scholarly journals Characterization of stroke-related upper limb motor impairments across various upper limb activities by use of kinematic core set measures

2022 ◽  
Vol 19 (1) ◽  
Author(s):  
Anne Schwarz ◽  
Miguel M. C. Bhagubai ◽  
Saskia H. G. Nies ◽  
Jeremia P. O. Held ◽  
Peter H. Veltink ◽  
...  
Keyword(s):  
Upper Limb ◽  
Daily Living ◽  
Healthy Subjects ◽  
Peak Velocity ◽  
Movement Time ◽  
Elbow Flexion ◽  
Wrist Flexion ◽  
Shoulder Flexion ◽  
Flexion Extension

Abstract Background Upper limb kinematic assessments provide quantifiable information on qualitative movement behavior and limitations after stroke. A comprehensive characterization of spatiotemporal kinematics of stroke subjects during upper limb daily living activities is lacking. Herein, kinematic expressions were investigated with respect to different movement types and impairment levels for the entire task as well as for motion subphases. Method Chronic stroke subjects with upper limb movement impairments and healthy subjects performed a set of daily living activities including gesture and grasp movements. Kinematic measures of trunk displacement, shoulder flexion/extension, shoulder abduction/adduction, elbow flexion/extension, forearm pronation/supination, wrist flexion/extension, movement time, hand peak velocity, number of velocity peaks (NVP), and spectral arc length (SPARC) were extracted for the whole movement as well as the subphases of reaching distally and proximally. The effects of the factors gesture versus grasp movements, and the impairment level on the kinematics of the whole task were tested. Similarities considering the metrics expressions and relations were investigated for the subphases of reaching proximally and distally between tasks and subgroups. Results Data of 26 stroke and 5 healthy subjects were included. Gesture and grasp movements were differently expressed across subjects. Gestures were performed with larger shoulder motions besides higher peak velocity. Grasp movements were expressed by larger trunk, forearm, and wrist motions. Trunk displacement, movement time, and NVP increased and shoulder flexion/extension decreased significantly with increased impairment level. Across tasks, phases of reaching distally were comparable in terms of trunk displacement, shoulder motions and peak velocity, while reaching proximally showed comparable expressions in trunk motions. Consistent metric relations during reaching distally were found between shoulder flexion/extension, elbow flexion/extension, peak velocity, and between movement time, NVP, and SPARC. Reaching proximally revealed reproducible correlations between forearm pronation/supination and wrist flexion/extension, movement time and NVP. Conclusion Spatiotemporal differences between gestures versus grasp movements and between different impairment levels were confirmed. The consistencies of metric expressions during movement subphases across tasks can be useful for linking kinematic assessment standards and daily living measures in future research and performing task and study comparisons. Trial registration: ClinicalTrials.gov Identifier NCT03135093. Registered 26 April 2017, https://clinicaltrials.gov/ct2/show/NCT03135093.

scholarly journals Distinction of Students and Expert Therapists Based on Therapeutic Motions on a Robotic Device Using Support Vector Machine

2020 ◽  
Vol 40 (6) ◽  
pp. 790-797
Author(s):  
Koike Yuji ◽  
Suzuki Makoto ◽  
Okino Akihisa ◽  
Takeda Kazuhisa ◽  
Takanami Yasuhiro ◽  
...  
Keyword(s):  
Support Vector Machine ◽  
Exercise Therapy ◽  
Upper Limb ◽  
Peak Velocity ◽  
Movement Time ◽  
Elbow Flexion ◽  
Flexion Angle ◽  
Support Vector ◽  
Robot Arm ◽  
Clinical Practices

Abstract Purpose To clarify the feature values of exercise therapy that can differentiate students and expert therapists and use this information as a reference for exercise therapy education. Methods The participants were therapists with 5 or more years of clinical experience and 4th year students at occupational therapist training schools who had completed their clinical practices. The exercise therapy task included Samothrace (code name, SAMO) exercises implemented on the elbow joint based on the elbow flexion angle, angular velocity, and exercise interval recordings. For analyses and student/therapist comparisons, the peak flexion angle, peak velocity, and movement time were calculated using data on elbow angle changes acquired via SAMO. Subsequently, bootstrap data were generated to differentiate between the exercise therapy techniques adopted by therapists and students, and a support vector machine was used to generate four types of data combinations with the peak flexion angle, peak velocity, and movement time values. These data were used to estimate and compare the respective accuracies with the Friedman test. Results The peak flexion angles were significantly smaller in the case of students. Furthermore, the peak velocities were larger, the peak flexion angles were smaller, and the movement times were shorter compared with those of therapists. The combination of peak velocity and peak flexion angle yielded the highest diagnostic accuracies. Conclusion When students and therapists performed upper limb exercise therapy techniques based on the kinematics movement of a robot arm, the movement speeds and joint angles differed. The combination of peak velocity and peak flexion angle was the most effective classifier used for the differentiation of the abilities of students and therapists. The peak velocity and peak flexion angle of the therapist group can be used as a reference for students when they learn upper limb therapeutic exercise techniques.

scholarly journals Measures of Interjoint Coordination Post-stroke Across Different Upper Limb Movement Tasks

2021 ◽  
Vol 8 ◽  
Author(s):  
Anne Schwarz ◽  
Janne M. Veerbeek ◽  
Jeremia P. O. Held ◽  
Jaap H. Buurke ◽  
Andreas R. Luft
Keyword(s):  
Upper Limb ◽  
Elbow Flexion ◽  
Shoulder Abduction ◽  
Kinematic Parameters ◽  
Limb Function ◽  
Interjoint Coordination ◽  
Upper Limb Function ◽  
Shoulder Flexion ◽  
Flexion Extension ◽  
Median Slope

Background: Deficits in interjoint coordination, such as the inability to move out of synergy, are frequent symptoms in stroke subjects with upper limb impairments that hinder them from regaining normal motor function. Kinematic measurements allow a fine-grained assessment of movement pathologies, thereby complementing clinical scales, like the Fugl–Meyer Motor Assessment of the Upper Extremity (FMMA-UE). The study goal was to investigate the effects of the performed task, the tested arm, the dominant affected hand, upper limb function, and age on spatiotemporal parameters of the elbow, shoulder, and trunk. The construct validity of the metrics was examined by relating them with each other, the FMMA-UE, and its arm section.Methods: This is a cross-sectional observational study including chronic stroke patients with mild to moderate upper limb motor impairment. Kinematic measurements were taken using a wearable sensor suit while performing four movements with both upper limbs: (1) isolated shoulder flexion, (2) pointing, (3) reach-to-grasp a glass, and (4) key insertion. The kinematic parameters included the joint ranges of shoulder abduction/adduction, shoulder flexion/extension, and elbow flexion/extension; trunk displacement; shoulder–elbow correlation coefficient; median slope; and curve efficiency. The effects of the task and tested arm on the metrics were investigated using a mixed-model analysis. The validity of metrics compared to clinically measured interjoint coordination (FMMA-UE) was done by correlation analysis.Results: Twenty-six subjects were included in the analysis. The movement task and tested arm showed significant effects (p < 0.05) on all kinematic parameters. Hand dominance resulted in significant effects on shoulder flexion/extension and curve efficiency. The level of upper limb function showed influences on curve efficiency and the factor age on median slope. Relations with the FMMA-UE revealed the strongest and significant correlation for curve efficiency (r = 0.75), followed by shoulder flexion/extension (r = 0.68), elbow flexion/extension (r = 0.53), and shoulder abduction/adduction (r = 0.49). Curve efficiency additionally correlated significantly with the arm subsection, focusing on synergistic control (r = 0.59).Conclusion: The kinematic parameters of the upper limb after stroke were influenced largely by the task. These results underpin the necessity to assess different relevant functional movements close to real-world conditions rather than relying solely on clinical measures.Study Registration: clinicaltrials.gov, identifier NCT03135093 and BASEC-ID 2016-02075.

ACTIVE EXOSKELETONS FOR UPPER-LIMB MOTION ASSIST

2007 ◽  
Vol 04 (03) ◽  
pp. 607-624 ◽  
Author(s):  
KAZUO KIGUCHI
Keyword(s):  
Upper Limb ◽  
Daily Living ◽  
Elbow Flexion ◽  
Daily Activities ◽  
Current State ◽  
Flexion Extension ◽  
State Of Research ◽  
Real Time Information ◽  
Time Information ◽  
Human Upper Limb

This paper presents the current state of research into power-assist exoskeletons for the upper limb. The assist of the upper limb is important for physically weak persons in daily activities, since upper-limb motion is involved in many important motions in daily living. The most important criterion is that power-assist exoskeletons assist the user's motion automatically in accordance with the user's motion intentions. Electromyogram (EMG) signals in which the user's motion intention is reflected could provide vital real-time information to facilitate accurate control of the power-assist exoskeleton in accordance with the user's motion intentions. A four degree-of-freedom active exoskeleton that assists human upper-limb motion (shoulder vertical flexion/extension, shoulder horizontal flexion/extension, elbow flexion/extension, and forearm supination/pronation) is also proposed.

scholarly journals Wearable upper limb motion assist robot for eating activity

2020 ◽  
Vol 1 (1) ◽  
pp. 1-10
Author(s):  
Uzair Kashtwari ◽  
Norsinnira Zainul Azlan ◽  
Ifrah Shahdad
Keyword(s):  
Upper Limb ◽  
Daily Living ◽  
Degrees Of Freedom ◽  
Low Cost ◽  
Elbow Flexion ◽  
Disabled People ◽  
Flexion Extension ◽  
Feeding Cycle ◽  
The Disabled ◽  
Upper Limb Movements

Many people all around the world are suffering from various types of disabilities and need to depend on others to perform activities of daily living. One of the essential daily living activities is eating. The disabled people should be able to eat their food independently at any time and place, without relying on the caregivers. This paper presents the development of a new wearable upper limb motion assist robot for helping the disabled to eat by themselves. The motion assists robot consists of two degrees of freedom (DOF) movement, focusing on the two most crucial upper limb movements in eating activity, which is the elbow flexion/extension and forearm pronation/supination. A light-weight material was used for the fabrication of the wearable motion assist robot, and Arduino was utilized as the microcontroller. The originality of the study was in terms of the design, operational sequence setting, and kinematic analysis of the wearable upper limb motion assist robot that was explicitly focusing on eating activity. The resulted prototype was portable, compact, light in weight, simple and low cost. The experimental results have proven that the proposed wearable upper limb motion assist robot for eating activity was successful in helping the users to perform the main upper extremity motions in eating. The success rate of the proposed system was 80%, and it took 6 seconds for the system to complete one feeding cycle.

scholarly journals The nature and extent of upper limb associated reactions during walking in people with acquired brain injury

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Michelle B. Kahn ◽  
Ross A. Clark ◽  
Gavin Williams ◽  
Kelly J. Bower ◽  
Megan Banky ◽  
...  
Keyword(s):  
Upper Limb ◽  
Walking Speed ◽  
Outcome Measure ◽  
Acquired Brain Injury ◽  
Elbow Flexion ◽  
Group Differences ◽  
Shoulder Abduction ◽  
Wrist Flexion ◽  
Forearm Rotation ◽  
Shoulder Flexion

Abstract Background Upper limb associated reactions (ARs) are common in people with acquired brain injury (ABI). Despite this, there is no gold-standard outcome measure and no kinematic description of this movement disorder. The aim of this study was to determine the upper limb kinematic variables most frequently affected by ARs in people with ABI compared with a healthy cohort at matched walking speed intention. Methods A convenience sample of 36 healthy control adults (HCs) and 42 people with ABI who had upper limb ARs during walking were recruited and underwent assessment of their self-selected walking speed using the criterion-reference three dimensional motion analysis (3DMA) at Epworth Hospital, Melbourne. Shoulder flexion, abduction and rotation, elbow flexion, forearm rotation and wrist flexion were assessed. The mean angle, standard deviation (SD), peak joint angles and total joint angle range of motion (ROM) were calculated for each axis across the gait cycle. On a group level, ANCOVA was used to assess the between-group differences for each upper limb kinematic outcome variable. To quantify abnormality prevalence on an individual participant level, the percentage of ABI participants that were outside of the 95% confidence interval of the HC sample for each variable were calculated. Results There were significant between-group differences for all elbow and shoulder abduction outcome variables (p < 0.01), most shoulder flexion variables (except for shoulder extension peak), forearm rotation SD and ROM and for wrist flexion ROM. Elbow flexion and shoulder abduction were the axes most frequently affected by ARs. Despite the elbow being the most prevalently affected (38/42, 90%), a large proportion of participants had abnormality, defined as ±1.96 SD of the HC mean, present at the shoulder (32/42, 76%), forearm (20/42, 48%) and wrist joints (10/42, 24%). Conclusion This study provides valuable information on ARs, and highlights the need for clinical assessment of ARs to include all of the major joints of the upper limb. This may inform the development of a criterion-reference outcome measure or classification system specific to ARs.

Functional Reorganization in Chronic Hemiparetic Patients after Training: fMRI Studies

2006 ◽  
Vol 321-323 ◽  
pp. 1016-1021
Author(s):  
Ki Sik Tae ◽  
Sung Jae Song ◽  
So Young Lee ◽  
Gi Young Park ◽  
Chul Ho Sohn ◽  
...  
Keyword(s):  
Training Program ◽  
Upper Limb ◽  
Hand Movement ◽  
Active Movement ◽  
Wrist Flexion ◽  
Motor Tasks ◽  
Neural Basis ◽  
Motor Network ◽  
Flexion Extension ◽  
Before And After

The aim of this study was to evaluate effects of short-term repetitive-bilateral exercise on the activation of motor network using functional magnetic resonance imaging (fMRI). Eight control subjects and four chronic hemiparetic patients were investigated for the present study. The training program with a symmetrical upper-limb motion trainer was performed at 1 hr/day, 5 days/week during 6 weeks. Fugl-Meyer assessments (FMA) were performed every two weeks during the training. We compared cerebral and cerebellar cortical activations in two different tasks before and after the training program: (1) the only unaffected hand movement (Task 1), and (2) passive movements of the affected hand by the active movement of the unaffected hand (Task 2). fMRI was performed at 3T with wrist flexion-extension movement at 1 Hz during the motor tasks. All patients showed significant improvements of FMA scores in their paretic limbs after training. fMRI studies in Task 1 showed that cortical activations decreased in ipsilateral SMC but increased in contralateral sensorimotor cortex (SMC) and ipsilateral cerebellum (CRB). Task 2 showed cortical reorganizations in bilateral SMC, pre-motor area (PMA), supplementary area (SMA) and CRB. This study demonstrated that plastic changes of motor network occurred as a neural basis of the improvement subsequent to repetitive-bilateral exercises using the symmetrical upper-limb motion trainer.

Effects of Upper Limb Muscle Vibration on Human Voluntary Wrist Flexion-Extension Movements

1994 ◽  
Vol 78 (1) ◽  
pp. 43-47 ◽  
Author(s):  
T. Kasai ◽  
M. Kawanishi ◽  
S. Yahagi
Keyword(s):  
Upper Limb ◽  
Limb Muscle ◽  
Wrist Flexion ◽  
Flexor Muscle ◽  
Simultaneous Application ◽  
Eyes Closed ◽  
Wrist Flexor ◽  
Flexion Extension ◽  
Flexor Muscles ◽  
Elbow Extensor

The effect of upper limb muscle tendon vibration during alternating step flexion-extension movements about the wrist was studied in 6 normal humans. A vibrator was mounted over either the wrist flexor muscle or the elbow flexor and extensor muscles. Vibration was applied either to a single muscle or simultaneously to both muscles during wrist flexion-extension movements. After a period of practice, subjects learned the required movements and were able to make them with their eyes closed. Simultaneous application of subthreshold vibration to the wrist flexor and the elbow extensor or flexor muscles during extension movements produced an undershooting of the required end-movement position. The observed results indicated the pattern of transjoint projections from elbow extensor and flexor muscles to motoneurons supplying wrist extensor and flexor muscles. It is also suggested that those transjoint projections play an important role in coordinated movement of wrist and elbow joints.

scholarly journals Development of a System Architecture for Evaluation and Training of Proprioceptive Deficits of the Upper Limb

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Roberto Colombo ◽  
Alessandra Mazzone ◽  
Carmen Delconte ◽  
Fabrizio Pisano
Keyword(s):  
Upper Limb ◽  
System Architecture ◽  
Horizontal Plane ◽  
Position Estimation ◽  
Wrist Flexion ◽  
Estimation Errors ◽  
Reliable Assessment ◽  
Flexion Extension ◽  
Robotic Devices ◽  
And Training

Proprioception plays a fundamental role in maintaining posture and executing movement, and the quantitative evaluation of proprioceptive deficits in poststroke patients is important. But currently it is not widely performed due to the complexity of the evaluation tools required for a reliable assessment. The aims of this pilot study were to (a) develop a system architecture for upper limb evaluation and training of proximal and distal sense of position in the horizontal plane and (b) test the system in healthy and pathological subjects. Two robotic devices for evaluation and training of, respectively, wrist flexion/extension and shoulder-elbow manipulation were employed. The system we developed was applied in a group of 12 healthy subjects and 10 patients after stroke. It was able to quantitatively evaluate upper limb sense of position in the horizontal plane thanks to a set of quantitative parameters assessing position estimation errors, variability, and gain. In addition, it was able to distinguish healthy from pathological conditions. The system could thus be a reliable method to detect changes in the sense of position of patients with sensory deficits after stroke and could enable the implementation of novel training approaches for the recovery of normal proprioception.

scholarly journals Measuring Upper Limb Kinematics of Forehand and Backhand Topspin Drives with IMU Sensors in Wheelchair and Able-Bodied Table Tennis Players

Sensors ◽  
2021 ◽  
Vol 21 (24) ◽  
pp. 8303
Author(s):  
Jia-Wen Yam ◽  
Jing-Wen Pan ◽  
Pui-Wah Kong
Keyword(s):  
Upper Limb ◽  
Wrist Joint ◽  
Elbow Flexion ◽  
Measurement Unit ◽  
Shoulder Abduction ◽  
Table Tennis ◽  
Tennis Players ◽  
Movement Strategies ◽  
Flexion Extension ◽  
Limb Kinematics

To better understand the biomechanics of para-table tennis players, this study compared the shoulder, elbow, and wrist joint kinematics among able-bodied (AB) and wheelchair players in different classifications. Nineteen participants (AB, n = 9; classification 1 (C1), n = 3; C2, n = 3; C3, n = 4) executed 10 forehand and backhand topspin drives. Shoulder abduction/adduction, elbow flexion/extension, wrist extension/flexion, respective range of motion (ROM), and joint patterns were obtained using inertial measurement unit (IMU) sensors. The results showed clear differences in upper limb kinematics between the able-bodied and wheelchair players, especially in the elbow and wrist. For the para-players, noticeable variations in techniques were also observed among the different disability classes. In conclusion, wheelchair players likely adopted distinct movement strategies compared to AB to compensate for their physical impairments and functional limitations. Hence, traditional table tennis programs targeting skills and techniques for able-bodied players are unsuitable for para-players. Future work can investigate how best to customize training programs and to optimize movement strategies for para-players with varied types and degrees of impairment.

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