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Montreal Cognitive Assessment of cognitive dysfunction after basal ganglia stroke. Acta Neurol Belg 2022; 122:881-884. [PMID: 35624396 PMCID: PMC9300492 DOI: 10.1007/s13760-022-01967-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 04/25/2022] [Indexed: 11/09/2022]
Abstract
Objective The Montreal Cognitive Assessment (MoCA) was used to evaluate cognitive dysfunction after basal ganglia stroke, and factors affecting total MoCA score were examined. Methods Data were retrospectively analyzed for 30 patients with basal ganglia intracerebral hemorrhage or basal ganglia cerebral infarction, who were admitted to The Second Affiliated Hospital of Fujian Traditional Medical University (Fujian, China) from January 2017 to March 2020. Cognitive impairment was assessed using the MoCA, and potential correlations were explored between clinicodemographic characteristics (sex, age, stroke location and etiology) and MoCA dimensions or total MoCA score. Results Univariate linear regression showed that the total MoCA score was significantly associated with sex, age, executive function, naming, attention, abstract generalization ability, memory ability, and visuospatial orientation. However, multivariate linear regression identified only executive function, naming, attention, memory ability, and visuospatial orientation as significantly associated with the total MoCA score. Conclusions We showed that the MoCA test can be used for patients with basal ganglia stroke. The total MoCA score of basal ganglia stroke was significantly associated with impairments in executive function, naming, attention, memory ability, and visuospatial orientation.
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2
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Schmidle S, Gulde P, Herdegen S, Böhme GE, Hermsdörfer J. Kinematic analysis of activities of daily living performance in frail elderly. BMC Geriatr 2022; 22:244. [PMID: 35321645 PMCID: PMC8943928 DOI: 10.1186/s12877-022-02902-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 03/04/2022] [Indexed: 11/20/2022] Open
Abstract
Background Frailty is accompanied by limitations of activities of daily living (ADL) and frequently associated with reduced quality of life, institutionalization, and higher health care costs. Despite the importance of ADL performance for the consequence of frailty, movement analyses based on kinematic markers during the performance of complex upper extremity-based manual ADL tasks in frail elderly is still pending. The main objective of this study was to evaluate if ADL task performance of two different tasks in frail elderlies can be assessed by an activity measurement based on an acceleration sensor integrated into a smartwatch, and further to what degree kinematic parameters would be task independent. Methods ADL data was obtained from twenty-seven elderly participants (mean age 81.6 ± 7.0 years) who performed two ADL tasks. Acceleration data of the dominant hand was collected using a smartwatch. Participants were split up in three groups, F (frail, n = 6), P (pre-frail, n = 13) and R (robust, n = 8) according to a frailty screening. A variety of kinematic measures were calculated from the vector product reflecting activity, agility, smoothness, energy, and intensity. Results Measures of agility, smoothness, and intensity revealed significant differences between the groups (effect sizes combined over tasks η2p = 0.18 – 0.26). Smoothness was particularly affected by frailty in the tea making task, while activity, agility, a different smoothness parameter and two intensity measures were related to frailty in the gardening task. Four of nine parameters revealed good reliability over both tasks (r = 0.44 – 0.69). Multiple linear regression for the data combined across tasks showed that only the variability of the magnitude of acceleration peaks (agility) contributed to the prediction of the frailty score (R2 = 0.25). Conclusion The results demonstrate that ADL task performance can be assessed by smartwatch-based measures and further shows task-independent differences between the three levels of frailty. From the pattern of impaired and preserved performance parameters across the tested tasks, we concluded that in persons with frailty ADL performance was more impaired by physiological deficiencies, i.e., physical power and endurance, than by cognitive functioning or sensorimotor control.
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Affiliation(s)
- Stephanie Schmidle
- Human Movement Science, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.
| | - Philipp Gulde
- Human Movement Science, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.,Center for Clinical Neuroplasticity Medical Park Loipl, Bischofswiesen, Germany
| | - Sophie Herdegen
- Human Movement Science, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Georg-Eike Böhme
- Lehelmed GmbH General Practitioners Lehel and Medical Center Motorworld, Munich, Germany
| | - Joachim Hermsdörfer
- Human Movement Science, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
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3
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Williams LJ, Kernot J, Hillier SL, Loetscher T. Spatial Neglect Subtypes, Definitions and Assessment Tools: A Scoping Review. Front Neurol 2021; 12:742365. [PMID: 34899565 PMCID: PMC8653914 DOI: 10.3389/fneur.2021.742365] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/14/2021] [Indexed: 12/03/2022] Open
Abstract
Objective: The objective of this scoping review was to capture the reported definitions for the subtypes of neglect post stroke and map the range of assessment tools employed for each neglect subtype. Methods: EMBASE, Emcare, Medline, and psychINFO were searched from database inception. Searching included all allied terms and mesh headings for stroke, spatial neglect, measurement, screening tools, psychometric properties. Two reviewers independently screened studies for inclusion. Primary studies with documented protocols of a spatial neglect tool for adults post stroke, with some aspect of validity or reliability were included. Two reviewers independently reviewed the documented protocols of each tool to determine the underlying subtypes and disagreements were resolved through discussion. Results: There were 371 articles included with 292 tools used for the screening or diagnosis of neglect. The majority of studies (67%) included a tool that did not specify the neglect subtype being assessed, therefore an analysis of the underlying subtypes for each tool is presented. Conclusions: There is no consistency with the terms used to refer to the syndrome of spatial neglect with over 200 different terms used within the included studies to refer to the syndrome as a whole or one of its subtypes. It is essential to unify the terminology and definition for each neglect subtype. There are hundreds of neglect tools available, however many are not able to differentiate presenting subtypes. It is important for clinicians and researchers to critically evaluate the neglect tools being used for the screening and diagnosis of neglect.
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Affiliation(s)
- Lindy J Williams
- Cognitive Aging and Impairment Neurosciences Lab, University of South Australia, Adelaide, SA, Australia.,Innovation IMPlementation and Clinical Translation (IIMPACT) in Health, University of South Australia, Adelaide, SA, Australia.,Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Jocelyn Kernot
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Susan L Hillier
- Innovation IMPlementation and Clinical Translation (IIMPACT) in Health, University of South Australia, Adelaide, SA, Australia.,Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Tobias Loetscher
- Cognitive Aging and Impairment Neurosciences Lab, University of South Australia, Adelaide, SA, Australia.,Justice and Society, University of South Australia, Adelaide, SA, Australia
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4
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Stiekema APM, Resch C, Donkervoort M, Jansen N, Jurrius KHM, Zadoks JM, van Heugten CM. Case management after acquired brain injury compared to care as usual: study protocol for a 2-year pragmatic randomized controlled superiority trial with two parallel groups. Trials 2020; 21:928. [PMID: 33203462 PMCID: PMC7672813 DOI: 10.1186/s13063-020-04804-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 10/12/2020] [Indexed: 12/19/2022] Open
Abstract
Background People with acquired brain injury may suffer from cognitive, emotional and behavioural changes in the long term. Continuity of care is often lacking, leading to a variety of unmet needs and hindering psychosocial functioning from the occurrence of brain injury up to years thereafter. Case management aims to prevent (escalation of) problems and to facilitate timely access to appropriate services. In other populations, case management has shown to improve psychosocial well-being. In this study, we aim to evaluate the feasibility of case management after acquired brain injury and its effectiveness and cost-effectiveness, compared to care as usual. Methods This is a pragmatic randomized controlled superiority trial with two parallel groups and repeated measures in adults with ABI and their family, taking place between November 2019 and December 2021 in three provinces in the Netherlands. Participants will be randomly allocated to either the case management group, receiving case management from hospital discharge up to 2 years thereafter, or the control group, receiving care as usual. Effectiveness will be evaluated every 6 months for 18–24 months by patient-reported psychosocial well-being (Hospital Anxiety and Depression Scale (HADS), Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P) restriction subscale and the Life Satisfaction Questionnaire (LiSat)), self-management (Patient Activation Measure (PAM)) and care needs (Longer-term Unmet Needs after Stroke (LUNS)). Family outcomes include self-efficacy (Carer Self-Efficacy Scale (CSES)), caregiver burden (Caregiver Strain Index (CSI)), psychosocial well-being (LiSat, HADS), family needs (Family Needs Questionnaire (FNQ)). Feasibility will be evaluated using qualitative methods, assessing fidelity, dose delivered, dose received, reach, recruitment and context. Cost-effectiveness will be determined by the EQ-5D-3L and service use. Discussion At the moment, there is no integrated health care service for people with acquired brain injury and their family members in the long term. If case management is shown to be feasible and (cost)-effective, it could bridge the gap between patients’ and families’ needs and the available services. Trial registration Netherlands Trial Register NL8104. Registered on 22 October 2019.
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Affiliation(s)
- Annemarie P M Stiekema
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Limburg Brain Injury Center, Maastricht University, Maastricht, The Netherlands
| | - Christine Resch
- Limburg Brain Injury Center, Maastricht University, Maastricht, The Netherlands.,Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Mireille Donkervoort
- Health Care and Social Work Division, Windesheim University of Applied Sciences, Almere, The Netherlands
| | - Natska Jansen
- Mevrouw Slimmer Werken Social Innovation in Health Care and Well-Being, Drogteropslagen, Netherlands.,Brain Injury Team, Overijssel, Netherlands
| | - Kitty H M Jurrius
- Health Care and Social Work Division, Windesheim University of Applied Sciences, Almere, The Netherlands
| | - Judith M Zadoks
- In-Tussen Foundation, Utrecht, the Netherlands.,BreinDok Innovation in Care, Utrecht, the Netherlands
| | - Caroline M van Heugten
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands. .,Limburg Brain Injury Center, Maastricht University, Maastricht, The Netherlands. .,Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands.
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5
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Alamer A, Getie K, Melese H, Mazea H. Effectiveness of Body Awareness Therapy in Stroke Survivors: A Systematic Review of Randomized Controlled Trials . OPEN ACCESS JOURNAL OF CLINICAL TRIALS 2020. [DOI: 10.2147/oajct.s260476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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6
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Bosma MS, Nijboer TCW, Caljouw MAA, Achterberg WP. Impact of visuospatial neglect post-stroke on daily activities, participation and informal caregiver burden: A systematic review. Ann Phys Rehabil Med 2019; 63:344-358. [PMID: 31200080 DOI: 10.1016/j.rehab.2019.05.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/25/2019] [Accepted: 05/08/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Visuospatial neglect (VSN) is a common cognitive disorder after stroke. The primary aim of this systematic review was to provide an overview of the impact of VSN in 3 aspects: (1) activities of daily living (ADL), (2) participation, and (3) caregiver burden. The second aim was to investigate the differences in studies focusing on populations with mean age<65 versus≥65 years. METHODS PubMed, EMBASE, Web of Science, Cochrane Library, Emcare, PsychINFO, Academic Search Premier and CENTRAL were searched systematically. Quality was assessed with the Mixed Methods Appraisal Tool. RESULTS Of the 115 included studies, 104 provided outcomes on ADL, 15 on participation (4 studies with mean age≥65), and 2 on caregiver burden (1 study with mean age≥65). Quality assessment yielded scores ranging from 0 to 100%. VSN had a negative impact on ADL (i.e., independence during ADL and performance in self-care, household tasks, reading, writing, walking, wheelchair navigation) and participation (i.e., driving, community mobility, orientation, work). The impact of VSN on fulfilling social roles was unclear. VSN had a negative effect on caregiver burden. We found no clear age-related differences. CONCLUSIONS AND IMPLICATIONS VSN has a negative impact not only on patients' independence but particularly on the performance of ADL. Despite the far fewer studies of VSN as compared with ADL, VSN also seems to hamper participation and increase caregiver burden, but further research is needed. Because of the large impact, VSN should be systematically and carefully assessed during rehabilitation. A considerable number of different instruments were used to diagnose VSN. Diagnosing VSN at more than one level [function (i.e., pen-and-paper test), activities, and participation] is strongly recommended. Consensus is needed on how to assess VSN and its negative impact for research and rehabilitation practice. SYSTEMATIC REVIEW REGISTRATION NO PROSPERPO Registration No. CRD42018087483.
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Affiliation(s)
- Martine S Bosma
- Department of public health and primary care, Leiden university medical center, Post zone V0-P, P.O. Box 9600, 2300 RC, Leiden, The Netherlands; Zorggroep Florence, Laan van Vredenoord 1, 2289 DA, Rijswijk, The Netherlands.
| | - Tanja C W Nijboer
- Center of excellence for rehabilitation medicine, UMC Utrecht brain center, university medical center Utrecht, and De Hoogstraat rehabilitation, Utrecht, The Netherlands; Utrecht university, department of experimental psychology, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands
| | - Monique A A Caljouw
- Department of public health and primary care, Leiden university medical center, Post zone V0-P, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - Wilco P Achterberg
- Department of public health and primary care, Leiden university medical center, Post zone V0-P, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
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Rohrbach N, Gulde P, Armstrong AR, Hartig L, Abdelrazeq A, Schröder S, Neuse J, Grimmer T, Diehl-Schmid J, Hermsdörfer J. An augmented reality approach for ADL support in Alzheimer's disease: a crossover trial. J Neuroeng Rehabil 2019; 16:66. [PMID: 31159816 PMCID: PMC6547460 DOI: 10.1186/s12984-019-0530-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 04/30/2019] [Indexed: 11/13/2022] Open
Abstract
Background Dementia of the Alzheimer’s type can impair the performance of activities of daily living and therefore severely impact independent living. Assistive technologies can support such patients when carrying out daily tasks. Methods In this crossover study, we used an augmented reality approach using a Microsoft HoloLens to support patients in a tea making task. During task execution, subjects received three-dimensional dynamic holograms of the sub-steps necessary to complete the task. Ten patients suffering from Alzheimer’s disease were tested and post-hoc semi-structured interviews were conducted to assess usability. Results The patients committed errors when executing the task with and without holographic assistance. No differences in success rates or error frequencies were observed (psuccess = .250, perrors = .887). Patients revealed prolonged trial durations (Glass’ Δ = 1.475) when wearing the augmented reality headset. A model of multiple linear regression (R2adjusted = .958) revealed an influence of the errors in the control condition and a moderation by the errors in the experimental condition. Patients with more severe problems in the natural performance of the task showed lower increases in trial durations when wearing the HoloLens. Conclusions We assume that the application was a secondary task requesting its own resources and impairing performance on its own. The regression suggests however that the given assistance was compensating these additional costs in patients with stronger needs of support. Interview data on usability revealed an overall positive feedback towards the application although the hardware was considered uncomfortable and too large. We conclude that the approach proved feasible and the acceptability was overall high, although advances in hardware and the patient-interface are necessary to assist patients suffering from Alzheimer’s disease in daily activities. Trial registration DRKS, DRKS00014870. Registered 11 June 2018 - Retrospectively registered, TrialID = DRKS00014870.
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Affiliation(s)
- Nina Rohrbach
- Chair of Human Movement Science, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.
| | - Philipp Gulde
- Chair of Human Movement Science, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Alan Robert Armstrong
- Chair of Human Movement Science, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Linda Hartig
- Chair of Human Movement Science, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Anas Abdelrazeq
- Cybernetics Lab IMA & IfU in Aachen, RWTH Aachen University, Aachen, Germany
| | - Stefan Schröder
- Cybernetics Lab IMA & IfU in Aachen, RWTH Aachen University, Aachen, Germany
| | - Johanne Neuse
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Joachim Hermsdörfer
- Chair of Human Movement Science, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
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8
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Mochizuki-Kawai H, Kotani I, Mochizuki S, Yamakawa Y. Structured Floral Arrangement Program Benefits in Patients With Neurocognitive Disorder. Front Psychol 2018; 9:1328. [PMID: 30123151 PMCID: PMC6085549 DOI: 10.3389/fpsyg.2018.01328] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 07/10/2018] [Indexed: 01/18/2023] Open
Abstract
We attempted to clarify positive benefits in cognitive abilities and motivation during our cognitive intervention [structured floral arrangement (SFA) program] for patients with neurocognitive disorder due to stroke, traumatic brain injury (TBI), and other related disorders. In this SFA program, participants are required to arrange cut flowers and leaves on absorbent foam according to an instruction sheet. In a previous study of patients with schizophrenia, our SFA program encouraged participants and contributed to stimulating their visuospatial process and memory. Here, 27 patients with neurocognitive disorders participated in this study. Sixteen patients were assigned to an SFA-treated group and participated in six sessions during two phases plus to daily activities. Eleven non-treated patients engaged only daily activities during the same period. We compared Apathy Scale scores and neuropsychological scores between the SFA-treated and non-treated patients. Their mean attendance rate was more than 90% during the two phases. SFA-treated patients copied a Rey–Osterrieth complex figure more accurately than non-treated patients (p < 0.05) during the later intervention phase, whereas during the earlier phase, accuracy was comparable between treated and non-treated groups. In the SFA-treated group, recall scores also improved (p < 0.01), and the positive outcomes were maintained for about 3 months (p < 0.05). The Apathy Scale scores did not show significant change in either the SFA-treated or non-treated groups. Our present results suggest that the SFA program encouraged continuous participation to cognitive intervention and was useful for ameliorating dysfunctions in visuospatial memory and recognition in patients with neurocognitive disorder.
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Affiliation(s)
- Hiroko Mochizuki-Kawai
- Institute of Vegetable and Floriculture Science, National Agriculture and Food Research Organization, Tsukuba, Japan
| | - Izumi Kotani
- Graduate School of Humanities and Social Sciences, University of Tsukuba, Tsukuba, Japan
| | | | - Yuriko Yamakawa
- Ibaraki Prefectural University of Health Sciences Hospital, Ami, Japan
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9
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Gulde P, Leippold K, Kohl S, Grimmer T, Diehl-Schmid J, Armstrong A, Hermsdörfer J. Step by Step: Kinematics of the Reciprocal Trail Making Task Predict Slowness of Activities of Daily Living Performance in Alzheimer's Disease. Front Neurol 2018; 9:140. [PMID: 29593639 PMCID: PMC5861153 DOI: 10.3389/fneur.2018.00140] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 02/26/2018] [Indexed: 11/25/2022] Open
Abstract
Dementia impairs the ability to perform everyday activities. Reduced motor capacity and executive functions as well as loss of memory function and forms of apraxia and action disorganization syndrome can be reasons for such impairments. In this study, an analysis of the hand trajectories during the sequential movements in an adapted version of the trail making task, the reciprocal trail making task (RTMT), was used to predict performance in activities of daily living (ADL) of patients suffering from mild cognitive impairment and dementia. 1 patient with dementia of the Alzheimer’s type and 15 healthy, age-matched adults were tested in the standardized ADL of tea making and document filing. The characteristics of the kinematic performance in the RTMT were assessed, and models of multiple linear regression were computed to predict the durations of the ADL. Patients showed increased trial durations (TDs) in the ADL (Cohen’s d: tea making 1.64, document filing 1.25). Parameters and explained variability differed across patients and control as well as between different activities. The models for the patient sample were stronger and particularly high for the document filing task for which kinematics explained 71% of the variance (Radjusted2: tea making 0.62, document filing 0.71; both tasks combined patients 0.55, controls 0.25). The most relevant factors for the models were the TD and a parameter characterizing movement fluency and variability (“movement harmonicity”) in the RTMT. The models of multiple linear regression suggested that the patients’ activity of daily living performance was limited by cognitive demands, namely, identifying the varying targets during sequencing and the healthy controls’ performance by their motor capacity. Such models could be used to estimate the severity of ADL impairments in patients.
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Affiliation(s)
- Philipp Gulde
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Katharina Leippold
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Sarah Kohl
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Alan Armstrong
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Joachim Hermsdörfer
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
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10
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Curreri C, Trevisan C, Carrer P, Facchini S, Giantin V, Maggi S, Noale M, De Rui M, Perissinotto E, Zambon S, Crepaldi G, Manzato E, Sergi G. Difficulties with Fine Motor Skills and Cognitive Impairment in an Elderly Population: The Progetto Veneto Anziani. J Am Geriatr Soc 2018; 66:350-356. [DOI: 10.1111/jgs.15209] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Chiara Curreri
- Department of Medicine; Geriatrics Division; University of Padova; Padova Italy
| | - Caterina Trevisan
- Department of Medicine; Geriatrics Division; University of Padova; Padova Italy
| | - Pamela Carrer
- Department of Medicine; Geriatrics Division; University of Padova; Padova Italy
| | - Silvia Facchini
- Department of Medicine; Geriatrics Division; University of Padova; Padova Italy
| | - Valter Giantin
- Department of Medicine; Geriatrics Division; University of Padova; Padova Italy
| | - Stefania Maggi
- National Research Council; Neuroscience Institute; Padova Italy
| | - Marianna Noale
- National Research Council; Neuroscience Institute; Padova Italy
| | - Marina De Rui
- Department of Medicine; Geriatrics Division; University of Padova; Padova Italy
| | - Egle Perissinotto
- Department of Cardiac; Thoracic and Vascular Sciences; University of Padova; Padova Italy
- Epidemiology and Public Health Unit; Department of Biostatistics; University of Padova; Padova Italy
| | - Sabina Zambon
- National Research Council; Neuroscience Institute; Padova Italy
- Department of Medicine; Clinica Medica I; University of Padova; Padova Italy
| | | | - Enzo Manzato
- Department of Medicine; Geriatrics Division; University of Padova; Padova Italy
- National Research Council; Neuroscience Institute; Padova Italy
| | - Giuseppe Sergi
- Department of Medicine; Geriatrics Division; University of Padova; Padova Italy
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11
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Buchmann I, Randerath J. Selection and application of familiar and novel tools in patients with left and right hemispheric stroke: Psychometrics and normative data. Cortex 2017; 94:49-62. [DOI: 10.1016/j.cortex.2017.06.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 05/27/2017] [Accepted: 06/01/2017] [Indexed: 10/19/2022]
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12
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Gulde P, Hermsdörfer J. Both hands at work: the effect of aging on upper-limb kinematics in a multi-step activity of daily living. Exp Brain Res 2017; 235:1337-1348. [PMID: 28210758 DOI: 10.1007/s00221-017-4897-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 01/28/2017] [Indexed: 01/23/2023]
Abstract
The kinematic performance of basic motor tasks shows a clear decrease with advancing age. This study examined if the rules known from such tasks can be generalized to activities of daily living. We examined the end-effector kinematics of 13 young and 13 elderly participants in the multi-step activity of daily living of tea-making. Furthermore, we analyzed bimanual behavior and hand dominance in the task using different conditions of execution. The elderly sample took substantially longer to complete the activity (almost 50%) with longer trajectories compared with the young sample. Models of multiple linear regression revealed that the longer trajectories prolonged the trial duration in both groups, and while movement speed influenced the trial duration of young participants, phases of inactivity negatively affected how long the activity took the elderly subjects. No differences were found regarding bimanual performance or hand dominance. We assume that in self-paced activities of daily living, the age-dependent differences in the kinematics are more likely to be based on the higher cognitive demands of the task rather than on pure motor capability. Furthermore, it seems that not all of the rules known from basic motor tasks can be generalized to activities of daily living.
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Affiliation(s)
- Philipp Gulde
- Department of Sport and Health Sciences, Institute of Movement Science, Technical University of Munich, Georg-Brauchle-Ring 60/62, Munich, Germany.
| | - Joachim Hermsdörfer
- Department of Sport and Health Sciences, Institute of Movement Science, Technical University of Munich, Georg-Brauchle-Ring 60/62, Munich, Germany
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13
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Gulde P, Hughes CML, Hermsdörfer J. Effects of Stroke on Ipsilesional End-Effector Kinematics in a Multi-Step Activity of Daily Living. Front Hum Neurosci 2017; 11:42. [PMID: 28223927 PMCID: PMC5293874 DOI: 10.3389/fnhum.2017.00042] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 01/19/2017] [Indexed: 11/13/2022] Open
Abstract
Background: Stroke frequently impairs activities of daily living (ADL) and deteriorates the function of the contra- as well as the ipsilesional limbs. In order to analyze alterations of higher motor control unaffected by paresis or sensory loss, the kinematics of ipsilesional upper limb movements in patients with stroke has previously been analyzed during prehensile movements and simple tool use actions. By contrast, motion recording of multi-step ADL is rare and patient-control comparisons for movement kinematics are largely lacking. Especially in clinical research, objective quantification of complex externally valid tasks can improve the assessment of neurological impairments. Methods: In this preliminary study we employed three-dimensional motion recording and applied kinematic analysis in a multi-step ADL (tea-making). The trials were examined with respect to errors and sub-action structure, durations, path lengths (PLs), peak velocities, relative activity (RA) and smoothness. In order to check for specific burdens the sub-actions of the task were extracted and compared. To examine the feasibility of the approach, we determined the behavioral and kinematic metrics of the (ipsilesional) unimanual performance of seven chronic stroke patients (64a ± 11a, 3 with right/4 with left brain damage (LBD), 2 with signs of apraxia, variable severity of paresis) and compared the results with data of 14 neurologically healthy age-matched control participants (70a ± 7a). Results: T-tests revealed that while the quantity and structure of sub-actions of the task were similar. The analysis of end-effector kinematics was able to detect clear group differences in the associated parameters. Specifically, trial duration (TD) was increased (Cohen's d = 1.77); the RA (Cohen's d = 1.72) and the parameters of peak velocities (Cohen's d = 1.49/1.97) were decreased in the patient group. Analysis of the task's sub-actions repeated measures analysis of variance (rmANOVA) revealed no impact of the different demands of the sub-actions on the relative performance of the patient group. Conclusion: The analyses revealed kinematic peculiarities in the performance with the ipsilesional hand. These deficits apparently arose from the cognitive demands like sequencing rather than motor constraints. End-effector kinematics proved as a sensitive method to detect and quantify aspects of disturbed multi-step ADL performance after stroke. If standardized, the examination and the analysis are quick and deliver objective data supporting clinical research.
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Affiliation(s)
- Philipp Gulde
- Institute of Movement Science, Department of Sport and Health Sciences, Technical University of Munich Munich, Germany
| | | | - Joachim Hermsdörfer
- Institute of Movement Science, Department of Sport and Health Sciences, Technical University of Munich Munich, Germany
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Bieńkiewicz MMN, Brandi M, Hughes C, Voitl A, Hermsdörfer J. The complexity of the relationship between neuropsychological deficits and impairment in everyday tasks after stroke. Brain Behav 2015; 5:e00371. [PMID: 26516606 PMCID: PMC4614052 DOI: 10.1002/brb3.371] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 06/17/2015] [Accepted: 07/19/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND PURPOSE A large body of research reports that stroke patients are debilitated in terms of daily independence after dismissal from the hospital unit. Patients struggle with the use of daily objects or performing complex actions. Differences between individual deficits of patients are often associated with the site of the brain damage. However, clinical studies suggest that patients exhibit varied constellations of action-associated difficulties and neuropsychological deficits. There is a lack of conclusive evidence indicating how different neuropsychological symptoms link to the impaired ability to perform activities of daily living (ADL). MATERIALS AND METHODS To further address this matter, in this study we compared the behavior of patients with left brain damage (LBD) and right brain damage (RBD) following stroke in two naturalistic task scenarios (tea making and document filing), and compared the committed action errors to the neuropsychological screening results. RESULTS We observed mild to severe impairments in both the LBD and RBD groups amounting to 37-55% of failure rate in attainment of action goal. Interestingly, the performance on both tasks was not correlated to each other, suggesting that the tasks involved a different set of higher cognitive functions. Despite similar behavioral manifestations, in the LBD group poor task performance was related to deficits in praxis performance and unilateral tactile and visual extinction. The presence of aphasia did not correlate with task performance, except for a link between low scores in Aachen aphasia test scales and misestimation error in the tea making task. In the RBD group, difficulties with performance were primarily linked to deficit in praxis and unilateral visual extinction. CONCLUSIONS Despite similar behavior, the underlying mechanisms of the deficits after stroke might be different (in patients with LBD and RBD) and reveal complex interlinks of cognitive networks involved in the ability to carry on everyday tasks.
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Affiliation(s)
- Marta M. N. Bieńkiewicz
- Department of Sport and Health SciencesInstitute of Human Movement ScienceTechnische Universität MünchenMünchenGermany
| | - Marie‐Luise Brandi
- Department of Sport and Health SciencesInstitute of Human Movement ScienceTechnische Universität MünchenMünchenGermany
- Graduate School of Systemic NeurosciencesLudwig‐Maximilians‐Universität MünchenPlanegg‐MartinsriedGermany
| | - Charmayne Hughes
- Department of Sport and Health SciencesInstitute of Human Movement ScienceTechnische Universität MünchenMünchenGermany
| | - Anna Voitl
- Department of Sport and Health SciencesInstitute of Human Movement ScienceTechnische Universität MünchenMünchenGermany
| | - Joachim Hermsdörfer
- Department of Sport and Health SciencesInstitute of Human Movement ScienceTechnische Universität MünchenMünchenGermany
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