Impaired motor control

Lang, Catherine E.

doi:10.1016/b978-0-323-02948-3.00024-9

Cited by 5 publications

(7 citation statements)

References 117 publications

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“…7,8,22 Most functional upperlimb tasks require four essential movement components: reaching for, grasping, moving/manipulating, and then releasing an object. 23 What varies across the repertoire of daily upper-limb tasks is how the combinations of the components are strung together and the specifics of the component (eg, direction of reach, type of grasp, and manipulative forces required). This intervention provided progressive training of combinations of these essential components through repeated practice of various tasks, with the desired goal of building the participant's capacity to perform a multitude of upper-limb functions.…”

Section: Dose Groups and The Interventionmentioning

confidence: 99%

Dose response of task‐specific upper limb training in people at least 6 months poststroke: A phase II, single‐blind, randomized, controlled trial

Lang

Strube²,

Bland

et al. 2016

Annals of Neurology

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Objective 1) Determine if higher doses of motor therapy in chronic post-stroke hemiparesis result in better outcomes compared to lower doses, and 2) Evaluate potential modifiers of the dose-response relationship. Methods Eighty-five adults with UE paresis ≥ 6 months after stroke were randomized to one of four dose groups in this single-blind, parallel, RCT. The dosing parameter manipulated was amount of task-specific training, as indexed by the number of task repetitions. Groups received 3200, 6400, 9600, or Individualized Maximum (IM) repetitions, during 1 hr sessions, 4 days/week for 8 weeks. The intervention was an individualized, progressive task-specific upper limb training program designed to improve upper limb functional motor capacity. The primary outcome was the slope of the Action Research Arm Test (ARAT) during the intervention. Effects of dose and potential modifiers of the dose-response relationship were evaluated with hierarchical linear models. Results ARAT scores for the 3200, 9600, and IM groups improved over time as indicated by slopes (ΔARAT/wk, mean ± SEs) of 0.40 ± 0.15, 0.31 ± 0.16, and 0.66 ± 0.14, respectively (p < 0.05). The slope of the 6400 group was smaller (−0.05 ± 0.15) and significantly different from the 3200 and IM groups (p < 0.001). Initial motor capacity, neglect, and other tested characteristics did not modify the dose-response relationship. Interpretation Overall, treatment effects were small. There was no evidence of a dose-response effect of task-specific training on functional capacity in people with long-standing upper limb paresis post stroke.

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Section: Dose Groups and The Interventionmentioning

confidence: 99%

Dose response of task‐specific upper limb training in people at least 6 months poststroke: A phase II, single‐blind, randomized, controlled trial

Lang

Strube²,

Bland

et al. 2016

Annals of Neurology

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196

208

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“…Movements that may be viewed as relatively invariant, such as reaching, are actually highly variable across the day, as people reach for many different objects, in many locations, for many purposes. The second reason is that humans perform an enormous number of movements and actions throughout the day with their upper-limbs (Lang, 2012). Therefore, even if waveform recognition or machine-learning approaches could accurately identify 10-20 movements, it is unlikely that they could identify and categorise all movements (i.e., all data points in the recordings).…”

Section: Turning the Accelerometer Signal Into Clinically Meaningful mentioning

confidence: 99%

“…The impact of epoch selection (1-second versus 15-seconds versus 60-seconds) on duration of upper-limb use is demonstrated in Table 2. Current reports in the literature of accelerometry for the upper-limb chunk data into 1-second or 15-second (Rand & Eng, 2010, 2012 epochs. We have included 60-seconds for demonstration purposes.…”

Section: Selecting the Length Of The Epochmentioning

confidence: 99%

“…Relevant papers were those that included a cohort of stroke survivors at any stage of recovery who had their upper-limb real-world arm use measured by an accelerometer. This paper discusses the commercially available Actigraph (Actigraph, Pensacola FL, Figure 1A) and Actical (Mini Mitter Co, Bend OR, Figure 1B) units as they are the most routinely cited in upper-limb stroke literature (Bailey, Klaesner, & Lang, 2014;Lang, Wagner, Edwards, & Dromerick, 2007;Rand & Eng, 2010, 2012Urbin, Hong, Lang, & Carter, 2014;Urbin, Waddell, & Lang, 2015). While we anticipate that the commercially available options for accelerometers will expand rapidly; we note that technology will advance but the underlying concepts of accelerometry will likely remain the same.…”

Section: Introductionmentioning

confidence: 99%

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Exploring the Role of Accelerometers in the Measurement of Real World Upper-Limb Use After Stroke

et al. 2015

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The ultimate goal of upper-limb rehabilitation after stroke is to promote real-world use, that is, use of the paretic upper-limb in everyday activities outside the clinic or laboratory. Although real-world use can be collected through self-report questionnaires, an objective indicator is preferred. Accelerometers are a promising tool. The current paper aims to explore the feasibility of accelerometers to measure upper-limb use after stroke and discuss the translation of this measurement tool into clinical practice. Accelerometers are non-invasive, wearable sensors that measure movement in arbitrary units called activity counts. Research to date indicates that activity counts are a reliable and valid index of upper-limb use. While most accelerometers are unable to distinguish between the type and quality of movements performed, recent advancements have used accelerometry data to produce clinically meaningful information for clinicians, patients, family and care givers. Despite this, widespread uptake in research and clinical environments remains limited. If uptake was enhanced, we could build a deeper understanding of how people with stroke use their arm in real-world environments. In order to facilitate greater uptake, however, there is a need for greater consistency in protocol development, accelerometer application and data interpretation.

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“…Alternatively, one might reach to lift or hold a delicate glass. Both cases involve essential movement components of the upper extremity: reaching for, grasping, and moving/manipulating an object (Lang, 2011), but with different grip types and task goals. Successful task performance, therefore, relies on the ability to move in a task-specific manner.…”

Section: Introductionmentioning

confidence: 99%

Grip Type and Task Goal Modify Reach-to-Grasp Performance in Post-Stroke Hemiparesis

Schaefer¹,

DeJong²,

Cherry³

et al. 2012

Motor Control

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This study investigated whether grip type and/or task goal influenced reaching and grasping performance in post-stroke hemiparesis. Sixteen adults with post-stroke hemiparesis and twelve healthy adults reached to and grasped a cylindrical object using one of two grip types (3-finger or palmar) to achieve one of two task goals (hold or lift). Performance of the stroke group was characteristic of hemiparetic limb movement during reach-to-grasp, with more curved handpaths and slower velocities compared to the control group. These effects were present regardless of grip type or task goal. Other measures of reaching (reach time and reach velocity at object contact) and grasping (peak thumb-index finger aperture during the reach and peak grip force during the grasp) were differentially affected by grip type, task goal, or both, despite the presence of hemiparesis, providing new evidence that changes in motor patterns after stroke may occur to compensate for stroke-related motor impairment.

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Impaired motor control

Cited by 5 publications

References 117 publications

Dose response of task‐specific upper limb training in people at least 6 months poststroke: A phase II, single‐blind, randomized, controlled trial

Dose response of task‐specific upper limb training in people at least 6 months poststroke: A phase II, single‐blind, randomized, controlled trial

Exploring the Role of Accelerometers in the Measurement of Real World Upper-Limb Use After Stroke

Grip Type and Task Goal Modify Reach-to-Grasp Performance in Post-Stroke Hemiparesis

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