Arm-plane representation of shoulder compensation during pointing movements in patients with stroke

Improvements in functional motor activities are often accompanied by motor compensations to overcome persistent motor impairment in the upper limb. Kinematic analysis is used to objectively quantify movement patterns including common motor compensations such as excessive trunk displacement during reaching. However, a common motor compensation to assist reaching, shoulder abduction, is not adequately characterized by current motion analysis approaches. We apply the arm-plane representation that accounts for the co-variation between movements of the whole arm, and investigate its ability to identify and quantify compensatory arm movements in stroke subjects when making forward arm reaches. This method has not been previously applied to the analysis of motion deficits. Sixteen adults with right post-stroke hemiparesis and eight healthy age-matched controls reached in three target directions (14 trials/target; sampling rate: 100 Hz). Arm-plane movement was validated against endpoint, joint, and trunk kinematics and compared between groups. In stroke subjects, arm-plane measures were correlated with arm impairment (Fugl-Meyer Assessment) and ability (Box and Blocks) scores and were more sensitive than clinical measures to detect mild motor impairment. Arm-plane motion analysis provides new information about motor compensations involving the co-variation of shoulder and elbow movements that may help to understand the underlying motor deficits in patients with stroke.     

On the measurement of movement difficulty in the standard approach to Fitts' law

Fitts' law is an empirical rule of thumb which predicts the time it takes people, under time pressure, to reach with some pointer a target of width W located at a distance D. It has been traditionally assumed that the predictor of movement time must be some mathematical transform of the quotient of D/W, called the index of difficulty (ID) of the movement task. We ask about the scale of measurement involved in this independent variable. We show that because there is no such thing as a zero-difficulty movement, the IDs of the literature run on non-ratio scales of measurement. One notable consequence is that, contrary to a widespread belief, the value of the y-intercept of Fitts' law is uninterpretable. To improve the traditional Fitts paradigm, we suggest grounding difficulty on relative target tolerance W/D, which has a physical zero, unlike relative target distance D/W. If no one can explain what is meant by a zero-difficulty movement task, everyone can understand what is meant by a target layout whose relative tolerance W/D is zero, and hence whose relative intolerance 1-W/D is 1 or 100%. We use the data of Fitts' famous tapping experiment to illustrate these points. Beyond the scale of measurement issue, there is reason to doubt that task difficulty is the right object to try to measure in basic research on Fitts' law, target layout manipulations having never provided users of the traditional Fitts paradigm with satisfactory control over the variations of the speed and accuracy of movements. We advocate the trade-off paradigm, a recently proposed alternative, which is immune to this criticism.     

Jerk-cost modulations during the practice of rapid arm movements

We examined how hand-trajectory smoothness changed during the practice of a motor task where smoothness was quantified by jerk-cost. Four human subjects each moved his nondominant arm between an upper target and a lower target, while circumnavigating a barrier that extended outward from the vertical plane of the targets. The two targets and the barrier placed boundary constraints on hand trajectories, but the motion was not restrained in any other way. Arm movements were recorded on high-speed ciné film, and linear and angular kinematical data were obtained for all arm segments. In each of 100 practice trials, subjects attempted to minimize movement time. After the practice trials, subjects repeated the same motor task but at movement times corresponding to the slowest, mid-range and fastest motion that had occurred during practice. Thus, jerk-cost could be compared for movements of different speeds during practice and after practice. Because the movement task contained several changes in hand-path direction, the changes in the vector characteristics of the hand accelerations were expected to be important for explaining the modulations in jerk-cost with practice. Total jerk-cost, therefore, was calculated as well as the separate magnitudinal and directional jerk-cost components. During practice, total movement time decreased, hand paths became more parabolic in shape, and significant changes occurred in hand acceleration magnitude, direction, and timing. Total jerk-cost and the magnitudinal and directional jerk-cost components were significantly less when slowest hand movements were compared after practice versus during practice. The decrease in jerk-cost indicated an increased smoothness of the practiced movements.K. Schneider was supported by the German Research Association (Deutsche Forschungsgemeinschaft)     

Two Agents in the Brain: Motor Control of Unimanual and Bimanual Reaching Movements

Previous studies have suggested that the left and right hands have different specialties for motor control that can be represented as two agents in the brain. This study examined how coordinated movements are performed during bimanual reaching tasks to highlight differences in the characteristics of the hands. We examined motor movement accuracy, reaction time, and movement time in right-handed subjects performing a three-dimensional motor control task (visually guided reaching). In the no-visual-feedback condition, right-hand movement had lower accuracy and a shorter reaction time than did left-hand movement, whereas bimanual movement had the longest reaction time, but the best accuracy. This suggests that the two hands have different internal models and specialties: closed-loop control for the right hand and open-loop control for the left hand. Consequently, during bimanual movements, both models might be used, creating better control and planning (or prediction), but requiring more computation time compared to the use of one hand only.     

Mental Representation of Arm Motion Dynamics in Children and Adolescents

Motor imagery, i.e., a mental state during which an individual internally represents an action without any overt motor output, is a potential tool to investigate action representation during development. Here, we took advantage of the inertial anisotropy phenomenon to investigate whether children can generate accurate motor predictions for movements with varying dynamics. Children (9 and 11 years), adolescents (14 years) and young adults (21 years) carried-out actual and mental arm movements in two different directions in the horizontal plane: rightwards (low inertia) and leftwards (high inertia). We recorded and compared actual and mental movement times. We found that actual movement times were greater for leftward than rightward arm movements in all groups. For mental movements, differences between leftward versus rightward movements were observed in the adults and adolescents, but not among the children. Furthermore, significant differences between actual and mental times were found at 9 and 11 years of age in the leftward direction. The ratio R/L (rightward direction/leftward direction), which indicates temporal differences between low inertia and high inertia movements, was inferior to 1 at all ages, except for the mental movements at 9 years of age, indicating than actual and mental movements were shorter for the rightward than leftward direction. Interestingly, while the ratio R/L of actual movements was constant across ages, it gradually decreased with age for mental movements. The ratio A/M (actual movement/mental movement), which indicates temporal differences between actual and mental movements, was near to 1 in the adults'' groups, denoting accurate mental timing. In children and adolescents, an underestimation of mental movement times appeared for the leftward movements only. However, this overestimation gradually decreased with age. Our results showed a refinement in the motor imagery ability during development. Action representation reached maturation at adolescence, during which mental actions were tightly related to their actual production.     

Behavior of dominant and non dominant arms during ballistic protractive target-directed movements

The purpose of this study is to investigate the asymmetry of dominant and non-dominant arms regarding reaction time (RT), velocity, force and power generated during ballistic target-directed movements. Fifty six, right-handed young males performed protractile movements with both arms separately by pushing a joystick towards a target-line as quickly and as accurately as possible. Participants performed 21 repetitions with each hand. The temporal, spatial, kinetic and kinematic parameters were computed. All movements were grouped regarding their accuracy (when joystick fell short, stopped precisely or overreached the target). Each group of movements was analyzed separately and the data obtained was compared across groups. The results showed that although the left arm was less accurate than the right one, it reached the target significantly faster, developing greater average force and power. The forces of acceleration and deceleration of the left arm were greater too. We did not observe a significant lateral difference in RT in situations when the arm fell short of the target, or stopped precisely on the target. It was only when the target was overreached that the left arm displayed a significantly greater RT than the right one. We explain the results from the asymmetry of motor behavior in favor of the influence of both hemispheres in this process.     

High accuracy decoding of movement target direction in non-human primates based on common spatial patterns of local field potentials

Background

The current development of brain-machine interface technology is limited, among other factors, by concerns about the long-term stability of single- and multi-unit neural signals. In addition, the understanding of the relation between potentially more stable neural signals, such as local field potentials, and motor behavior is still in its early stages.

Methodology/Principal Findings

We tested the hypothesis that spatial correlation patterns of neural data can be used to decode movement target direction. In particular, we examined local field potentials (LFP), which are thought to be more stable over time than single unit activity (SUA). Using LFP recordings from chronically implanted electrodes in the dorsal premotor and primary motor cortex of non-human primates trained to make arm movements in different directions, we made the following observations: (i) it is possible to decode movement target direction with high fidelity from the spatial correlation patterns of neural activity in both primary motor (M1) and dorsal premotor cortex (PMd); (ii) the decoding accuracy of LFP was similar to the decoding accuracy obtained with the set of SUA recorded simultaneously; (iii) directional information varied with the LFP frequency sub-band, being greater in low (0.3–4 Hz) and high (48–200 Hz) frequency bands than in intermediate bands; (iv) the amount of directional information was similar in M1 and PMd; (v) reliable decoding was achieved well in advance of movement onset; and (vi) LFP were relatively stable over a period of one week.

Conclusions/Significance

The results demonstrate that the spatial correlation patterns of LFP signals can be used to decode movement target direction. This finding suggests that parameters of movement, such as target direction, have a stable spatial distribution within primary motor and dorsal premotor cortex, which may be used for brain-machine interfaces.     

Quantization of human motions and learning of accurate movements

This paper presents a mathematical model for the learning of accurate human arm movements. Its main features are that the movement is the superposition of smooth submovements, the intrinsic deviation of arm movements is considered, visual and kinesthetic feedback are integrated in the motion control, and the movement duration and accuracy are optimized with practice. This model is consistent with the jerky arm movements of infants, and may explain how the adult motion behavior emerges from the infant behavior. Comparison with measurements of adult movements shows that the kinematics of accurate movements are well predicted by the model. Received: 15 May 1997 / Accepted 5 December 1997     

Fractional Anisotropy in Corpus Callosum Is Associated with Facilitation of Motor Representation during Ipsilateral Hand Movements

Background

Coactivation of primary motor cortex ipsilateral to a unilateral movement (M1_ipsilateral) has been observed, and the magnitude of activation is influenced by the contracting muscles. It has been suggested that the microstructural integrity of the callosal motor fibers (CMFs) connecting M1 regions may reflect the observed response. However, the association between the structural connectivity of CMFs and functional changes in M1_ipsilateral remains unclear. The purpose of this study was to investigate the relationship between functional changes within M1_ipsilateral during unilateral arm or leg movements and the microstructure of the CMFs connecting both homotopic representations (arm or leg).

Methods

Transcranial magnetic stimulation was used to assess changes in motor evoked potentials (MEP) in an arm muscle during unilateral movements compared to rest in fifteen healthy adults. Functional magnetic resonance imaging was then used to identify regions of M1 associated with either arm or leg movements. Diffusion-weighted imaging data was acquired to generate CMFs for arm and leg areas using the areas of activation from the functional imaging as seed masks. Individual values of regional fractional anisotropy (FA) of arm and leg CMFs was then calculated by examining the overlap between CMFs and a standard atlas of corpus callosum.

Results

The change in the MEP was significantly larger in the arm movement compared to the leg movement. Additionally, regression analysis revealed that FA in the arm CMFs was positively correlated with the change in MEP during arm movement, whereas a negative correlation was observed during the leg movement. However, there was no significant relationship between FA in the leg CMF and the change in MEP during the movements.

Conclusions

These findings suggest that individual differences in interhemispheric structural connectivity may be used to explain a homologous muscle-dominant effect within M1_ipsilateral hand representation during unilateral movement with topographical specificity.     

The representation of time for motor learning

We have identified factors that control precise motor timing by studying learning in smooth pursuit eye movements. Monkeys tracked a target that moved horizontally for a fixed time interval before changing direction through the addition of a vertical component of motion. After repeated presentations of the same target trajectory, infrequent probe trials of purely horizontal target motion evoked a vertical eye movement around the time when the change in target direction would have occurred. The pursuit system timed the vertical eye movement by keeping track of the duration of horizontal target motion and by measuring the distance the target traveled before changing direction, but not by learning the position in space where the target changed direction. We conclude that high temporal precision in motor output relies on multiple signals whose contributions to timing vary according to task requirements.     

Kinematic and EMG characteristics of simple shoulder movements with proprioception and visual feedback.

The objective of this study was to determine if simple, shoulder movements use the dual control hypothesis strategy, previously demonstrated with elbow movements, and to see if this strategy also applies in the absence of visual feedback. Twenty subjects were seated with their right arm abducted to 90 degrees and externally rotated in the scapular plane. Subjects internally rotated to a target position using a custom shoulder wheel at three different speeds with and without visual feedback. Kinematics were collected with a motion analysis system and electromyographic (EMG) recordings of the pectoralis major (PECT), infraspinatus (INFRA), anterior and posterior (ADELT, PDELT) deltoid muscles were used to evaluate muscle activity patterns during movements. Kinematics changed as movement speed increased with less accuracy (p<0.01). Greater EMG activity was observed in the PECT, PDELT, and INFRA with shorter durations for the ADELT, PDELT and INFRA. Movements with only kinesthetic feedback were less accurate (p<0.01) and performed faster (p<0.01) than movements with visual feedback. EMG activity suggests no major difference in CNS control strategies in movements with and without visual feedback. Greater resolution with visual feedback enables the implementation of a dual control strategy, allowing greater movement velocity while maintaining accuracy.     

Characterising Upper Limb Movements in Huntington's Disease and the Impact of Restricted Visual Cues

Background

Voluntary motor deficits are a common feature in Huntington''s disease (HD), characterised by movement slowing and performance inaccuracies. This deficit may be exacerbated when visual cues are restricted.

Objective

To characterize the upper limb motor profile in HD with various levels of difficulty, with and without visual targets.

Methods

Nine premanifest HD (pre-HD), nine early symptomatic HD (symp-HD) and nine matched controls completed a motor task incorporating Fitts'' law, a model of human movement enabling the quantification of movement timing, via the manipulation of task difficulty (i.e., target size, and distance between targets). The task required participants to make reciprocal movements under cued and blind conditions. Dwell times (time stationary between movements), speed, accuracy and variability of movements were compared between groups.

Results

Symp-HD showed significantly prolonged and less consistent movement times, compared with controls and pre-HD. Furthermore, movement planning and online control were significantly impaired in symp-HD, compared with controls and pre-HD, evidenced by prolonged dwell times and deceleration times. Speed and accuracy were comparable across groups, suggesting that group differences observed in movement time, variability, dwell time and deceleration time were evident over and above simple performance measures. The presence of cues resulted in greater movement time variability in symp-HD, compared with pre-HD and controls, suggesting that the deficit in movement consistency manifested only in response to targeted movements.

Conclusions

Collectively, these findings provide evidence of a deficiency in both motor planning, particularly in relation to movement timing and online control, which became exacerbated as a function of task difficulty during symp-HD stages. These variables may provide a more sensitive measure of motor dysfunction than speed and/or accuracy alone in symp-HD.     

How Moving Backgrounds Influence Interception

Reaching movements towards an object are continuously guided by visual information about the target and the arm. Such guidance increases precision and allows one to adjust the movement if the target unexpectedly moves. On-going arm movements are also influenced by motion in the surrounding. Fast responses to motion in the surrounding could help cope with moving obstacles and with the consequences of changes in one’s eye orientation and vantage point. To further evaluate how motion in the surrounding influences interceptive movements we asked subjects to tap a moving target when it reached a second, static target. We varied the direction and location of motion in the surrounding, as well as details of the stimuli that are known to influence eye movements. Subjects were most sensitive to motion in the background when such motion was near the targets. Whether or not the eyes were moving, and the direction of the background motion in relation to the direction in which the eyes were moving, had very little influence on the response to the background motion. We conclude that the responses to background motion are driven by motion near the target rather than by a global analysis of the optic flow and its relation with other information about self-motion.     

Motor control of voluntary arm movements

The motor control of pointing and reaching-to-grasp movements was investigated using two different approaches (kinematic and modelling) in order to establish whether the type of control varies according to modifications of arm kinematics. Kinematic analysis of arm movements was performed on subjects' hand trajectories directed to large and small stimuli located at two different distances. The subjects were required either to grasp and to point to each stimulus. The kinematics of the subsequent movement, during which subject's hand came back to the starting position, were also studied. For both movements, kinematic analysis was performed on hand linear trajectories as well as on joint angular trajectories of shoulder and elbow. The second approach consisted in the parametric identification of the black box (ARMAX) model of the controller driving the arm movement. Such controller is hypothesized to work for the correct execution of the motor act. The order of the controller ARMAX model was analyzed with respect to the different experimental conditions (distal task, stimulus size and distance). Results from kinematic analysis showed that target distance and size influenced kinematic parameters both of angular and linear displacements. Nevertheless, the structure of the motor program was found to remain constant with distane and distal task, while it varied with precision requirements due to stimulus size. The estimated model order of the controller confirmed the invariance of the control law with regard to movement amplitude, whereas it was sensitive to target size.     

Changes in limb dynamics during the practice of rapid arm movements

In our study we examined Bernstein's hypothesis that practice alters the motor coordination among the muscular and passive joint moments. In particular, we conducted dynamical analyses of a human multisegmental movement during the practice of a task involving the upper extremity. Seven male human volunteers performed maximal-speed, unrestrained vertical arm movements whose upward and downward trajectories between two target endpoints required the hand to round a barrier, resulting in complex shoulder, elbow, and wrist joint movements. These movements were recorded by high-speed ciné film, and myopotentials from selected upper-extremity muscles were recorded. The arm was modeled as interconnected rigid bodies, so that dynamical interactions among the upper arm, forearm, and hand could be calculated. With practice, subjects achieved significantly shorter movement times. As movement times decreased, all joint-moment components (except gravity) increased, and the moment-time and EMG profiles were changed significantly. Particularly during reversals in movement direction, the changes in moment-time and EMG profiles were consistent with Bernstein's hypothesis relating practice effects and intralimb coordination: with practice, motor coordination was altered so that individuals employed reactive phenomena in such a way as to use muscular moments to counterbalance passive-interactive moments created by segment movements.     

Influence of Vibration on Motor Responses in the Upper Arm Muscles under Stationary Conditions and during Voluntary and Evoked Arm Movements under Limb Unloading Conditions

Locomotion of mammals, including humans, is based on the rhythmic activity of spinal cord circuitries. The functioning of these circuitries depends on multimodal afferent information and on supraspinal influences from the motor cortex. Using the method of transcranial magnetic stimulation (TMS) of arm muscle areas in the motor cortex, we studied the motor evoked potentials (MEP) in the upper arm muscles in stationary conditions and during voluntary and vibration-evoked arm movements. The study included 13 healthy subjects under arm and leg unloading conditions. In the first series of experiments, with motionless limbs, the effect of vibration of left upper arm muscles on motor responses in these muscles was evaluated. In the second series of experiments, MEP were compared in the same muscles during voluntary and rhythmic movements generated by left arm m. triceps brachii vibration (the right arm was stationary). Motionless left arm vibration led to an increase in MEP values in both vibrated muscle and in most of the non-vibrated muscles. For most target muscles, MEP was greater with voluntary arm movements than with vibration-evoked movements. At the same time, a similar MEP modulation in the cycle of arm movements was observed in the same upper arm muscles during both types of arm movements. TMS of the motor cortex significantly potentiated arm movements generated by vibration, but its effect on voluntary movements was weaker. These results indicate significant differences in the degree of motor cortex involvement in voluntary and evoked arm movements. We suppose that evoked arm movements are largely due to spinal rather than central mechanisms of generation of rhythmic movements.     

The Temporal Structure of Vertical Arm Movements

The present study investigates how the CNS deals with the omnipresent force of gravity during arm motor planning. Previous studies have reported direction-dependent kinematic differences in the vertical plane; notably, acceleration duration was greater during a downward than an upward arm movement. Although the analysis of acceleration and deceleration phases has permitted to explore the integration of gravity force, further investigation is necessary to conclude whether feedforward or feedback control processes are at the origin of this incorporation. We considered that a more detailed analysis of the temporal features of vertical arm movements could provide additional information about gravity force integration into the motor planning. Eight subjects performed single joint vertical arm movements (45° rotation around the shoulder joint) in two opposite directions (upwards and downwards) and at three different speeds (slow, natural and fast). We calculated different parameters of hand acceleration profiles: movement duration (MD), duration to peak acceleration (D PA), duration from peak acceleration to peak velocity (D PA-PV), duration from peak velocity to peak deceleration (D PV-PD), duration from peak deceleration to the movement end (D PD-End), acceleration duration (AD), deceleration duration (DD), peak acceleration (PA), peak velocity (PV), and peak deceleration (PD). While movement durations and amplitudes were similar for upward and downward movements, the temporal structure of acceleration profiles differed between the two directions. More specifically, subjects performed upward movements faster than downward movements; these direction-dependent asymmetries appeared early in the movement (i.e., before PA) and lasted until the moment of PD. Additionally, PA and PV were greater for upward than downward movements. Movement speed also changed the temporal structure of acceleration profiles. The effect of speed and direction on the form of acceleration profiles is consistent with the premise that the CNS optimises motor commands with respect to both gravitational and inertial constraints.     

Robot-Assisted Arm Assessments in Spinal Cord Injured Patients: A Consideration of Concept Study

Robotic assistance is increasingly used in neurological rehabilitation for enhanced training. Furthermore, therapy robots have the potential for accurate assessment of motor function in order to diagnose the patient status, to measure therapy progress or to feedback the movement performance to the patient and therapist in real time. We investigated whether a set of robot-based assessments that encompasses kinematic, kinetic and timing metrics is applicable, safe, reliable and comparable to clinical metrics for measurement of arm motor function. Twenty-four healthy subjects and five patients after spinal cord injury underwent robot-based assessments using the exoskeleton robot ARMin. Five different tasks were performed with aid of a visual display. Ten kinematic, kinetic and timing assessment parameters were extracted on joint- and end-effector level (active and passive range of motion, cubic reaching volume, movement time, distance-path ratio, precision, smoothness, reaction time, joint torques and joint stiffness). For cubic volume, joint torques and the range of motion for most joints, good inter- and intra-rater reliability were found whereas precision, movement time, distance-path ratio and smoothness showed weak to moderate reliability. A comparison with clinical scores revealed good correlations between robot-based joint torques and the Manual Muscle Test. Reaction time and distance-path ratio showed good correlation with the “Graded and Redefined Assessment of Strength, Sensibility and Prehension” (GRASSP) and the Van Lieshout Test (VLT) for movements towards a predefined position in the center of the frontal plane. In conclusion, the therapy robot ARMin provides a comprehensive set of assessments that are applicable and safe. The first results with spinal cord injured patients and healthy subjects suggest that the measurements are widely reliable and comparable to clinical scales for arm motor function. The methods applied and results can serve as a basis for the future development of end-effector and exoskeleton-based robotic assessments.     

Kinematic invariants during cyclical arm movements

It has been observed that the motion of the arm end-point (the hand, fingertip or the tip of a pen) is characterized by a number of regularities (kinematic invariants). Trajectory is usually straight, and the velocity profile has a bell shape during point-to-point movements. During drawing movements, a two-thirds power law predicts the dependence of the end-point velocity on the trajectory curvature. Although various principles of movement organization have been discussed as possible origins of these kinematic invariants, the nature of these movement trajectory characteristics remains an open question. A kinematic model of cyclical arm movements derived in the present study analytically demonstrates that all three kinematic invariants can be predicted from a two-joint approximation of the kinematic structure of the arm and from sinusoidal joint motions. With this approach, explicit expressions for two kinematic invariants, the two-thirds power law during drawing movements and the velocity profile during point-to-point movements are obtained as functions of arm segment lengths and joint motion parameters. Additionally, less recognized kinematic invariants are also derived from the model. The obtained analytical expressions are further validated with experimental data. The high accuracy of the predictions confirms practical utility of the model, showing that the model is relevant to human performance over a wide range of movements. The results create a basis for the consolidation of various existing interpretations of kinematic invariants. In particular, optimal control is discussed as a plausible source of invariant characteristics of joint motions and movement trajectories.     

Prediction of a moving target's position in fast goal-directed action

 Subjects made fast goal-directed arm movements towards moving targets. In some cases, the perceived direction of target motion was manipulated by moving the background. By comparing the trajectories towards moving targets with those towards static targets, we determined the position towards which subjects were aiming at movement onset. We showed that this position was an extrapolation in the target’s perceived direction from its position at that moment using its perceived direction of motion. If subjects were to continue to extrapolate in the perceived direction of target motion from the position at which they perceive the target at each instant, the error would decrease during the movements. By analysing the differences between subjects’ arm movements towards targets moving in different (apparent) directions with a linear second-order model, we show that the reduction in the error that this predicts is not enough to explain how subjects compensate for their initial misjudgements. Received: 10 February 1995/Accepted in revised form: 30 May 1995