Smoothness is a main characteristic of goal-directed human movements. The suitability of approaches quantifying movement smoothness is dependent on the analyzed signal's structure. Recently, activities of daily living (ADL) received strong interest in research on aging and neurorehabilitation. Such tasks have complex signal structures and kinematic parameters need to be adapted. In the present study we examined four different approaches to quantify movement smoothness in ADL. We tested the appropriateness of these approaches, namely the number of velocity peaks per meter (NoP), the spectral arc length (SAL), the speed metric (SM) and the log dimensionless jerk (LDJ), by comparing movement signals from eight healthy elderly (67.1a ± 7.1a) with eight healthy young (26.9a ± 2.1a) participants performing an activity of daily living (making a cup of tea). All approaches were able to identify group differences in smoothness (Cohen's d NoP = 2.53, SAL = 1.95, SM = 1.69, LDJ = 4.19), three revealed high to very high sensitivity (z-scores: NoP = 1.96 ± 0.55, SAL = 1.60 ± 0.64, SM = 3.41 ± 3.03, LDJ = 5.28 ± 1.52), three showed low within-group variance (NoP = 0.72, SAL = 0.60, SM = 0.11, LDJ = 0.71), two showed strong correlations between the first and the second half of the task execution (intra-trial R2s: NoP = 0.22 n.s., SAL = 0.33, SM = 0.36, LDJ = 0.91), and one was independent of other kinematic parameters (SM), while three showed strong models of multiple linear regression (R2s: NoP = 0.61, SAL = 0.48, LDJ = 0.70). Based on our results we make suggestion toward use examined smoothness measures. In total the log dimensionless jerk proved to be the most appropriate in ADL, as long as trial durations are controlled.
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 (p success = .250, p errors = .887). Patients revealed prolonged trial durations (Glass’ Δ = 1.475) when wearing the augmented reality headset. A model of multiple linear regression (R 2 adjusted = .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 .
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.
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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