Self-paced reaching after stroke: a quantitative assessment of longitudinal and directional sensitivity using the H-Man planar robot for upper limb neurorehabilitation

Technology aided measures offer a sensitive, accurate and time-efficient approach for the assessment of sensorimotor function after neurological insult compared to standard clinical assessments. This study investigated the sensitivity of robotic measures to capture differences in planar reaching movements as a function of neurological status (stroke, healthy), direction (front, ipsilateral, contralateral), movement segment (outbound, inbound), and time (baseline, post-training, 2-week follow-up) using a planar, two-degrees of freedom, robotic-manipulator (H-Man). Twelve chronic stroke (age: 55 ± 10.0 years, 5 female, 7 male, time since stroke: 11.2 ± 6.0 months) and nine aged-matched healthy participants (age: 53 ± 4.3 years, 5 female, 4 male) participated in this study. Both healthy and stroke participants performed planar reaching movements in contralateral, ipsilateral and front directions with the H-Man, and the robotic measures, spectral arc length (SAL), normalized time to peak velocities (TpeakN), and root-mean square error (RMSE) were evaluated. Healthy participants went through a one-off session of assessment to investigate the baseline. Stroke participants completed a 2-week intensive robotic training plus standard arm therapy (8 × 90 min sessions). Motor function for stroke participants was evaluated prior to training (baseline, week-0), immediately following training (post-training, week-2), and 2-weeks after training (follow-up, week-4) using robotic assessment and the clinical measures Fugl-Meyer Assessment (FMA), Activity-Research-Arm Test (ARAT), and grip-strength. Robotic assessments were able to capture differences due to neurological status, movement direction, and movement segment. Movements performed by stroke participants were less-smooth, featured longer TpeakN, and larger RMSE values, compared to healthy controls. Significant movement direction differences were observed, with improved reaching performance for the front, compared to ipsilateral and contralateral movement directions. There were group differences depending on movement segment. Outbound reaching movements were smoother and featured longer TpeakN values than inbound movements for control participants, whereas SAL, TpeakN, and RMSE values were similar regardless of movement segment for stroke patients. Significant change in performance was observed between initial and post-assessments using H-Man in stroke participants, compared to conventional scales which showed no significant difference. Results of the study indicate the potential of H-Man as a sensitive tool for tracking changes in performance compared to ordinal scales (i.e., FM, ARAT)

Bimanual grasp planning reflects changing rather than fixed constraint dominance

We studied whether motor-control constraints for grasping objects that are moved to new positions reflect a rigid constraint hierarchy or a flexible constraint hierarchy. In two experiments, we asked participants to move two plungers from the same start locations to different target locations (both high, both low, or one high and one low). We found that participants grasped the plungers symmetrically and at heights that ensured comfortable or easy-to-control end postures when the plungers had the same target heights, but these grasp tendencies were reduced when the plungers had different target heights. In addition, when the plungers had different mass distributions, participants behaved in ways that suggested still-different emphases of the relevant grasp constraints. When the plungers had different mass distributions, participants sacrificed bimanual symmetry for end-state comfort. The results suggest that bimanual grasp planning relies on a flexible rather than static hierarchy. Different constraints take on different degrees of importance depending on the nature of the task and on the level of task experience. The results have implications for the understanding of perceptual-motor skill learning. It may be that one mechanism underlying such learning is changing the priorities of task constraints

Keeping an eye on the violinist: motor experts show superior timing consistency in a visual perception task

Common coding theory states that perception and action may reciprocally induce each other. Consequently, motor expertise should map onto perceptual consistency in specific tasks such as predicting the exact timing of a musical entry. To test this hypothesis, ten string musicians (motor experts), ten non-string musicians (visual experts), and ten non-musicians were asked to watch progressively occluded video recordings of a first violinist indicating entries to fellow members of a string quartet. Participants synchronised with the perceived timing of the musical entries. Results revealed significant effects of motor expertise on perception. Compared to visual experts and non-musicians, string players not only responded more accurately, but also with less timing variability. These findings provide evidence that motor experts’ consistency in movement execution—a key characteristic of expert motor performance—is mirrored in lower variability in perceptual judgements, indicating close links between action competence and perception

Individual differences in motor planning during a multi-segment object manipulation task

Seegelke C, Hughes C, Schütz C, Schack T. Individual differences in motor planning during a multi-segment object manipulation task. Experimental Brain Research. 2012;222(1-2):125-136.Research has demonstrated that people will adopt initially awkward grasps if they afford more comfortable postures at the end of the movement. This end-state comfort effect provides evidence that humans represent future posture states and select appropriate grasps in anticipation of these postures. The purpose of the study was to examine to what extent the final action goal of a task influences motor planning of preceding segments, and whether grasp postures are planned to optimize end-state comfort during a three-segment action sequence in which two objects are manipulated, and participants can select from a continuous range of possible grasp postures. In the current experiment, participants opened a drawer, grasped an object from inside the drawer, and placed it on a table in one of the three target orientations (0A degrees, 90A degrees, or 180A degrees object rotation required). Grasp postures during the initial movement segment (drawer opening) were not influenced by the final action goal (i.e., required target orientation). In contrast, both the intermediate (i.e., object grasping) and the final movement segment (i.e., object placing) were influenced by target orientation. In addition, participants adopted different strategies to achieve the action goal when the object required 180A degrees rotation, with 42 % of participants prioritizing intermediate-state comfort and 58 % prioritizing end-state comfort. The results indicate that individuals optimize task performance by selecting lower level constraints that allow for successful completion of the action goal and that the selection of these constraints is dependent upon contextual, environmental, and internal influences

Representation of grasp postures and anticipatory motor planning in children

Stoeckel T, Hughes C, Schack T. Representation of grasp postures and anticipatory motor planning in children. Psychological Research. 2012;76(6):768-776

Laying the foundation for genomically-based risk assessment in chronic myeloid leukemia

Outcomes for patients with chronic myeloid leukemia (CML) have substantially improved due to advances in drug development and rational treatment intervention strategies. Despite these significant advances there are still unanswered questions on patient management regarding how to more reliably predict treatment failure at the time of diagnosis and how to select frontline tyrosine kinase inhibitor (TKI) therapy for optimal outcome. The BCR-ABL1 transcript level at diagnosis has no established prognostic impact and cannot guide frontline TKI selection. BCR-ABL1 mutations are detected in ~50% of TKI resistant patients but are rarely responsible for primary resistance. Other resistance mechanisms are largely uncharacterized and there are no other routine molecular testing strategies to facilitate the evaluation and further stratification of TKI resistance. Advances in next-generation sequencing technology has aided the management of a growing number of other malignancies, enabling the incorporation of somatic mutation profiles in diagnosis, classification, and prognostication. A largely unexplored area in CML research is whether expanded genomic analysis at diagnosis, resistance, and disease transformation can enhance patient management decisions, as has occurred for other cancers. The aim of this article is to review publications that reported mutated cancer-associated genes in CML patients at various disease phases. We discuss the frequency and type of such variants at initial diagnosis and at the time of treatment failure and transformation. Current limitations in the evaluation of mutants and recommendations for future reporting are outlined. The collective evaluation of mutational studies over more than a decade suggests a limited set of cancer-associated genes are indeed recurrently mutated in CML and some at a relatively high frequency. Genomic studies have the potential to lay the foundation for improved diagnostic risk classification according to clinical and genomic risk, and to enable more precise early identification of TKI resistance.Susan Branford, Dennis Dong Hwan Kim, Jane F. Apperley, Christopher A. Eide, Satu Mustjoki, S. Tiong Ong ... et al. (on behalf of the International CML Foundation Genomics Alliance

Representation and Anticipation in Motor Action

Schack T, Schütz C, Krause AF, Seegelke C. Representation and Anticipation in Motor Action. In: Nadin M, ed. Anticipation Across Disciplines. Cognitive Systems Monographs. Vol 29. Cham: Springer Science + Business Media; 2015: 203-215