Continuous and discontinuous drawing: high temporal variability exists only in discontinuous circling in young children

Development and Implementation of an End-Effector Upper Limb Rehabilitation Robot for Hemiplegic Patients with Line and Circle Tracking Training

Numerous robots have been widely used to deliver rehabilitative training for hemiplegic patients to improve their functional ability. Because of the complexity and diversity of upper limb motion, customization of training patterns is one key factor during upper limb rehabilitation training. Most of the current rehabilitation robots cannot intelligently provide adaptive training parameters, and they have not been widely used in clinical rehabilitation. This article proposes a new end-effector upper limb rehabilitation robot, which is a two-link robotic arm with two active degrees of freedom. This work investigated the kinematics and dynamics of the robot system, the control system, and the realization of different rehabilitation therapies. We also explored the influence of constraint in rehabilitation therapies on interaction force and muscle activation. The deviation of the trajectory of the end effector and the required trajectory was less than 1 mm during the tasks, which demonstrated the movement accuracy of the robot. Besides, results also demonstrated the constraint exerted by the robot provided benefits for hemiplegic patients by changing muscle activation in the way similar to the movement pattern of the healthy subjects, which indicated that the robot can improve the patient's functional ability by training the normal movement pattern.

Examining the relationship between motor assessments and handwriting consistency in children with and without probable developmental coordination disorder

Children with Developmental Coordination Disorder (DCD) often experience difficulties in handwriting. The current study examined the relationships between three motor assessments and the spatial and temporal consistency of handwriting. Twelve children with probable DCD and 29 children from 7 to 12 years who were typically developing wrote the lowercase letters "e" and "l" in cursive and printed forms repetitively on a digitizing tablet. Three behavioral assessments, including the Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI), the Minnesota Handwriting Assessment (MHA) and the Movement Assessment Battery for Children (MABC), were administered. Children with probable DCD had low scores on the VMI, MABC and MHA and showed high temporal, not spatial, variability in the letter-writing task. Their MABC scores related to temporal consistency in all handwriting conditions, and the Legibility scores in their MHA correlated with temporal consistency in cursive "e" and printed "l". It appears that children with probable DCD have prominent difficulties on the temporal aspect of handwriting. While the MHA is a good product-oriented assessment for measuring handwriting deficits, the MABC shows promise as a good assessment for capturing the temporal process of handwriting in children with DCD.

Developmental Characteristics in Cursive and Printed Letter-Writing for School-Age Children

The current study evaluated the developmental characteristics of printed and cursive letter writing in early school-age children. We predicted fewer age-related changes on spatial and temporal measures in cursive letter writing due to lower explicit timing demands compared with printed letter writing. Thirty children wrote the letters e and l in cursive and printed forms repetitively. For printed letters, significant age effects were seen in temporal consistency, whereas cursive letters showed age-related improvement in spatial consistency. Children tended to have higher consistency for printed handwriting than they did for cursive writing. Because of an overall advantage for printed handwriting, the explicit timing hypothesis was not fully supported. We argue that experiential factors influence the development of handwriting.

Statistical persistence and timing characteristics of repetitive circle drawing in children with ASD

OBJECTIVE

Standardized tests to assess movement difficulties in autism spectrum disorder (ASD) evaluate motor output, but do not provide information about underlying dynamics. The objective of this research is to study the statistical persistence and temporal dynamics of a circle drawing task in children with ASD.

METHODS

For this study 15 children diagnosed with ASD, aged 4-8 years, were asked to draw circles under various conditions using a computerized tablet. We then assessed fractal dynamics and global temporal dynamics (mean and coefficient of variation) and compared these quantities to those of typically developing (TD) controls.

RESULTS

No difference in statistical persistence was found between children with ASD and TD children. Temporal measures showed increased variability in the ASD population in the discontinuous task.

CONCLUSION

Results support the hypothesis that children with ASD have an intact ability to consistently produce continuous movements, but increased variability in production of discontinuous movements.

Development of multisensory reweighting is impaired for quiet stance control in children with developmental coordination disorder (DCD)

Background

Developmental Coordination Disorder (DCD) is a leading movement disorder in children that commonly involves poor postural control. Multisensory integration deficit, especially the inability to adaptively reweight to changing sensory conditions, has been proposed as a possible mechanism but with insufficient characterization. Empirical quantification of reweighting significantly advances our understanding of its developmental onset and improves the characterization of its difference in children with DCD compared to their typically developing (TD) peers.

Methodology/Principal Findings

Twenty children with DCD (6.6 to 11.8 years) were tested with a protocol in which visual scene and touch bar simultaneously oscillateded medio-laterally at different frequencies and various amplitudes. Their data were compared to data on TD children (4.2 to 10.8 years) from a previous study. Gains and phases were calculated for medio-lateral responses of the head and center of mass to both sensory stimuli. Gains and phases were simultaneously fitted by linear functions of age for each amplitude condition, segment, modality and group. Fitted gains and phases at two comparison ages (6.6 and 10.8 years) were tested for reweighting within each group and for group differences. Children with DCD reweight touch and vision at a later age (10.8 years) than their TD peers (4.2 years). Children with DCD demonstrate a weak visual reweighting, no advanced multisensory fusion and phase lags larger than those of TD children in response to both touch and vision.

Conclusions/Significance

Two developmental perspectives, postural body scheme and dorsal stream development, are provided to explain the weak vision reweighting. The lack of multisensory fusion supports the notion that optimal multisensory integration is a slow developmental process and is vulnerable in children with DCD.

Handwriting: hand-pen contact force synergies in circle drawing tasks

This study investigated synergistic actions of hand-pen contact forces during circle drawing tasks in three-dimensional (3D) space. Twenty-four right-handed participants drew thirty concentric circles in the counterclockwise (CCW) and clockwise (CW) directions. Three-dimensional forces acting on an instrumented pen as well as 3D linear and angular positions of the pen were recorded. These contact forces were then transformed into the 3D radial, tangential, and normal force components specific to circle drawing. Uncontrolled manifold (UCM) analysis was employed to calculate the magnitude of the hand-pen contact force synergy. Three hypotheses were tested. First, hand-pen contact force synergies during circle drawing are dependent on the angular position of the pen tip. Second, hand-pen contact force synergies are dependent on force components in circle drawing. Third, hand-pen contact force synergies are greater in CCW direction than CW direction. The results showed that the strength of the hand-pen contact force synergy increased during the initial phase of circle drawing and decreased during the final phase. The synergy strength was greater for the radial and tangential components as compared to the normal component. Also, the circle drawing in CW direction was associated with greater hand-pen contact force synergy than the CCW direction. The results of this study suggest that the central nervous system (CNS) prioritizes hand-pen contact force synergies for the force components (i.e., radial and tangential) that are critical for circle drawing. The CNS modulates hand-pen contact force synergies for preparation and conclusion of circle drawing, respectively.