Need for Speed

DeJong, Stacey L.; Schaefer, Sydney Y.; Lang, Catherine E.

doi:10.1177/1545968311425926

Cited by 37 publications

(16 citation statements)

References 62 publications

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“…Our finding that reaching at a faster speed increased ApEn of the UE joints compared with reaching at preferred speed after stroke is consistent with observations by DeJong et al (2012) in which linear measures of UE kinematics, including movement time, reach trajectories, reach path, and grasp aperture path ratios, increased when individuals with stroke reached at faster speeds. The underlying neurological mechanisms responsible for altering ApEn as a function of increased speed remain unclear.…”

Section: Discussionsupporting

confidence: 90%

“…Based on studies using linear measures, speed and rhythm of movement are two simple movement variables that may improve the temporal structure of variability and adaptability of UE movements (DeJong et al, 2012; Malcolm, Massie, & Thaut, 2009; Thaut, Kenyon, Hurt, McIntosh, & Hoemberg, 2002). For example, reaching at faster than preferred speed has been shown to significantly improve linear measures of UE movements including, reach duration, peak grasp aperture, aperture-path ratio, and reach trajectories (DeJong et al, 2012). Moreover, when moving fast, the performance of individuals poststroke became more similar to healthy controls moving at their preferred speed (DeJong et al, 2012).…”

mentioning

confidence: 99%

“…For example, reaching at faster than preferred speed has been shown to significantly improve linear measures of UE movements including, reach duration, peak grasp aperture, aperture-path ratio, and reach trajectories (DeJong et al, 2012). Moreover, when moving fast, the performance of individuals poststroke became more similar to healthy controls moving at their preferred speed (DeJong et al, 2012). Apart from movement speed, movements produced with rhythmic auditory cuing in individuals with poststroke have been found to increase UE performance on linear measures including shoulder and elbow joint excursions, reduced compensatory trunk displacement, and straighter reaching trajectories compared to movements produced without rhythmic cues in individuals poststroke (Malcolm, Massie, & Thaut, 2009; Thaut, Kenyon, Hurt, McIntosh, & Hoemberg, 2002).…”

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confidence: 99%

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Speed and Rhythm Affect Temporal Structure of Variability in Reaching Poststroke: A Pilot Study

Sethi

Stergiou

Patterson

et al. 2016

Journal of Motor Behavior

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Temporal structure reveals the potential adaptive strategies employed during upper extremity movements. The authors compared the temporal structure of upper extremity joints under 3 different reaching conditions: preferred speed, fast speed, and reaching with rhythmic auditory cues in 10 individuals post-stroke. They also investigated the temporal structure of these 3 reaching conditions in 8 healthy controls to aid in the interpretation of the observed patterns in the poststroke cohort. Approximate entropy (ApEn) was used to measure the temporal structure of the upper extremity joints. ApEn was similar between conditions in controls. After stroke, ApEn was significantly higher for shoulder, elbow, and wrist both at fast speed and with rhythmic cues compared with preferred speed. ApEn at index finger was significantly higher only with rhythmic cues compared with preferred speed. The authors propose that practice reaching at faster speed and with rhythmic cues as a component of rehabilitation interventions may enhance adaptability after stroke. Keywords nonlinear; rhythm; stroke; temporal structure; upper extremity Stroke is the leading cause of adult-onset disability in the United States (American Heart Association, 2016). Up to 85% of individuals with stroke exhibit upper extremity (UE) paresis immediately poststroke (Kwakkel & Kollen, 2007;Kwakkel, Kollen, van der Grond, & Prevo, 2003;Olsen, 1990). Recent advances in our understanding of the principles of neuroplasticity provide motivation for development of interventions enhancing UE function in stroke survivors (Jang et al., 2003;Liepert, Graef, Uhde, Leidner, & Weiller, 2000; Correspondence address: Amit Sethi, Assistant Professor, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, 5019 Forbes Tower, Pittsburgh, PA 15260, USA. asethi@pitt.edu. HHS Public AccessAuthor manuscript J Mot Behav. Author manuscript; available in PMC 2018 January 01. Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript Sawaki et al., 2008;Wolf et al., 2006). Regrettably, despite advanced rehabilitation approaches, residual UE impairments still persist. Current clinical assessment tools do not sensitively quantify the underlying motor impairments, limiting the ability to detect clinically important change in response to rehabilitation interventions. Insights provided by contemporary analyses are needed to better detect motor impairments and develop potentially more targeted and effective rehabilitation interventions after stroke.While clinical and biomechanical (kinematic) assessments of UE movements are typically used to characterize motor impairments, measures that quantify movement variability offer a unique advantage to assess motor adaptability during performance of everyday tasks (Stergiou & Decker, 2011). However, these approaches have received less attention in clinical motor assessment and rehabilitation studies. Variability in reaching movements, which is characterized by the ability to u...

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Section: Discussionsupporting

confidence: 90%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Speed and Rhythm Affect Temporal Structure of Variability in Reaching Poststroke: A Pilot Study

Sethi

Stergiou

Patterson

et al. 2016

Journal of Motor Behavior

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“…When instructed to move quickly, individuals post-stroke generate faster and smoother reaching movements than when instructed to move at preferred speed 51 . Thus, could the decreases in movement time and in number of peaks in our study simply be instruction-dependent, with no actual improvements due to training?…”

Section: Discussionmentioning

confidence: 97%

Short-Duration and Intensive Training Improves Long-Term Reaching Performance in Individuals With Chronic Stroke

Park

Kim

Winstein

et al. 2015

Neurorehabil Neural Repair

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Previous studies have shown that multiple sessions of reach training lead to long-term improvements in movement time and smoothness in individuals post-stroke. Yet, such long-term training regimens are often difficult to implement in actual clinical settings. Here, we evaluated the long-term and generalization effects of short-duration and intensive reach training in 16 individuals with chronic stroke and mild to moderate impairments. Participants performed two sessions of unassisted intensive reach training, with 600 movements per session, and with display of performance-based feedback after each movement. The participants’ trunks were restrained with a belt to avoid compensatory movements. Training resulted in significant and durable (1-month) improvements in movement time (20.4% on average) and movement smoothness (22.7% on average). The largest improvements occurred in individuals with the largest initial motor impairments. In addition, training induced generalization to non-trained targets, which persisted in 1-day and in 1-month retention tests. Finally, there was a significant improvement in the Box and Block test from baseline to 1-month retention test (23% on average). Thus, short-duration and intensive reach training can lead to generalized and durable benefits in individuals with chronic stroke and mild to moderate impairments.

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“…The initial position of the hand was on the table edge with elbow flexed at 90°. The participant was asked to use the index finger of the affected arm to press the bell as quickly as possible [ 41 ].…”

Section: Methodsmentioning

confidence: 99%

Sequencing bilateral robot-assisted arm therapy and constraint-induced therapy improves reach to press and trunk kinematics in patients with stroke

Hsieh

Liing

Lin

et al. 2016

J NeuroEngineering Rehabil

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BackgroundThe combination of robot-assisted therapy (RT) and a modified form of constraint-induced therapy (mCIT) shows promise for improving motor function of patients with stroke. However, whether the changes of motor control strategies are concomitant with the improvements in motor function after combination of RT and mCIT (RT + mCIT) is unclear. This study investigated the effects of the sequential combination of RT + mCIT compared with RT alone on the strategies of motor control measured by kinematic analysis and on motor function and daily performance measured by clinical scales.MethodsThe study enrolled 34 patients with chronic stroke. The data were derived from part of a single-blinded randomized controlled trial. Participants in the RT + mCIT and RT groups received 20 therapy sessions (90 to 105 min/day, 5 days for 4 weeks). Patients in the RT + mCIT group received 10 RT sessions for first 2 weeks and 10 mCIT sessions for the next 2 weeks. The Bi-Manu-Track was used in RT sessions to provide bilateral practice of wrist and forearm movements. The primary outcome was kinematic variables in a task of reaching to press a desk bell. Secondary outcomes included scores on the Wolf Motor Function Test, Functional Independence Measure, and Nottingham Extended Activities of Daily Living. All outcome measures were administered before and after intervention.ResultsRT + mCIT and RT demonstrated different benefits on motor control strategies. RT + mCIT uniquely improved motor control strategies by reducing shoulder abduction, increasing elbow extension, and decreasing trunk compensatory movement during the reaching task. Motor function and quality of the affected limb was improved, and patients achieved greater independence in instrumental activities of daily living. Force generation at movement initiation was improved in the patients who received RT.ConclusionA combination of RT and mCIT could be an effective approach to improve stroke rehabilitation outcomes, achieving better motor control strategies, motor function, and functional independence of instrumental activities of daily living.Trial registrationClinicalTrials.gov. NCT01727648

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Need for Speed

Cited by 37 publications

References 62 publications

Speed and Rhythm Affect Temporal Structure of Variability in Reaching Poststroke: A Pilot Study

Speed and Rhythm Affect Temporal Structure of Variability in Reaching Poststroke: A Pilot Study

Short-Duration and Intensive Training Improves Long-Term Reaching Performance in Individuals With Chronic Stroke

Sequencing bilateral robot-assisted arm therapy and constraint-induced therapy improves reach to press and trunk kinematics in patients with stroke

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