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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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Related in: MedlinePlus

Examples of measured and estimated angles during hand opening. Thumb abduction angles (TAB) of two unimpaired individuals (a, b) and proximal interphalangeal joint angles (IPJ2 and IPJ3) of two stroke subjects (c, d) during movements of hand opening. Coefficient of determination (R2) and root mean square error (RMSE) are reported.
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Figure 4: Examples of measured and estimated angles during hand opening. Thumb abduction angles (TAB) of two unimpaired individuals (a, b) and proximal interphalangeal joint angles (IPJ2 and IPJ3) of two stroke subjects (c, d) during movements of hand opening. Coefficient of determination (R2) and root mean square error (RMSE) are reported.

Mentions: Analysis of all hand opening/closing movements performed by healthy subjects confirmed that the selected mathematical model accurately characterized the shape of angular profiles of MCPJ and IPJ of long fingers and thumb. This was confirmed by R2 and RMSE mean (± SD) values which were, respectively, 0.996 (± 0.009) and 1.6° (± 0.6°) for hand opening and 0.995 (± 0.009) and 1.7°(± 0.7°) for hand closing. With regard to thumb abduction angles (TAB), the mathematical model accurately characterised TAB only in 75% of all tested hands (R2 = 0.964 ± 0.043, RMSE = 0.9° ± 0.5°), as shown in Figure 4a. The remaining thumb abduction angles (25%) showed significantly lower values of R2 (0.517 ± 0.210) and higher RMSE (2.6° ± 1.3°), as indicated in the example of Figure 4b. For this reason, TAB angles were considered not well fitted by the selected model and, consequently, only the angular values reached at maximally closed and open hand, as calculated from the measured data, were included in the analysis.


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

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

Examples of measured and estimated angles during hand opening. Thumb abduction angles (TAB) of two unimpaired individuals (a, b) and proximal interphalangeal joint angles (IPJ2 and IPJ3) of two stroke subjects (c, d) during movements of hand opening. Coefficient of determination (R2) and root mean square error (RMSE) are reported.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: Examples of measured and estimated angles during hand opening. Thumb abduction angles (TAB) of two unimpaired individuals (a, b) and proximal interphalangeal joint angles (IPJ2 and IPJ3) of two stroke subjects (c, d) during movements of hand opening. Coefficient of determination (R2) and root mean square error (RMSE) are reported.
Mentions: Analysis of all hand opening/closing movements performed by healthy subjects confirmed that the selected mathematical model accurately characterized the shape of angular profiles of MCPJ and IPJ of long fingers and thumb. This was confirmed by R2 and RMSE mean (± SD) values which were, respectively, 0.996 (± 0.009) and 1.6° (± 0.6°) for hand opening and 0.995 (± 0.009) and 1.7°(± 0.7°) for hand closing. With regard to thumb abduction angles (TAB), the mathematical model accurately characterised TAB only in 75% of all tested hands (R2 = 0.964 ± 0.043, RMSE = 0.9° ± 0.5°), as shown in Figure 4a. The remaining thumb abduction angles (25%) showed significantly lower values of R2 (0.517 ± 0.210) and higher RMSE (2.6° ± 1.3°), as indicated in the example of Figure 4b. For this reason, TAB angles were considered not well fitted by the selected model and, consequently, only the angular values reached at maximally closed and open hand, as calculated from the measured data, were included in the analysis.

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