatigability, subjects maintained a sustained contraction equal to 30% of their MVC until failure using visual feedback. After baseline testing, subjects made six visits to the laboratory over a two week period to have IPC performed on their paretic leg. A blood pressure cuff was inflated on the thigh to 225 mmHg for five, five-minute bouts per session. Five minutes of rest was given between inflation cycles. After the last session, subjects returned within 48 hours to have MVC and TTF reassessed. Results: Three subjects completed all study procedures. One subject withdrew for medical reasons unrelated to the study. The IPC procedure was well tolerated by all subjects. After two-week IPC training, knee extensor MVC increased in the paretic leg (45.0 ± 2.7 Nm vs. 52.6 ± 5.7 Nm). Fatigability of the muscles was dramatically reduced after IPC training as TTF tripled (359 ± 180 seconds vs. 1097 ± 343 seconds). Conclusions: We are the first group to show that IPC is a well-tolerated and effective stimulus to improve paretic leg strength and reduce muscle fatigability in subjects with chronic stroke. The results of this pilot study warrant a larger study to determine whether IPC improves muscle performance post-stroke through neural, vascular, or muscle-related mechanisms.


2021 ◽  
pp. 74-77
Author(s):  
Kinjal Bagthariya(M.P.T)

EAST syndrome is autosomal recessive disorder due to mutations in gene KCNJ10, a gene encoding a potassium channel expressed in the brain, eye, ear and kidney. It is characterized by four cardinal features; Epilepsy, Ataxia, Sensorineural deafness, and renal salt-wasting Tubulopathy, thus the acronym EAST syndrome. It was rst described as a distinct clinical entity in 2009 by Bockenhauer and scholl, who named this condition EAST syndrome and SeSAME syndrome for Seizures, Sensorineural deafness, Ataxia, Mental retardation and Electrolyte imbalance respectively. Neurodevelopmental delay is evident in most patients with EAST syndrome that were old enough to be assessed; Thus, physiotherapy intervention also plays a vital role in EAST syndrome along with medical management. From physiotherapy perspective; symptomatic management to Improve overall health, wellbeing and motor control becomes ultimate goal in the patient with EAST syndrome. As there is no specic physical therapy treatment approach and no specic tool to evaluate function for children with EAST syndrome; for clinically presented delay development and ataxia, Neurodevelopment therapy (NDT) was utilized as treatment approach and Gross motor function measure (GMFM) & Gross motor performance measure (GMPM) were utilized for assessment in this case study to track progress on follow ups. Result showed marked improvement in GMFM and GMPM scores at follow ups and concluded that Physical therapy intervention improves the gross motor function as well as gross motor performance in patient with EAST syndrome.


Author(s):  
Arthur Prochazka

About 2% of people have weak or paralysed upper limbs (ULs) due to stroke or spinal cord injury (SCI). Physiotherapy involving exercise can improve motor function in many such cases, but the time and resources required are often unavailable. Adherence to repeated intensive exercise tends to decline, especially after participants leave the clinical environment. There is a need for technology that can restore neuromuscular control and improve motivation by making exercise therapy enjoyable, and that extends the therapy into the home with the use of remote communication (e.g. ‘tele-coaching’). Over the last 20 years many devices have been developed and tested. Neuroprostheses (NPs) that activate UL muscles with functional electrical stimulation (FES) either via surface or implanted electrodes are now commercially available or in clinical trials. The use of robotic devices to enhance exercise therapy has been an active area of research and development. Recent studies indicate that improvements in motor function depend largely on the efforts made by the participant. This chapter reviews conventional exercise therapy, FES, and robotic and passive exercise devices that improve motor function and enhance engagement in UL rehabilitation. It is suggested that important developments in the next few years will include the widespread availability of affordable FES and in-home exercise devices, and the gradual adoption of tele-coaching over the internet.


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