Jeng Feng Yang

The role of kinematic redundancy in adaptation of reaching

Although important differences exist between learning a new motor skill and adapting a well-learned skill to new environmental constraints, studies of force field adaptation have been used frequently in recent years to identify processes underlying learning. Most of these studies have been of reaching tasks that were each hand position was specified by a unique combination of joint angles. At the same time, evidence has been provided from a variety of tasks that the central nervous system takes advantage of the redundancy available to it when planning and executing functional movements. The current study attempted to determine whether a change in the use of joint motion redundancy is associated with the adaptation process. Both experimental and control subjects performed 160 trials of reaching in each of four adaptation phases, while holding the handle of a robot manipulandum. During the first and last adaptation phases, the robot motors were turned off. During phases 2 and 3 the motors produced a velocity-dependent force field to which experimental subjects had to adapt to regain relatively straight line hand movements during reaching to a target, while the motors remained off for the control group. The uncontrolled manifold (UCM) method was used to partition the variance of planar clavicle–scapular, shoulder, elbow and wrist joint movements into two orthogonal components, one (VUCM) that reflected combinations of joint angles that were equivalent with respect to achieving the average hand path and another (VORT) that took the hand away from its average path. There was no change in either variance component for the control group performing 640 non-perturbed reaches across four ‘pseudo-adaptation’ phases. The experimental group showed adaptation to reaching in the force field that was accompanied initially by an increase in both components of variance, followed by a smaller decrease of VUCM than VORT during 320 practice reaches in the force field. After initial re-adaptation to reaching to the null field, VUCM was higher in experimental than in control subjects after performing a comparable number of reaches. VUCM was also larger in the experimental group after re-adaptation when compared to the 160 null field reaching trials performed prior to initial force field introduction. The results suggest that the central nervous system makes use of kinematic redundancy, or flexibility of motor patterns, to adapt reaching performance to unusual force fields, a fact that has implications for the hypothesis that motor adaptation requires learning of formal models of limb and environmental dynamics.

Learning a throwing task is associated with differential changes in the use of motor abundance

This study sought to characterize changes in the synergy of joint motions related to learning a Frisbee throwing task and, in particular, how the use of abundant solutions to joint coordination changed during the course of learning for successful performance. The latter information was helpful in determining the relative importance of different performance-related variables (PVs) to performance improvement. Following a pre-test, the main experiment consisted of six subjects practicing a Frisbee throw to a laterally-placed target for five days, 150 throws per day, followed by a post-test. A subgroup of three subjects continued to practice for an extended period of extensive practice amounting to 1800–2700 additional throws each, followed by a second post-test. Motor abundance was addressed through the uncontrolled manifold approach (UCM), which was used to partition the variance of joint configurations into two components with respect to relevant PVs, one component leading to a consistent value of the PV across repetitions, and a reflection of motor abundance, and a second component resulting in unstable values of the relevant PV. The method was used to test hypotheses about the relative importance of controlling the PVs that have an impact on successful task performance: movement extent, movement direction, hand path velocity, and the hand’s orientation to the target. In addition, the amount of self-motion, or apparently extraneous joint motion having no effect on the hand’s motion, compared to joint motion that does affect the hand’s motion, was determined. After a week of practice, all subjects showed improvement in terms of targeting accuracy. Hand movement variability also decreased with practice and this was associated with a decrease in overall joint configuration variance. This trend continued to a greater extent in the three subjects who participated in extended practice. Although the component of joint configuration variance that was consistent with a stable value of all PVs was typically substantially higher than variance leading to unstable values of those PVs, both components decreased with practice. However, the decrease in joint configuration variance reflecting motor abundance was less than the other variance component only in relation to control of movement direction and the hand’s orientation to the target. These results indicate that improvement of throwing performance in this experiment was more related to improved stabilization of movement direction and to the hand’s orientation to the target than to movement extent and hand velocity. Nonetheless, the relative values of the two joint variance components were such that the instantaneous value of both hand path velocity and movement extent were stabilized throughout the experiment and showed a consistent compensatory relationship at the time of Frisbee release, despite not changing with practice. Finally, the amount of self-motion increased significantly with practice, possibly reflecting better compensation for perturbations due to the limb’s dynamics. The results are consistent with other studies, suggesting the need to reevaluate Bernstein’s hypothesis of freeing and freezing DOFs with learning.

Joint coordination during quiet stance: effects of vision

Stabilization of the center of mass (CM) is an important goal of the postural control system. Coordination of several joints along the human “pendulum” is required to achieve this goal. We studied the coordination among body segments with respect to horizontal CM stabilization during a quiet stance task and the effects of vision on CM stability. Subjects were asked to stand quietly on a narrow wooden block supporting only the mid-foot, with either open (EO) or closed (EC) eyes on separate trials. Instant equilibrium points (IEPs) in the center of pressure (CP) trajectory were determined when the horizontal component of the ground reaction force was zero and the CP data were decomposed into their rambling and trembling components. The joint angle, CM and CP data were divided into short cycles (time-normalized to 100 data points) or longer segments (time-normalized to 1000 data points) of equal length beginning and ending in an IEP. Motor abundance with respect to patterns of joint coordination was evaluated using the uncontrolled manifold (UCM) approach. Here, a UCM is a subspace spanning all joint combinations resulting in a given CM position. All combinations of joint angles that lie within this subspace are equivalent with respect to that CM position while joint angle combinations lying in a subspace orthogonal to the UCM lead to deviation from that CM position. UCM analysis was performed on data organized either across time within longer segments or at each point in time across multiple segments or across multiple cycles. Regardless of method of analysis, most of the variance in joint space was constrained to be within the UCM, preserving the mean CM position in both the EO and EC conditions. Joint configuration variance was significantly higher in the EC than in the EO condition although this increase occurred primarily within the UCM rather than in the orthogonal subspace that would have led to variation of the CM position. These results demonstrate the ability of the control system to selectively “channel” motor variability into directions in joint space that stabilize the CM position. This effect was enhanced when the task was made more challenging in the absence of vision. There was also a significant relationship between joint variance that led to a change in the CM position and, in particular, the rambling component of the CP path, lending some support to the idea that the CNS prescribes a certain stable trajectory of the CP during quiet stance that leads to a small controlled movement of the CM.

An investigation of the factors affecting flatfoot in children with delayed motor development

This study investigated the prevalence of flatfoot in children with delayed motor development and the relevant factors affecting it. In total, 121 preschool-aged children aged 3-6 with delayed motor development (male: 81; female: 40) were enrolled in the motor-developmentally delayed children group, and 4 times that number, a total of 484 children (male: 324; female: 160), of gender- and age-matched normal developmental children were used as a control group for further analyses. The age was from 3.0 to 6.9 years old for the participants. The judgment criterion of flatfoot was the Chippaux-Smirak index >62.70%, in footprint measurement. The results showed that the prevalence of flatfoot in children with motor developmental delay was higher than that in normal developmental children, approximately 58.7%, and that it decreased with age from 62.8% of 3-year-olds to 50.0% of 6-year-olds. The results also showed that motor-developmentally delayed children with flatfoot are at about 1.5 times the risk of normal developmental children (odds ratio=1.511, p=0.005). In addition, the prevalence of flatfoot is relatively higher in overweight children with delayed motor development, and that in obese children is even as high as 95.8% (23/24). Children with both excessive joint laxity and delayed development are more likely to suffer from flatfoot. The findings of this study can serve as a reference for clinical workers to deal with foot issues in children with delayed motor development.

Directional Effect on Post-Stroke Motor Overflow Characteristics

Motor overflow (MO) is an involuntary muscle activation associated with strenuous contralateral movement and may become manifested after stroke. The study was undertaken to investigate physiological correlation underlying atypical directional effect of joint movement on post-stroke MO in the affected upper limb. Thirty patients with unilateral post-stroke hemiparesis and fifteen age-matched healthy controls participated in this study. According to motor function assessed with the Fugl-Meyer arm scale, the patients were categorized into two groups of equal number with better (CVA_G; n = 15) or poorer motor functions (CVA_P; n = 15). Surface electromyography (EMG) was used to record irradiated muscle activation from eight muscles of the affected upper limb when the subjects performed maximal isometric contractions in different directions with the unaffected shoulder, elbow and wrist joints. The results showed that only MO amplitude of the CVA_G and the control groups was more sensitive to variations in direction of joint movement in the unaffected arm than the CVA_P group. The CVA_G group exhibited larger amplitudes of MO than the control analog, whereas this tendency was reversed for the CVA_P group. In terms of EMG polar plots, spatial representations of post-stroke MO were insensitive to direction of contralateral movement. The spatial representations of the CVA_G and CVA_P groups were predominated by potent flexion-abduction synergy, contrary to the typical extension adduction synergy seen in the control analog. In conclusion, post-stroke MO amplitude was subject to contralateral movement direction for healthy controls and stroke patients with better motor recovery. However, alterations in MO spatial pattern due to directional effect were not strictly related to the degree of motor deficits of the stroke victims.

Organization of physiological tremors and coordination solutions to postural pointing on an uneven stance surface

The study investigated the destabilization effect on multi-segment physiological tremors and coordinative control for a postural-suprapostural task under different stance conditions. Twenty volunteers executed postural pointing from a level surface and a seesaw balance board; meanwhile, physiological tremors of the whole postural system and fluctuation movements of fingertip/stance surface were recorded. In reference to level stance, seesaw stance led to much fewer tremor increments of the upper limb and less fluctuation movement of the fingertip than tremor increment of the lower limb and rolling movement of the stance surface. Tremor coupling between the adjacent segments organized differentially with stance surface. In reference to level stance, seesaw stance reinforced tremor coupling of the upper limb but enfeebled the coupling in the arm-lumbar and calf-foot complexes. Stance-related differences in physiological tremors could be explained by characteristic changes in the primary and secondary principal components (PC1 and PC2), with relatively high communality with segment tremors of the lower and upper limbs, respectively. Seesaw stance introduced a prominent 4-8Hz spectral peak in PC1 and potentiated 1-4Hz and 8-12Hz spectral peaks of PC2. Structural reorganization of physiological tremors with stance configuration suggests that seesaw stance involves distinct suprapostural and postural synergies for regulating degree of freedom in joint space.

Convergent validity and responsiveness of the EQ-5D utility weights for stroke survivors

OBJECTIVE This prospective study examined the convergent validity and responsiveness of the EuroQoL-5 Dimensions Health Questionnaire (EQ-5D) utility weights in stroke survivors at the subacute stage. METHODS Repeated assessments were conducted in rehabilitation wards of a medical centre. A study cohort was recruited from inpatients (n = 478). A total of 342 participants (71.5%) completed 2 assessments; 1 at ward admission and 1 before hospital discharge. Outcome measures, including the Barthel Index (BI), Patient Health Questionnaire (PHQ-9) and EQ-5D, were administered at ward admission and before hospital discharge. RESULTS The validity of the EQ-5D utility weights was assessed by comparison with the scores of the BI and PHQ-9. The absolute values of Pearson correlation coefficients ranged from 0.40 to 0.52 for the association of EQ-5D utility weights with BI scores and PHQ-9 scores at admission and before hospital discharge. The EQ-5D utility weights had a moderate effect size (0.76), moderate standardized response mean (0.74), and a significant difference (paired t-value = 13.7, p < 0.001) between baseline and follow-up in their ability to detect changes in the health status of stroke survivors staying in a rehabilitation ward. CONCLUSION This study supports the use of the EQ-5D utility weights as a valid and responsive instrument for performing cost-utility analyses of stroke survivors, including those with higher levels of dependence, at the subacute stage.

Reducing the time needed to administer a sustained attention test in patients with stroke

Administering a sustained attention test often takes a lengthy time, which can hamper routine assessments in clinical settings. Therefore, we first proposed a method to reduce the time needed for administering a sustained attention test (the Computerized Digit Vigilance Test, C-DVT). The method was to retrieve 5 segments from different trial positions of the original C-DVT testing. Then we compared the concurrent validity, convergent validity, and random measurement error of the examinees’ performance on these segments to find the segment with better psychometric properties. The 5 segments were as follows: the first 50% of testing, the 21st~50th percentile of testing, the first 60% of testing, the 31st~60th percentile of testing, and the 36th~65th percentile of testing. Then we compared the validities and random measurement error of the examinees’ performance on these segments. Ninety patients with stroke participated in the validity study, and 44 of them participated in the random measurement error study. The patients’ scores on the 5 segments were highly correlated with those of the C-DVT (Pearson’s r ≥ 0.98), indicating excellent concurrent validity. The patients’ scores on the 5 segments were moderately correlated with those of the Tablet-based Symbol Digit Modalities Test (Pearson’s r = -0.51~-0.48), indicating sufficient convergent validity. The amounts of random measurement error (percent standard error of measurement) were all limited: 5.1% for the C-DVT, 6.6% for the first 50% of testing, 6.0% for the 21st~50th percentile of testing, 6.1% for the first 60% of testing, 6.0% for the 31st~60th percentile of testing, and 6.1% for the 36th~65th percentile of testing. The patients needed on average 3~4 minutes to complete all the aforementioned testing. The patients’ scores on the 5 segments showed excellent concurrent validity, sufficient convergent validity, and limited amounts of random measurement error in patients with stroke. We suggest the 31st~60th percentile of testing segment for users because it had the lowest amount of random measurement error and can reduce the time needed for formal testing by about 40%.

Characterization of information-based learning benefits with submovement dynamics and muscular rhythmicity

For skill advancement, motor variability must be optimized based on target information during practice sessions. This study investigated structural changes in kinematic variability by characterizing submovement dynamics and muscular oscillations after practice with visuomotor tracking under different target conditions. Thirty-six participants were randomly assigned to one of three groups (simple, complex, and random). Each group practiced tracking visual targets with trajectories of varying complexity. The velocity trajectory of tracking was decomposed into 1) a primary contraction spectrally identical to the target rate and 2) an intermittent submovement profile. The learning benefits and submovement dynamics were conditional upon experimental manipulation of the target information. Only the simple and complex groups improved their skills with practice. The size of the submovements was most greatly reduced by practice with the least target information (simple > complex > random). Submovement complexity changed in parallel with learning benefits, with the most remarkable increase in practice under a moderate amount of target information (complex > simple > random). In the simple and complex protocols, skill improvements were associated with a significant decline in alpha (8–12 Hz) muscular oscillation but a potentiation of gamma (35–50 Hz) muscular oscillation. However, the random group showed no significant change in tracking skill or submovement dynamics, except that alpha muscular oscillation was reduced. In conclusion, submovement and gamma muscular oscillation are biological markers of learning benefits. Effective learning with an appropriate amount of target information reduces the size of submovements. In accordance with the challenge point hypothesis, changes in submovement complexity in response to target information had an inverted-U function, pertaining to an abundant trajectory-tuning strategy with target exactness.