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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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Inter-joint coordination in healthy subjects. Results related to the delay between IPJ and MCPJ of thumb (TH) and long fingers (LF) for healthy subjects, during hand opening (a) and hand closing (b). Columns and whiskers represent mean and standard deviation, respectively. **p < 0.01, ***p < 0.001 (TH vs LF, Wilcoxon matched pairs test).
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Figure 6: Inter-joint coordination in healthy subjects. Results related to the delay between IPJ and MCPJ of thumb (TH) and long fingers (LF) for healthy subjects, during hand opening (a) and hand closing (b). Columns and whiskers represent mean and standard deviation, respectively. **p < 0.01, ***p < 0.001 (TH vs LF, Wilcoxon matched pairs test).

Mentions: Within each long finger, a proximal-to-distal sequence was evident for hand opening movements (see Figure 5, left panels). In particular, MCPJ started extending first, followed by IPJ after an average delay of 7.4%Dur (see Figure 6a). Contrarily to long fingers, a distal-to-proximal sequence was noticed in the thumb (see Figure 5, upper-left panel): IPJ started extending first followed by MCPJ after a mean delay of 4% (Figure 6a). During hand closing inter-joint sequence was reversed for both thumb and long fingers (see Figure 5, right panels). In particular, a proximal-to distal sequence (i.e. MCPJ-IPJ) was noticed in the thumb and a distal-to proximal sequence (i.e. IPJ-MCPJ) was evident in long fingers (see Figure 6b). In both hand opening and closing MCPJ of finger 2 to 5 moved together, simultaneously reaching peak velocity at approximately 50% of the movement duration. Synchronous motion was noticed also in IPJ, which reached the maximum speed at nearly 57% of the whole duration (see Figure 5).


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

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

Inter-joint coordination in healthy subjects. Results related to the delay between IPJ and MCPJ of thumb (TH) and long fingers (LF) for healthy subjects, during hand opening (a) and hand closing (b). Columns and whiskers represent mean and standard deviation, respectively. **p < 0.01, ***p < 0.001 (TH vs LF, Wilcoxon matched pairs test).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 6: Inter-joint coordination in healthy subjects. Results related to the delay between IPJ and MCPJ of thumb (TH) and long fingers (LF) for healthy subjects, during hand opening (a) and hand closing (b). Columns and whiskers represent mean and standard deviation, respectively. **p < 0.01, ***p < 0.001 (TH vs LF, Wilcoxon matched pairs test).
Mentions: Within each long finger, a proximal-to-distal sequence was evident for hand opening movements (see Figure 5, left panels). In particular, MCPJ started extending first, followed by IPJ after an average delay of 7.4%Dur (see Figure 6a). Contrarily to long fingers, a distal-to-proximal sequence was noticed in the thumb (see Figure 5, upper-left panel): IPJ started extending first followed by MCPJ after a mean delay of 4% (Figure 6a). During hand closing inter-joint sequence was reversed for both thumb and long fingers (see Figure 5, right panels). In particular, a proximal-to distal sequence (i.e. MCPJ-IPJ) was noticed in the thumb and a distal-to proximal sequence (i.e. IPJ-MCPJ) was evident in long fingers (see Figure 6b). In both hand opening and closing MCPJ of finger 2 to 5 moved together, simultaneously reaching peak velocity at approximately 50% of the movement duration. Synchronous motion was noticed also in IPJ, which reached the maximum speed at nearly 57% of the whole duration (see Figure 5).

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