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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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Marker placement, hand local reference system and finger joint angles. Markers position. Mi: head of the metacarpal bone of finger i (i = 1-5); Pi: head of proximal phalanx of finger i (i = 1-5); Di: head of distal phalanx of the thumb (i = 1) and head of middle phalanx of long fingers (i = 2-5); SU: styloid process of ulna; SR: styloid process of radius. Local reference system XYZ. The origin is in correspondence of the marker M2. Vectors (M2-M5) and (M2 - SR) define the metacarpal plane of the hand (grey triangle). Z-axis is normal to the metacarpal plane pointing palmarly, Y-axis has the direction of vector (M2 - SR) pointing distally, while X-axis is calculated as the cross-product of Y and Z-axis, pointing radially. Joint angles in transverse plane YZ (a) and in sagittal plane XY (b) of the hand. MCPJi: metacarpophalangeal joint flexion angle of finger i (i = 1-5); IPJi: proximal interphalangeal joint flexion angle of finger i (i = 1-5); TAB: thumb abduction angle. MCPJi (i = 2-5) is defined as the angle between Y-axis and the projection of the vector (Pi - Mi) on the YZ plane; IPJi (i = 2-5) is the angle between the projections of vectors (Di-Pi) and (Pi-Mi) on the YZ plane. TAB is the angle between the vector (P1 - M1) and the XY plane. MCPJ1 is the angle between X-axis and the projection of vector (P1 - M1) on the XY plane. IPJ1 is the angle between vectors (D1 - P1) and (P1 - M1).
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Figure 2: Marker placement, hand local reference system and finger joint angles. Markers position. Mi: head of the metacarpal bone of finger i (i = 1-5); Pi: head of proximal phalanx of finger i (i = 1-5); Di: head of distal phalanx of the thumb (i = 1) and head of middle phalanx of long fingers (i = 2-5); SU: styloid process of ulna; SR: styloid process of radius. Local reference system XYZ. The origin is in correspondence of the marker M2. Vectors (M2-M5) and (M2 - SR) define the metacarpal plane of the hand (grey triangle). Z-axis is normal to the metacarpal plane pointing palmarly, Y-axis has the direction of vector (M2 - SR) pointing distally, while X-axis is calculated as the cross-product of Y and Z-axis, pointing radially. Joint angles in transverse plane YZ (a) and in sagittal plane XY (b) of the hand. MCPJi: metacarpophalangeal joint flexion angle of finger i (i = 1-5); IPJi: proximal interphalangeal joint flexion angle of finger i (i = 1-5); TAB: thumb abduction angle. MCPJi (i = 2-5) is defined as the angle between Y-axis and the projection of the vector (Pi - Mi) on the YZ plane; IPJi (i = 2-5) is the angle between the projections of vectors (Di-Pi) and (Pi-Mi) on the YZ plane. TAB is the angle between the vector (P1 - M1) and the XY plane. MCPJ1 is the angle between X-axis and the projection of vector (P1 - M1) on the XY plane. IPJ1 is the angle between vectors (D1 - P1) and (P1 - M1).

Mentions: Hand kinematics were recorded by an optoelectronic motion analysis system (Smart, EMotion, Italy) consisting of nine infrared video cameras (sampling rate = 60 Hz). The working volume (70 × 70 × 70 cm3) was calibrated to provide an accuracy of less than 0.3 mm. Seventeen retro-reflective hemispheric markers, with diameter of 6 mm were attached to the hand of the subjects, according to the protocol described in Carpinella et al.[11], on the bony landmarks shown in Figure 2. After the acquisition, marker coordinates were low-pass filtered using a 5th order, zero-lag, Butterworth digital filter, with a cut-off frequency of 6 Hz.


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

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

Marker placement, hand local reference system and finger joint angles. Markers position. Mi: head of the metacarpal bone of finger i (i = 1-5); Pi: head of proximal phalanx of finger i (i = 1-5); Di: head of distal phalanx of the thumb (i = 1) and head of middle phalanx of long fingers (i = 2-5); SU: styloid process of ulna; SR: styloid process of radius. Local reference system XYZ. The origin is in correspondence of the marker M2. Vectors (M2-M5) and (M2 - SR) define the metacarpal plane of the hand (grey triangle). Z-axis is normal to the metacarpal plane pointing palmarly, Y-axis has the direction of vector (M2 - SR) pointing distally, while X-axis is calculated as the cross-product of Y and Z-axis, pointing radially. Joint angles in transverse plane YZ (a) and in sagittal plane XY (b) of the hand. MCPJi: metacarpophalangeal joint flexion angle of finger i (i = 1-5); IPJi: proximal interphalangeal joint flexion angle of finger i (i = 1-5); TAB: thumb abduction angle. MCPJi (i = 2-5) is defined as the angle between Y-axis and the projection of the vector (Pi - Mi) on the YZ plane; IPJi (i = 2-5) is the angle between the projections of vectors (Di-Pi) and (Pi-Mi) on the YZ plane. TAB is the angle between the vector (P1 - M1) and the XY plane. MCPJ1 is the angle between X-axis and the projection of vector (P1 - M1) on the XY plane. IPJ1 is the angle between vectors (D1 - P1) and (P1 - M1).
© Copyright Policy - open-access
Related In: Results  -  Collection

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Figure 2: Marker placement, hand local reference system and finger joint angles. Markers position. Mi: head of the metacarpal bone of finger i (i = 1-5); Pi: head of proximal phalanx of finger i (i = 1-5); Di: head of distal phalanx of the thumb (i = 1) and head of middle phalanx of long fingers (i = 2-5); SU: styloid process of ulna; SR: styloid process of radius. Local reference system XYZ. The origin is in correspondence of the marker M2. Vectors (M2-M5) and (M2 - SR) define the metacarpal plane of the hand (grey triangle). Z-axis is normal to the metacarpal plane pointing palmarly, Y-axis has the direction of vector (M2 - SR) pointing distally, while X-axis is calculated as the cross-product of Y and Z-axis, pointing radially. Joint angles in transverse plane YZ (a) and in sagittal plane XY (b) of the hand. MCPJi: metacarpophalangeal joint flexion angle of finger i (i = 1-5); IPJi: proximal interphalangeal joint flexion angle of finger i (i = 1-5); TAB: thumb abduction angle. MCPJi (i = 2-5) is defined as the angle between Y-axis and the projection of the vector (Pi - Mi) on the YZ plane; IPJi (i = 2-5) is the angle between the projections of vectors (Di-Pi) and (Pi-Mi) on the YZ plane. TAB is the angle between the vector (P1 - M1) and the XY plane. MCPJ1 is the angle between X-axis and the projection of vector (P1 - M1) on the XY plane. IPJ1 is the angle between vectors (D1 - P1) and (P1 - M1).
Mentions: Hand kinematics were recorded by an optoelectronic motion analysis system (Smart, EMotion, Italy) consisting of nine infrared video cameras (sampling rate = 60 Hz). The working volume (70 × 70 × 70 cm3) was calibrated to provide an accuracy of less than 0.3 mm. Seventeen retro-reflective hemispheric markers, with diameter of 6 mm were attached to the hand of the subjects, according to the protocol described in Carpinella et al.[11], on the bony landmarks shown in Figure 2. After the acquisition, marker coordinates were low-pass filtered using a 5th order, zero-lag, Butterworth digital filter, with a cut-off frequency of 6 Hz.

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