Relationship between spasticity and upper limb movement disorders in patients with stroke using stochastic spatiotemporal modeling

Solomon, John M (2019) Relationship between spasticity and upper limb movement disorders in patients with stroke using stochastic spatiotemporal modeling. Neurorehabilitation and Neural Repair, 33 (2). pp. 141-152.

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Abstract

Background. Spasticity is common in patients with stroke, yet current quantification methods are insufficient for determining the relationship between spasticity and voluntary movement deficits. This is partly, due to the effects of spasticity on the spatio-temporal characteristics of movement as well as to the variability of voluntary movement. These variables can be captured by Gaussian Mixture Models (GMMs). Objectives. To determine the influence of spasticity on upper limb voluntary motion, as assessed by the Bi-directional Kullback-Liebler Divergence (BKLD) between motion GMMs. Methods.Sixteen subjects with sub-acute stroke and thirteen, healthy aged-matched controls,reached-to-grasp four targets (Near-Center, Contralateral, Far-Center, and Ipsilateral).Two-dimensional GMMs (angle and time) were estimated for elbow extension motion.BKLD was computed for each subject and target, within the control group and between the control and stroke groups. Movement time, final elbow angle, average elbow velocity,and velocity smoothness were computed. Results. Between-group BKLDs were much larger than within control-group BKLDs. Between-group BKLDs for the Near-Center target were lower than those for the Far-Center and Contralateral targets, but similar to BKLDs for the Ipsilateral target. For patients, the final angle was lower for the Near-Center target, and the average velocity was higher and velocity smoothness lower for the Near-Center than for the Ipsilateral target. A regression showed that elbow flexor and extensor passive muscle resistance (MAS) strongly explained the BKLD values.Conclusions. The results support the view that patients with spasticity have a velocitydependent reduction in active joint control range and that BKLD can be used as an objective measure of the effects of spasticity on reaching kinematics

Item Type: Article
Uncontrolled Keywords: Spasticity; Stroke; Upper limb kinematics; GMM; KLD
Subjects: Allied Health > MCOAHS Manipal > Physiotherapy
Depositing User: KMC Library
Date Deposited: 06 Aug 2019 09:19
Last Modified: 06 Aug 2019 09:19
URI: http://eprints.manipal.edu/id/eprint/154284

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