Improving upper-limb and trunk kinematics by interactive gaming in individuals with chronic stroke: A single-blinded RCT.

Background: Commercial gaming systems are increasingly being used for stroke rehabilitation; however, their effect on upper-limb recovery versus compensation is unknown.

Objectives: We aimed to compare the effect of upper-limb rehabilitation using interactive gaming (Nintendo Wii) with dose-matched conventional therapy on elbow extension (recovery) and forward trunk motion (compensation) in individuals with chronic stroke. Secondary aims were to compare the effect on (1) clinical tests of impairment and activity, pain and effort, and (2) trajectory kinematics.

Kinematics of the Shoulder Girdle During Pointing: Coordination Between Joints and their Contribution to the Peri-Personal Workspace.

This study explored the coordination between the components of the shoulder girdle (clavicle, scapula and humerus), and how they contribute to hand movement in the peri-personal space. Shoulder girdle motion was recorded in 10 healthy subjects during pointing movements to 9 targets in the peri-personal space, using electromagnetic sensors fixed to the trunk, scapula and upper arm. Most of the 9 degrees of freedom (DoF) of the shoulder girdle were finely scaled to target position.

Influence of the side of brain damage on postural upper-limb control including the scapula in stroke patients.

Following stroke, control of both the contralesional (paretic) and ipsilesional (less affected) arms is altered. The purpose of this study was to analyse the consequences of stroke on joint rotations of both shoulder girdles, that is, glenohumeral (GH) and scapula motion. Because of hemispheric specialization, we hypothesized that changes would relate to the side of hemisphere damage.

The trunk as a part of the kinematic chain for reaching movements in healthy subjects and hemiparetic patients.

The aims of this study were first to further assess the role of the 3D trunk angular rotations as part of the kinematic chain for seated-reaching movements within arm's length in a large 3D workspace in healthy subjects and second, to assess if these degrees of freedom participate in the compensatory strategy in hemiparetic patients. Ten healthy subjects, eight patients with right, and eight patients with left hemiparesis following stroke were included. They performed seated reaching movements at a comfortable speed to nine targets positioned in a large 3D workspace within arm's length.

A methodology to quantify alterations in human upper limb movement during co-manipulation with an exoskeleton.

While a large number of robotic exoskeletons have been designed by research teams for rehabilitation, it remains rather difficult to analyse their ability to finely interact with a human limb: no performance indicators or general methodology to characterize this capacity really exist. This is particularly regretful at a time when robotics are becoming a recognized rehabilitation method and when complex problems such as 3-D movement rehabilitation and joint rotation coordination are being addressed. The aim of this paper is to propose a general methodology to evaluate, through a reduced set of simple indicators, the ability of an exoskeleton to interact finely and in a controlled way with a human.

Botulinum toxin to treat upper-limb spasticity in hemiparetic patients: analysis of function and kinematics of reaching movements.

Background: Poor control of reaching in spastic hemiparetic patients could be because of a combination of poor individuation of joints, weakness, spasticity, and/or sensory loss.

Objective: To assess the effect of botulinum toxin injections (BTIs) on spasticity, upper-limb function, and kinematics of reaching movements in patients with spastic hemiparesis caused by brain injury.

Methods: Fifteen patients with spastic hemiparesis and 9 healthy controls were included in this single-site, open-labeled study.

Effect of auditory feedback differs according to side of hemiparesis: a comparative pilot study.

Background: Following stroke, patients frequently demonstrate loss of motor control and function and altered kinematic parameters of reaching movements. Feedback is an essential component of rehabilitation and auditory feedback of kinematic parameters may be a useful tool for rehabilitation of reaching movements at the impairment level. The aim of this study was to investigate the effect of 2 types of auditory feedback on the kinematics of reaching movements in hemiparetic stroke patients and to compare differences between patients with right (RHD) and left hemisphere damage (LHD).

Relevance of botulinum toxin injection and nerve block of rectus femoris to kinematic and functional parameters of stiff knee gait in hemiplegic adults.

Stiff knee gait (SKG) is common in hemiplegic patients. The main focus of treatment is rectus femoris (RF) spasticity. The aims of this study were to evaluate the effect of botulinum toxin injection (BTI) in the RF muscle on peak knee flexion during swing phase and its quantitative and functional impact on gait.