scholarly journals Observation of others’ actions during limb immobilization prevents the subsequent decay of motor performance

2021 ◽  
Vol 118 (47) ◽  
pp. e2025979118
Author(s):  
Doriana De Marco ◽  
Emilia Scalona ◽  
Maria Chiara Bazzini ◽  
Arturo Nuara ◽  
Elisa Taglione ◽  
...  
Keyword(s):  
Upper Limb ◽  
Motor Performance ◽  
Action Observation ◽  
Motor Impairment ◽  
Motor Deficits ◽  
Control Group ◽  
Reach To Grasp ◽  
Action Execution ◽  
Limb Immobilization ◽  
Experimental Group

There is rich clinical evidence that observing normally executed actions promotes the recovery of the corresponding action execution in patients with motor deficits. In this study, we assessed the ability of action observation to prevent the decay of healthy individuals’ motor abilities following upper-limb immobilization. To this end, upper-limb kinematics was recorded in healthy participants while they performed three reach-to-grasp movements before immobilization and the same movements after 16 h of immobilization. The participants were subdivided into two groups; the experimental group observed, during the immobilization, the same reach-to-grasp movements they had performed before immobilization, whereas the control group observed natural scenarios. After bandage removal, motor impairment in performing reach-to-grasp movements was milder in the experimental group. These findings support the hypothesis that action observation, via the mirror mechanism, plays a protective role against the decline of motor performance induced by limb nonuse. From this perspective, action observation therapy is a promising tool for anticipating rehabilitation onset in clinical conditions involving limb nonuse, thus reducing the burden of further rehabilitation.

Functional and structural plasticity following action observation training in multiple sclerosis

2018 ◽  
Vol 25 (11) ◽  
pp. 1472-1487 ◽  
Author(s):  
Maria A Rocca ◽  
Alessandro Meani ◽  
Silvia Fumagalli ◽  
Elisabetta Pagani ◽  
Roberto Gatti ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Upper Limb ◽  
Action Observation ◽  
Gray Matter Volume ◽  
Motor Impairment ◽  
Motor Deficits ◽  
Dominant Hand ◽  
Upper Limb Function ◽  
Mri Scans ◽  
Observation Training

Background: Hand motor deficits contribute to multiple sclerosis (MS)-related disability. Action observation training (AOT) is promising to improve upper limb function in neurologic patients. Objectives: In this preliminary study, we investigated AOT effects on dominant-hand motor performance in MS patients with upper limb motor impairment and performed an explorative analysis of their anatomical and functional magnetic resonance imaging (MRI) substrates. Methods: In total, 46 healthy controls (HC) and 41 MS patients with dominant-hand motor impairment were randomized to AOT (HC-AOT = 23; MS-AOT = 20; watching daily-life action videos and execution) or control-training (HC-Control = 23; MS-Control = 21; watching landscapes videos and execution). Behavioral, structural, and functional (at rest and during object manipulation) MRI scans were acquired before and after a 2-week training. Results: After training, MS groups improved in right upper limb functions, mainly in AOT group ( p from 0.02 to 0.0001). All groups showed regional increased and decreased gray matter volume, with specific AOT effects in fronto-temporal areas in MS-AOT ( p < 0.001), without white matter (WM) integrity modifications. Increased and reduced recruitments of the action observation matching system and its connections in MS-AOT were found ( p < 0.001). Motor improvements were correlated with volumetric and functional MRI modifications ( r from −0.78 to 0.77, p < 0.001). Conclusion: The 10-day AOT promotes clinical improvements in MS patients through structural and functional modifications of the action observation matching system.

scholarly journals Effect of post-stroke spasticity on voluntary movement of the upper limb

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Hadar Lackritz ◽  
Yisrael Parmet ◽  
Silvi Frenkel-Toledo ◽  
Melanie C. Baniña ◽  
Nachum Soroker ◽  
...  
Keyword(s):  
Upper Limb ◽  
Target Location ◽  
Distance Measure ◽  
Movement Time ◽  
Motor Impairment ◽  
Reach To Grasp ◽  
Motion Patterns ◽  
Post Stroke ◽  
The Impact ◽  
Elbow Motion

Abstract Background Hemiparesis following stroke is often accompanied by spasticity. Spasticity is one factor among the multiple components of the upper motor neuron syndrome that contributes to movement impairment. However, the specific contribution of spasticity is difficult to isolate and quantify. We propose a new method of quantification and evaluation of the impact of spasticity on the quality of movement following stroke. Methods Spasticity was assessed using the Tonic Stretch Reflex Threshold (TSRT). TSRT was analyzed in relation to stochastic models of motion to quantify the deviation of the hemiparetic upper limb motion from the normal motion patterns during a reaching task. Specifically, we assessed the impact of spasticity in the elbow flexors on reaching motion patterns using two distinct measures of the ‘distance’ between pathological and normal movement, (a) the bidirectional Kullback–Liebler divergence (BKLD) and (b) Hellinger’s distance (HD). These measures differ in their sensitivity to different confounding variables. Motor impairment was assessed clinically by the Fugl-Meyer assessment scale for the upper extremity (FMA-UE). Forty-two first-event stroke patients in the subacute phase and 13 healthy controls of similar age participated in the study. Elbow motion was analyzed in the context of repeated reach-to-grasp movements towards four differently located targets. Log-BKLD and HD along with movement time, final elbow extension angle, mean elbow velocity, peak elbow velocity, and the number of velocity peaks of the elbow motion were computed. Results Upper limb kinematics in patients with lower FMA-UE scores (greater impairment) showed greater deviation from normality when the distance between impaired and normal elbow motion was analyzed either with the BKLD or HD measures. The severity of spasticity, reflected by the TSRT, was related to the distance between impaired and normal elbow motion analyzed with either distance measure. Mean elbow velocity differed between targets, however HD was not sensitive to target location. This may point at effects of spasticity on motion quality that go beyond effects on velocity. Conclusions The two methods for analyzing pathological movement post-stroke provide new options for studying the relationship between spasticity and movement quality under different spatiotemporal constraints.

The Effectiveness of Action Observation Therapy Based on Mirror Neuron Theory in Chinese Patients with Apraxia of Speech after Stroke

2019 ◽  
Vol 81 (5-6) ◽  
pp. 278-286
Author(s):  
Li You ◽  
Yao Wang ◽  
Wenli Chen ◽  
Sicong Zhang ◽  
Jiang Rao ◽  
...  
Keyword(s):  
Action Observation ◽  
Mirror Neuron ◽  
Assessment Method ◽  
Chinese Patients ◽  
Control Group ◽  
Apraxia Of Speech ◽  
Language Therapy ◽  
Before And After ◽  
Neuron Theory ◽  
Experimental Group

Objective: The present study aimed to evaluate the efficacy of action observation therapy (AOT) on apraxia of speech (AOS) in patients after stroke. Materials and Methods: Forty-two patients diagnosed with AOS after stroke were randomly divided into an experimental group (n = 21) and a control group (n = 21). Both groups received 30 min of conventional language therapy twice daily, 5 days a week for 4 weeks. The patients in the experimental group additionally received 20 min of AOT before 10 min language therapy each day. The speech function and aphasia severity of the 2 groups were assessed using the speech apraxia assessment method of the China Rehabilitation Research Center, Western Aphasia Battery (WAB), and the Boston Diagnostic Aphasia Examination before and after treatment. Results: AOS and WAB scores increased significantly after treatment in both groups (p < 0.05). AOS and WAB scores exhibited significant differences between the experimental group and the control group after training (p < 0.05). The response rate in the experimental group was significantly higher than that in the control group (p < 0.05). Conclusion: AOT based on mirror neuron theory may improve language function in patients with AOS after stroke.

scholarly journals Eye Gaze Correlates of Motor Impairment in VR Observation of Motor Actions

2016 ◽  
Vol 55 (01) ◽  
pp. 79-83 ◽  
Author(s):  
A. Vourvopoulos ◽  
A. Bernardino ◽  
i Bermúdez Badia ◽  
J. Alves
Keyword(s):  
Virtual Reality ◽  
Smooth Pursuit ◽  
Healthy Subjects ◽  
Eye Gaze ◽  
Action Observation ◽  
Motor Impairment ◽  
Motor Deficits ◽  
Stroke Patients ◽  
Motor Actions ◽  
Healthy Participants

Summary Introduction: This article is part of the Focus Theme of Methods of Information in Medicine on “Methodologies, Models and Algorithms for Patients Rehabilitation”. Objective: Identify eye gaze correlates of motor impairment in a virtual reality motor observation task in a study with healthy participants and stroke patients. Methods: Participants consisted of a group of healthy subjects (N = 20) and a group of stroke survivors (N = 10). Both groups were required to observe a simple reach-and-grab and place-and-release task in a virtual environment. Additionally, healthy subjects were required to observe the task in a normal condition and a constrained movement condition. Eye movements were recorded during the observation task for later analysis. Results: For healthy participants, results showed differences in gaze metrics when comparing the normal and arm-constrained conditions. Differences in gaze metrics were also found when comparing dominant and non-dominant arm for saccades and smooth pursuit events. For stroke patients, results showed longer smooth pursuit segments in action observation when observing the paretic arm, thus providing evidence that the affected circuitry may be activated for eye gaze control during observation of the simulated motor action. Conclusions: This study suggests that neural motor circuits are involved, at multiple levels, in observation of motor actions displayed in a virtual reality environment. Thus, eye tracking combined with action observation tasks in a virtual reality display can be used to monitor motor deficits derived from stroke, and consequently can also be used for re -habilitation of stroke patients.

Effects of prenatal x-irradiation on motor performance in the rat

1961 ◽  
Vol 201 (4) ◽  
pp. 703-706 ◽  
Author(s):  
Jack Werboff ◽  
Irving Goodman ◽  
Joan Havlena ◽  
Melvin R. Sikov
Keyword(s):  
Motor Performance ◽  
Motor Impairment ◽  
Whole Body ◽  
Control Group ◽  
Albino Rats ◽  
Sprague Dawley ◽  
X Irradiation ◽  
Motor Strength ◽  
Low Levels ◽  
Almost All

Gravid albino rats of the Sprague-Dawley strain received either 25, 50, or 100 r whole-body X-radiation on either day 5, 10, 15, or 20 of gestation. Controls were sham-irradiated. Over 500 surviving offspring were evaluated on measures of motor maturation of the upright and righting responses, motor strength, and locomotor learning during the neonatal period. The results indicate that radiation exposure of 100 r on day 15 of gestation retards motor maturation of the upright and righting responses. Almost all of the radiation groups show a decrease in motor strength as compared to the control group with maximum deficits in the groups receiving 50 or 100 r on day 10 or 15 of gestation. On the locomotor learning measure, the results are not consistent, but the group receiving 100 r on day 15 of gestation is maximally affected. These deficits in motor performance are related to observable motor impairment. It is concluded that low levels of radiation received prenatally can have detrimental effects on the development of motor performances in the rat.

scholarly journals Effect of Additional Rehabilitation After Botulinum Toxin-A on Upper Limb Activity in Chronic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (2) ◽  
pp. 556-562
Author(s):  
Natasha A. Lannin ◽  
Louise Ada ◽  
Coralie English ◽  
Julie Ratcliffe ◽  
Steven G. Faux ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Upper Limb ◽  
Goal Attainment ◽  
Botulinum Toxin A ◽  
Chronic Stroke ◽  
Mean Difference ◽  
Control Group ◽  
Toxin A ◽  
Upper Limb Rehabilitation ◽  
Experimental Group

Background and Purpose— The aim of this trial was to determine the effect of additional upper limb rehabilitation following botulinum toxin-A for upper limb activity in chronic stroke. Methods— We conducted a multicenter phase III randomized trial with concealed allocation, blinded measurement, and intention-to-treat analysis. One hundred forty stroke survivors who were scheduled to receive botulinum toxin-A in any muscle(s) that cross the wrist because of moderate to severe spasticity after a stroke >3 months ago, who had completed formal rehabilitation and had no significant cognitive impairment. Experimental group received botulinum toxin-A plus evidence-based movement training while the control group received botulinum toxin-A plus a handout of exercises. Primary outcomes were goal attainment (Goal Attainment Scaling) and upper limb activity (Box and Block Test) at 3 months (end of intervention). Secondary outcomes were spasticity, range of motion, strength, pain, burden of care, and health-related quality of life. Results— In terms of goal attainment, the experimental group scored the same (mean difference, 2 T-score [95% CI, −2 to 7]) as the control group on the Goal Attainment Scale. In terms of upper limb activity, by 3 months the experimental group moved blocks at the same speed (mean difference, 0.00 blocks/s [95% CI, −0.02 to 0.01]) as the control group on the Box and Block Test. There were no differences between groups on any secondary outcome except strength, in favor of the experimental group (mean difference, 1.4 kg [95% CI, 0.2–2.7]). Conclusions— Findings suggest that additional intensive upper limb rehabilitation following botulinum toxin-A in chronic stroke survivors with a disabled upper limb is not effective. Registration— URL: https://www.clinicaltrials.gov . Unique identifier: ACTRN12615000616572.

Sensor-based technology for upper limb rehabilitation in patients with multiple sclerosis: A randomized controlled trial

2020 ◽  
Vol 38 (4) ◽  
pp. 333-341
Author(s):  
Marco Tramontano ◽  
Giovanni Morone ◽  
Sara De Angelis ◽  
Laura Casagrande Conti ◽  
Giovanni Galeoto ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Upper Limb ◽  
Controlled Trial ◽  
Control Group ◽  
Hand Rehabilitation ◽  
Upper Limb Rehabilitation ◽  
Rehabilitation Programs ◽  
Scale Scores ◽  
Limb Rehabilitation ◽  
Experimental Group

Background: Sensor-based technological therapy devices may be good candidates for neuromotor rehabilitation of people with Multiple Sclerosis (MS), especially for treating upper extremities function limitations. The sensor-based device rehabilitation is characterized by interactive therapy games with audio-visual feedback that allows training the movement of shoulders, elbows, and wrist, measuring the strength and the active range of motion of upper limb, registering data in an electronic database to quantitatively monitoring measures and therapy progress. Objective: This study aimed to investigate the effects of sensor-based motor rehabilitation in add-on to the conventional neurorehabilitation, on increasing the upper limb functions of patients with MS. Methods: Thirty patients were enrolled in the study and randomly assigned to the experimental group and the control group. The training consisting of twelve sessions of upper limb training was compared with twelve sessions of upper limb sensory-motor training, without robotic support. Both rehabilitation programs were performed for 40 minutes three times a week, for 4 weeks, in addition to conventional therapy. All patients were evaluated at the baseline (T0) and after 4 weeks of training (T1). Results: The within-subject analysis showed a statistically significant improvement in both groups, in the Modified Barthel Index and in the Rivermead Mobility Index scores and a significant improvement in Multiple Sclerosis Quality of Life-54 in the experimental. The analysis of effectiveness revealed that, compared with baseline (T0), the improvement percentage in all clinical scale scores was greater in the experimental group than the control group. Conclusions: Proposed training provides an intensive and functional-oriented rehabilitation that objectively evaluates achieved progress through exercises. Therefore, it can represent a good complementary strategy for hand rehabilitation in MS patients.

scholarly journals Kinematic Parameters for Tracking Patient Progress during Upper Limb Robot-Assisted Rehabilitation: An Observational Study on Subacute Stroke Subjects

2019 ◽  
Vol 2019 ◽  
pp. 1-12
Author(s):  
Michela Goffredo ◽  
Stefano Mazzoleni ◽  
Annalisa Gison ◽  
Francesco Infarinato ◽  
Sanaz Pournajaf ◽  
...  
Keyword(s):  
Upper Limb ◽  
Motor Performance ◽  
Time Course ◽  
Motor Impairment ◽  
Kinematic Parameters ◽  
Kinematic Data ◽  
Subacute Stroke ◽  
Severe Motor ◽  
Severe Motor Impairment ◽  
Point To Point

Background. Upper limb robot-assisted therapy (RT) provides intensive, repetitive, and task-specific treatment, and its efficacy for stroke survivors is well established in literature. Biomechanical data from robotic devices has been widely employed for patient’s assessment, but rarely it has been analysed for tracking patient progress during RT. The goal of this retrospective study is to analyse built-in kinematic data registered by a planar end-effector robot for assessing the time course of motor recovery and patient’s workspace exploration skills. A comparison of subjects having mild and severe motor impairment has been also conducted. For that purpose, kinematic data recorded by a planar end-effector robot have been processed for investigating how motor performance in executing point-to-point trajectories with different directions changes during RT.Methods. Observational retrospective study of 68 subacute stroke patients who conducted 20 daily sessions of upper limb RT with the InMotion 2.0 (Bionik Laboratories, USA): planar point-to-point reaching tasks with an “assist as needed” strategy. The following kinematic parameters (KPs) were computed for each subject and for each point-to-point trajectory executed during RT: movement accuracy, movement speed, number of peak speed, and task completion time. The Wilcoxon signed-rank tests were used with clinical outcomes. the Friedman test and post hoc Conover’s test (Bonferroni’s correction) were applied to KPs. A secondary data analysis has been conducted by comparing patients having different severities of motor impairment. The level of significance was set atpvalue < 0.05.Results. At the RT onset, the movements were less accurate and smoothed, and showed higher times of execution than those executed at the end of treatment. The analysis of the time course of KPs highlighted that RT seems to improve the motor function mainly in the first sessions of treatment: most KPs show significant intersession differences during the first 5/10 sessions. Afterwards, no further significant variations occurred. The ability to perform movements away from the body and from the hemiparetic side remains more challenging. The results obtained from the data stratification show significant differences between subjects with mild and severe motor impairment.Conclusion. Significant improvements in motor performance were registered during the time course of upper limb RT in subacute stroke patients. The outcomes depend on movement direction and motor impairment and pave the way to optimize healthcare resources and to design patient-tailored rehabilitative protocols.

scholarly journals Relationship Between Clinical Measures of Upper Limb Movement Quality and Activity Poststroke

2019 ◽  
Vol 33 (6) ◽  
pp. 432-441 ◽  
Author(s):  
Mindy F. Levin ◽  
Vimonwan Hiengkaew ◽  
Yongchai Nilanont ◽  
Donna Cheung ◽  
David Dai ◽  
...  
Keyword(s):  
Upper Limb ◽  
Controlled Trial ◽  
Motor Impairment ◽  
Limb Movement ◽  
Reach To Grasp ◽  
Cross Sectional ◽  
Movement Quality ◽  
Performance Time ◽  
Multicenter Randomized Controlled Trial ◽  
The Relationship

Background. Understanding the relationship between movement quality (impairment) and performance (activity) in poststroke patients is important for rehabilitation intervention studies. This has led to an interest in kinematic characterization of upper limb motor impairment. Since instrumented motion analysis is not readily clinically available, observational kinematics may be a viable alternative. Objective. To determine if upper limb movement quality during a reach-to-grasp task identified by observation could be used to describe the relationship between motor impairments and the time to perform functional tasks. Methods. Cross-sectional, secondary analysis of baseline data from 141 participants with stroke, age 18 to 85 years, who participated in a multicenter randomized controlled trial. Clinical assessment of movement quality using the Reaching Performance Scale for Stroke (RPSS–Close and Far targets) and of performance (activity) from the Wolf Motor Function Test (WMFT–7 items) was assessed. The degree to which RPSS component scores explained scores on WMFT items was determined by multivariable regression. Results. Clinically significant decreases (>2 seconds) in performance time for some of the more complex WMFT tasks involving prehension were predicted from RPSS–Close and Far target components. Trunk compensatory movements did not predict either increases or decreases in performance time for the WMFT tasks evaluated. Overall, the strength of the regression models was low. Conclusions. In lieu of kinematic analysis, observational clinical movement analysis may be a valid and accessible method to determine relationships between motor impairment, compensations and upper limb function in poststroke patients. Specific relationships are unlikely to generalize to all tasks due to kinematic redundancy and task specificity.

scholarly journals Leap motion controlled video game-based therapy for upper limb rehabilitation in patients with Parkinson’s disease: a feasibility study

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Pilar Fernández-González ◽  
María Carratalá-Tejada ◽  
Esther Monge-Pereira ◽  
Susana Collado-Vázquez ◽  
Patricia Sánchez-Herrera Baeza ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Feasibility Study ◽  
Upper Limb ◽  
Serious Games ◽  
Post Treatment ◽  
Control Group ◽  
Leap Motion ◽  
Affected Side ◽  
Experimental Group

Abstract Background Non-immersive video games are currently being used as technological rehabilitation tools for individuals with Parkinson’s disease (PD). The aim of this feasibility study was to evaluate the effectiveness of the Leap Motion Controller® (LMC) system used with serious games designed for the upper limb (UL), as well as the levels of satisfaction and compliance among patients in mild-to-moderate stages of the disease. Methods A non-probabilistic sampling of non-consecutive cases was performed. 23 PD patients, in stages II-IV of the Hoehn & Yahr scale, were randomized into two groups: an experimental group (n = 12) who received treatment based on serious games designed by the research team using the LMC system for the UL, and a control group (n = 11) who received a specific intervention for the UL. Grip muscle strength, coordination, speed of movements, fine and gross UL dexterity, as well as satisfaction and compliance, were assessed in both groups pre-treatment and post-treatment. Results Within the experimental group, significant improvements were observed in all post-treatment assessments, except for Box and Blocks test for the less affected side. Clinical improvements were observed for all assessments in the control group. Statistical intergroup analysis showed significant improvements in coordination, speed of movements and fine motor dexterity scores on the more affected side of patients in the experimental group. Conclusions The LMC system and the serious games designed may be a feasible rehabilitation tool for the improvement of coordination, speed of movements and fine UL dexterity in PD patients. Further studies are needed to confirm these preliminary findings.

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