scholarly journals The Probability of Choosing Both Hands Depends on an Interaction Between Motor Capacity and Limb-Specific Control in Chronic Stroke

2020 ◽  
Author(s):  
Rini Varghese ◽  
Jason J Kutch ◽  
Nicolas Schweighofer ◽  
Carolee J Winstein
Keyword(s):  
Primary Outcome ◽  
Motor Impairment ◽  
Chronic Stroke ◽  
Task Demands ◽  
Functional Activities ◽  
Photo Album ◽  
Severe Motor ◽  
Severe Motor Impairment ◽  
Specific Control ◽  
Bimanual Tasks

A goal of rehabilitation after stroke is to promote pre-stroke levels of arm use for everyday, frequently bimanual, functional activities. We reasoned that, after a stroke, the choice to use one or both hands for bimanual tasks might depend not only on residual motor capacity but also the specialized demands imposed by the task on the paretic hand. To capture spontaneous, task-specific choices, we covertly observed 50 pre-stroke right-handed chronic stroke survivors (25 left hemisphere damage, LHD) and recorded their hand use strategies for two pairs of bimanual tasks with distinct demands: one with greater precision requirements (photo-album tasks), and another with greater stabilization requirements (letter-envelope tasks). The primary outcome was the choice to use one or both hands. Logistic regression was used to test the hypothesis that the probability of choosing a bimanual strategy would be greater in those with less severe motor impairment and those with LHD. When collapsed across the four subtasks, we found support for this hypothesis. However, notably, the influence of these factors on bimanual choice varied based on task demands. For the photo-album task, the probability of a bimanual strategy was greater for those with LHD compared to RHD, regardless of the degree of motor impairment. For the letter-envelope task, we found a significant interaction between impairment and side of lesion in determining the likelihood of choosing both hands. Therefore, the manner in which side of lesion moderates the effect of impairment on hand use depends on the task.

scholarly journals Combined Brain and Peripheral Nerve Stimulation in Chronic Stroke Patients With Moderate to Severe Motor Impairment

2017 ◽  
Vol 21 (2) ◽  
pp. 176-183 ◽  
Author(s):  
Isabella S. Menezes ◽  
Leonardo G. Cohen ◽  
Eduardo A. Mello ◽  
André G. Machado ◽  
Paul Hunter Peckham ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Motor Impairment ◽  
Chronic Stroke ◽  
Peripheral Nerve Stimulation ◽  
Stroke Patients ◽  
Severe Motor ◽  
Severe Motor Impairment

Implementation of an SSVEP-based intelligent home service robot system

2020 ◽  
pp. 1-16
Author(s):  
Yuxin Zhang ◽  
Qiang Gao ◽  
Yu Song ◽  
Zhe Wang
Keyword(s):  
Brain Activity ◽  
Neuromuscular Disorders ◽  
Motor Impairment ◽  
Service Robot ◽  
Task Completion ◽  
Home Service Robot ◽  
Home Service ◽  
Severe Motor ◽  
Severe Motor Impairment ◽  
The Subject

BACKGROUND: People with severe neuromuscular disorders caused by an accident or congenital disease cannot normally interact with the physical environment. The intelligent robot technology offers the possibility to solve this problem. However, the robot can hardly carry out the task without understanding the subject’s intention as it relays on speech or gestures. Brain-computer interface (BCI), a communication system that operates external devices by directly converting brain activity into digital signals, provides a solution for this. OBJECTIVE: In this study, a noninvasive BCI-based humanoid robotic system was designed and implemented for home service. METHODS: A humanoid robot that is equipped with multi-sensors navigates to the object placement area under the guidance of a specific symbol “Naomark”, which has a unique ID, and then sends the information of the scanned object back to the user interface. Based on this information, the subject gives commands to the robot to grab the wanted object and give it to the subject. To identify the subject’s intention, the channel projection-based canonical correlation analysis (CP-CCA) method was utilized for the steady state visual evoked potential-based BCI system. RESULTS: The offline results showed that the average classification accuracy of all subjects reached 90%, and the online task completion rate was over 95%. CONCLUSION: Users can complete the grab task with minimum commands, avoiding the control burden caused by complex commands. This would provide a useful assistance means for people with severe motor impairment in their daily life.

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 Movement Kinematics of the Ipsilesional Upper Extremity in Persons With Moderate or Mild Stroke

2017 ◽  
Vol 31 (4) ◽  
pp. 376-386 ◽  
Author(s):  
Eva-Lena Bustrén ◽  
Katharina Stibrant Sunnerhagen ◽  
Margit Alt Murphy
Keyword(s):  
Upper Extremity ◽  
Movement Time ◽  
Motor Impairment ◽  
Stroke Severity ◽  
Movement Kinematics ◽  
Movement Performance ◽  
Severe Motor ◽  
Daily Task ◽  
Severe Motor Impairment ◽  
Mild Stroke

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.

scholarly journals Development of Smart Wheelchair System for a User with Severe Motor Impairment

2012 ◽  
Vol 41 ◽  
pp. 538-546 ◽  
Author(s):  
Mohd Razali Md Tomari ◽  
Yoshinori Kobayashi ◽  
Yoshinori Kuno
Keyword(s):  
Motor Impairment ◽  
Severe Motor ◽  
Severe Motor Impairment ◽  
Smart Wheelchair

scholarly journals Motoric impairment versus iron deposition gradient in the subthalamic nucleus in Parkinson’s disease

2020 ◽  
pp. 1-7
Author(s):  
Weiyuan Huang ◽  
Richard Ogbuji ◽  
Liangdong Zhou ◽  
Lingfei Guo ◽  
Yi Wang ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Subthalamic Nucleus ◽  
Rating Scale ◽  
Statistical Tests ◽  
Motor Impairment ◽  
Iron Deposition ◽  
Severe Motor ◽  
Severe Motor Impairment ◽  
The Right

OBJECTIVEThe objective of this study was to investigate the correlation between the quantitative susceptibility mapping (QSM) signal gradient of the subthalamic nucleus (STN) and motor impairment in patients with Parkinson’s disease (PD).METHODSAll PD patients who had undergone QSM MRI for presurgical deep brain stimulation (DBS) planning were eligible for inclusion in this study. The entire STN and its three functional subdivisions, as well as the adjacent white matter (WM), were segmented and measured. The QSM value difference between the entire STN and adjacent WM (STN-WM), between the limbic and associative regions of the STN (L-A), and between the associative and motor regions of the STN (A-M) were obtained as measures of gradient and were input into an unsupervised k-means clustering algorithm to automatically categorize the overall boundary distinctness between the STN and adjacent WM and between STN subdivisions (gradient blur [GB] and gradient sharp [GS] groups). Statistical tests were performed to compare clinical and image measurements for discrimination between GB and GS groups.RESULTSOf the 39 study patients, 19 were categorized into the GB group and 20 into the GS group, based on quantitative cluster analysis. The GB group had a significantly higher presurgical off-medication Unified Parkinson’s Disease Rating Scale Part III score (51.289 ± 20.741) than the GS group (38.5 ± 16.028; p = 0.037). The GB group had significantly higher QSM values for the STN and its three subdivisions and adjacent WM than those for the GS group (p < 0.01). The GB group also demonstrated a significantly higher STN-WM gradient in the right STN (p = 0.01). The GB group demonstrated a significantly lower L-A gradient in both the left and the right STN (p < 0.02).CONCLUSIONSAdvancing PD with more severe motor impairment leads to more iron deposition in the STN and adjacent WM, as shown in the QSM signal. Loss of the STN inner QSM signal gradient should be considered as an image marker for more severe motor impairment in PD patients.

A Case Study of Successful Self-Catheterization in an Adolescent with Spina Bifida, Mental Retardation, and Severe Motor Impairment

Spina Bifida ◽  
1999 ◽  
pp. 407-412
Author(s):  
Eri Shinoki ◽  
Taiko Hirose ◽  
Kiyomi Yoshimura ◽  
Akemi Hamamatsu ◽  
Chizuko Horio ◽  
...  
Keyword(s):  
Mental Retardation ◽  
Spina Bifida ◽  
Motor Impairment ◽  
Severe Motor ◽  
Severe Motor Impairment
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