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Multi-finger coordination in healthy subjects and stroke patients: a mathematical modelling approach.

Carpinella I, Jonsdottir J, Ferrarin M - J Neuroeng Rehabil (2011)

Bottom Line: Test-retest reliability was found to be excellent, with ICC > 0.75 and remarking errors comparable to those obtained with other methods.Comparison with healthy controls revealed that hemiparetic hand movement was impaired not only in joints ROM but also in the temporal aspects of motion: peak velocities were significantly decreased, inter-digit coordination was reduced of more than 50% and inter-joint coordination patterns were highly disrupted.In particular, the stereotypical proximal-to-distal opening sequence (reversed during hand closing) found in healthy subjects, was altered in stroke subjects who showed abnormally high delay between IPJ and MCPJ movement or reversed moving sequences.

View Article: PubMed Central - HTML - PubMed

Affiliation: Biomedical Technology Department, Found, Don C, Gnocchi Onlus, IRCCS, Milan, Italy. icarpinella@dongnocchi.it

ABSTRACT

Background: Approximately 60% of stroke survivors experience hand dysfunction limiting execution of daily activities. Several methods have been proposed to objectively quantify fingers' joints range of motion (ROM), while few studies exist about multi-finger coordination during hand movements. The present work analysed this aspect, by providing a complete characterization of spatial and temporal aspects of hand movement, through the mathematical modelling of multi-joint finger motion in healthy subjects and stroke patients.

Methods: Hand opening and closing movements were examined in 12 healthy volunteers and 14 hemiplegic stroke survivors by means of optoelectronic kinematic analysis. The flexion/extension angles of metacarpophalangeal (MCPJ) and proximal interphalangeal joints (IPJ) of all fingers were computed and mathematically characterized by a four-parameter hyperbolic tangent function. Accuracy of the selected model was analysed by means of coefficient of determination (R2) and root mean square error (RMSE). Test-retest reliability was quantified by intraclass correlation coefficient (ICC) and test-retest errors. Comparison between performances of healthy controls and stroke subjects were performed by analysing possible differences in parameters describing angular and temporal aspects of hand kinematics and inter-joint, inter-digit coordination.

Results: The angular profiles of hand opening and closing were accurately characterized by the selected model, both in healthy controls and in stroke subjects (R2 > 0.973, RMSE < 2.0°). Test-retest reliability was found to be excellent, with ICC > 0.75 and remarking errors comparable to those obtained with other methods. Comparison with healthy controls revealed that hemiparetic hand movement was impaired not only in joints ROM but also in the temporal aspects of motion: peak velocities were significantly decreased, inter-digit coordination was reduced of more than 50% and inter-joint coordination patterns were highly disrupted. In particular, the stereotypical proximal-to-distal opening sequence (reversed during hand closing) found in healthy subjects, was altered in stroke subjects who showed abnormally high delay between IPJ and MCPJ movement or reversed moving sequences.

Conclusions: The proposed method has proven to be a promising tool for a complete objective characterization of spatial and temporal aspects of hand movement in stroke, providing further information for a more targeted planning of the rehabilitation treatment to each specific patient and for a quantitative assessment of therapy's outcome.

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Experimental set-up. Example of a subject performing hand opening/closing task.
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Figure 1: Experimental set-up. Example of a subject performing hand opening/closing task.

Mentions: Subjects were asked to sit upright in a chair behind a table. The forearm was maintained semi-prone on the table, the elbow was flexed of about 120° while the wrist was kept in a neutral position (see Figure 1). Healthy subjects were required to maintain the hand relaxed for 2-3 seconds, open the hand at self-selected speed, rest with the hand maximally opened for 2 seconds, close the hand at self-selected speed and rest with the hand maximally closed for 2 seconds. The sequence was repeated 5 times. Both hands were tested (Nco = 24). Subjects with stroke performed, with the paretic hand (Nst = 14), the same task but with a resting period of at least 10 seconds between two sequences of hand opening/closing, in order to reduce the effect of fatigue and to minimize the onset of co-contractions [23].


Multi-finger coordination in healthy subjects and stroke patients: a mathematical modelling approach.

Carpinella I, Jonsdottir J, Ferrarin M - J Neuroeng Rehabil (2011)

Experimental set-up. Example of a subject performing hand opening/closing task.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3113947&req=5

Figure 1: Experimental set-up. Example of a subject performing hand opening/closing task.
Mentions: Subjects were asked to sit upright in a chair behind a table. The forearm was maintained semi-prone on the table, the elbow was flexed of about 120° while the wrist was kept in a neutral position (see Figure 1). Healthy subjects were required to maintain the hand relaxed for 2-3 seconds, open the hand at self-selected speed, rest with the hand maximally opened for 2 seconds, close the hand at self-selected speed and rest with the hand maximally closed for 2 seconds. The sequence was repeated 5 times. Both hands were tested (Nco = 24). Subjects with stroke performed, with the paretic hand (Nst = 14), the same task but with a resting period of at least 10 seconds between two sequences of hand opening/closing, in order to reduce the effect of fatigue and to minimize the onset of co-contractions [23].

Bottom Line: Test-retest reliability was found to be excellent, with ICC > 0.75 and remarking errors comparable to those obtained with other methods.Comparison with healthy controls revealed that hemiparetic hand movement was impaired not only in joints ROM but also in the temporal aspects of motion: peak velocities were significantly decreased, inter-digit coordination was reduced of more than 50% and inter-joint coordination patterns were highly disrupted.In particular, the stereotypical proximal-to-distal opening sequence (reversed during hand closing) found in healthy subjects, was altered in stroke subjects who showed abnormally high delay between IPJ and MCPJ movement or reversed moving sequences.

View Article: PubMed Central - HTML - PubMed

Affiliation: Biomedical Technology Department, Found, Don C, Gnocchi Onlus, IRCCS, Milan, Italy. icarpinella@dongnocchi.it

ABSTRACT

Background: Approximately 60% of stroke survivors experience hand dysfunction limiting execution of daily activities. Several methods have been proposed to objectively quantify fingers' joints range of motion (ROM), while few studies exist about multi-finger coordination during hand movements. The present work analysed this aspect, by providing a complete characterization of spatial and temporal aspects of hand movement, through the mathematical modelling of multi-joint finger motion in healthy subjects and stroke patients.

Methods: Hand opening and closing movements were examined in 12 healthy volunteers and 14 hemiplegic stroke survivors by means of optoelectronic kinematic analysis. The flexion/extension angles of metacarpophalangeal (MCPJ) and proximal interphalangeal joints (IPJ) of all fingers were computed and mathematically characterized by a four-parameter hyperbolic tangent function. Accuracy of the selected model was analysed by means of coefficient of determination (R2) and root mean square error (RMSE). Test-retest reliability was quantified by intraclass correlation coefficient (ICC) and test-retest errors. Comparison between performances of healthy controls and stroke subjects were performed by analysing possible differences in parameters describing angular and temporal aspects of hand kinematics and inter-joint, inter-digit coordination.

Results: The angular profiles of hand opening and closing were accurately characterized by the selected model, both in healthy controls and in stroke subjects (R2 > 0.973, RMSE < 2.0°). Test-retest reliability was found to be excellent, with ICC > 0.75 and remarking errors comparable to those obtained with other methods. Comparison with healthy controls revealed that hemiparetic hand movement was impaired not only in joints ROM but also in the temporal aspects of motion: peak velocities were significantly decreased, inter-digit coordination was reduced of more than 50% and inter-joint coordination patterns were highly disrupted. In particular, the stereotypical proximal-to-distal opening sequence (reversed during hand closing) found in healthy subjects, was altered in stroke subjects who showed abnormally high delay between IPJ and MCPJ movement or reversed moving sequences.

Conclusions: The proposed method has proven to be a promising tool for a complete objective characterization of spatial and temporal aspects of hand movement in stroke, providing further information for a more targeted planning of the rehabilitation treatment to each specific patient and for a quantitative assessment of therapy's outcome.

Show MeSH
Related in: MedlinePlus