Biomedical subjects

D G Kamper

Publications and source records attributed to D G Kamper.

11 recordsLinked to original sources

PubMed2006

Kinematics of point-to-point finger movements.

The goal of this study was to examine the characteristics of planar fingertip movements with respect to the hand. Ten subjects with no known neuromuscular impairments performed a series of point-to-point movements with their dominant index fingertips. Subjects were instructed to move between five pairs of targets within the workspace of the index finger in each direction, for a total of ten separate movement tasks. We hypothesized that the trajectories with respect to the hand of these movements would exhibit curved paths contrary to the findings of similar hand path studies. The ratio of the path taken to the straight-line distance between the two targets was dependent upon the movement task (P < 0.01), as was the mean residual between the actual and straight-line paths (P < 0.001). For selected pairs of targets, these values were significantly different for the two opposing movement directions between a given pair of targets. This directional dependence of the curvature of the chosen finger-only trajectory observed in the initial protocol is incompatible with motor planning based solely on kinematic constraints, instead mechanical properties of the finger are likely incorporated.

Adult↗

PubMed2005

Kinetic and kinematic workspaces of the index finger following stroke.

The objective of this study was to explore motor impairment of the index finger following stroke. More specifically, the kinetics and kinematics of the index finger were analysed throughout its workspace. Twenty-four stroke survivors with chronic hemiparesis of the hand participated in the trials, along with six age-matched controls. Hand impairment was classified according to the clinical Chedoke-McMaster Stage of Hand scale. Subjects were instructed to generate fingertip force in six orthogonal directions at five different positions within the workspace. Split-plot analysis of variance revealed that clinical impairment level had a significant effect on measured force (P < 0.001), with the weakness in stroke survivors being directionally dependent (P < 0.01). Electromyographic recordings revealed altered muscle activation patterns in the more impaired subjects. Unlike the control subjects, these subjects exhibited peak muscle excitation of flexor digitorum superficialis, extensor digitorum communis and first dorsal interosseous during the generation of fingertip flexion forces. Subjects also attempted to reach locations scattered throughout the theoretical workspace of the index finger. Quantification of the active kinematic workspace demonstrated a relationship between impairment level and the percentage of the theoretical workspace that could be attained (P < 0.001). The stroke survivors exhibited a high correlation between mean force production and active workspace (R = 0.90). Thus, our data suggest that altered muscle activation patterns contribute to directionally dependent weakness following stroke. Both the modulation of muscle excitation with force direction and the independence of muscle activation seem to be reduced. These alterations translate into a significantly reduced active range of motion for the fingers.

Adult↗

PubMed2003

Stereotypical fingertip trajectories during grasp.

The kinematics of movement of all five digits was analyzed during reach-and-grasp tasks for a variety of objects. Ten healthy subjects performed 20 trials involving the grasp of five objects of distinct size and shape. Joint angles were recorded, and digit trajectories were computed using forward kinematics. For a given subject, fingertip trajectories were consistent across trials. The different-sized objects largely produced movement along different portions of a stereotypical trajectory described by a logarithmic spiral. The spirals fit the actual finger positions with a mean error across all trials of 0.23 +/- 0.25 cm and accounted for over 98% of the variance in finger position. These patterns were consistent independent of initial finger posture. Subjects did not produce straight-line movements, either in Cartesian space or joint space. The direction of the thumb trajectories exhibited a greater dependence on object type than the finger trajectories, but still utilized a small percentage (<5%) of the available workspace. These results suggest that restoration of a small but specific part of the workspace could have significant impact on function following hand impairment.

Adult↗

PubMed2003

Relative contributions of neural mechanisms versus muscle mechanics in promoting finger extension deficits following stroke.

The origins of impaired finger and hand function were examined in 10 stroke survivors with chronic spastic hemiparesis, with the intent of assessing whether mechanical restraint or altered neurophysiological control mechanisms are responsible for the well-known impairment of finger extension. Simultaneous extension of all four metacarpophalangeal (MCP) joints of the impaired hand was either externally imposed using a rotary actuator or attempted voluntarily by the subject. Trials were conducted both before and after administration of a local anesthetic, blocking the median and ulnar nerves at the elbow. The anesthetic was administered to reduce the activity of the muscles flexing the MCP joints, in order to distinguish mechanical from neuronal resistance to imposed MCP rotation. We found that the nerve blockade resulted in a reduction in velocity-dependent torque (P = 0.01), thereby indicating significant joint impedance due to spasticity. Blockade also produced a posture-dependent reduction in static torque in declaratively relaxed subjects (P = 0.04), suggesting some tonic flexor activity for specific hand postures. No change in either extensor isometric (P = 0.33) or isokinetic (0.53) torque was apparent, but 3 of the 10 subjects did exhibit substantial (>10 degrees ) improvement in voluntary MCP extension following the blockade. This improvement seemed largely due to a decrease in inappropriate flexor activity during the movement, rather than an increase in extensor activity. We argue that persistent and inappropriate flexor activation plays a role in limiting voluntary finger extension, and that this activation is potentially a reflection of altered supraspinal control of key spinal pathways. In all cases, this inappropriate activation was compounded by weakness, apparent in both the extensor and flexor muscles.

Biomechanical Phenomena↗

PubMed2001

Impairment of voluntary control of finger motion following stroke: role of inappropriate muscle coactivation.

Subjects with chronic hemiplegia following stroke attempted to perform voluntary isometric, isokinetic, and free contractions of the extensor muscles of the metacarpophalangeal (MCP) joints. We recorded torque, metacarpophalangeal joint angle and velocity, and electromyographic (EMG) activity of the extrinsic extensors and flexors and the first dorsal interosseous (FDI). We found that voluntary MCP joint extension in hemiparetic subjects was greatly impaired in comparison with control subjects: only two of the 11 stroke subjects were able to generate even 0.21 N-m of isometric extension torque, only two could produce positive finger extension with no load, and none could develop an isokinetic concentric extension. Deficits seemed to result from a combination of coactivation of the finger flexor and extensor muscles and decreased voluntary excitation of the extensors, as normalized flexor and FDI EMG activity were greater for stroke than for control subjects (P < 0.001), but normalized extensor activity was reduced (P < 0.001).

Aged↗

PubMed2001

Effect of muscle biomechanics on the quantification of spasticity.

The impact of muscle biomechanics on spasticity was assessed by comparison of the reflex responses of the elbow and metacarpophalangeal (MCP) flexor muscles in individuals with chronic spastic hemiplegia following stroke. Specifically, methods were developed to quantify reflex responses and to normalize these responses for comparison across different muscle groups. Stretch reflexes were elicited in the muscles of interest by constant velocity ramp-and-hold stretches at the corresponding joint. The muscles were initially passive, with the joint placed in a midrange position. Estimates of biomechanical parameters were used to convert measured reflex joint torque and joint angle into composite flexor muscle stress and stretch. We found that the stretch reflex response for the MCP muscle group had a 74% greater mean stiffness modulus than that for the elbow muscle group, and that the reflex threshold was initiated at an 80% shorter mean muscle stretch. However, we determined that initial normalized fiber length was significantly greater for the experiments involving the MCP muscles than for those involving the elbow muscles. Increasing the initial composite fiber length of the elbow flexors produced significant reduction of the reflex threshold (p<0.001), while decreasing the initial length of the MCP flexors significantly reduced their measured reflex stiffness (p<0.001). Thus, biomechanical parameters of muscle do appear to have an important effect on the stretch reflex in individuals with impairment following stroke, and this effect should be accounted for when attempting to quantify spasticity.

Aged↗

PubMed2000

Quantitative features of the stretch response of extrinsic finger muscles in hemiparetic stroke.

Despite its potential importance in hand dysfunction, spasticity in the finger muscles following stroke has not been well described. To explore this area, we assessed the role of finger flexor spasticity, along with that of passive mechanical forces, in resisting finger movement in 13 chronic stroke subjects. Subjects were tested with a device that stretched the extrinsic finger muscles through imposed rotation of the metacarpophalangeal (MCP) joints. Both maintained and constant-velocity stretches were imposed. For the constant-velocity stretches, eight of the 13 stroke subjects exhibited strong stretch reflexes, as determined by electromyography and net work. The net work of this reflex response, calculated from the integral of the torque-angle plots, increased proportionally with increasing velocity, indicating a contribution from flexor muscle spasticity. Conversely, nine of the 13 stroke subjects did not possess distinctly greater passive, mechanical resistance to MCP rotation than control subjects. While extensor spasticity was not observed, stretch of the extrinsic finger flexors also produced some reflex activity in the finger extensors concomitant with reflex excitation of the flexors. These findings suggest that resistance to muscle stretching following stoke is mediated primarily by neurological rather than biomechanical disturbances, although changes in muscle fiber length may exaggerate the resistance.

Aged↗

PubMed1999

Effects of geometric joint constraints on the selection of final arm posture during reaching: a simulation study.

Significant debate exists regarding the neural strategies underlying the positioning and orienting of the hand during voluntary reaching movements of the human upper extremity. Some authors have suggested that positioning and orienting are controlled independently, while others have argued that a strong interdependence exists. In an effort to address this uncertainty, our study employed computer simulations to examine the impact of physiological limitations of joint rotation on the proposed independence of hand position and orientation. Specifically, we analyzed the effects of geometric constraints on final arm postures using a 7 degree-of-freedom model of the human arm. For 20 different hand configurations within the attainable workspace, we computed sets of achievable joint angles by applying inverse kinematics. From each set, we then calculated the locus of possible elbow positions for the particular final hand posture. When the joints were allowed 360 degrees of rotation, the loci formed complete circles; however, when joint ranges were limited to physiological values, the extent of the loci decreased to an average arc angle of 54.6 degrees (+/-27.9 degrees). Imposition of joint limits also led to practically linear relationships between joint angles within a solution set. These theoretical results suggest a requirement for coordinated interaction between control of the joints associated with hand position and those involved with hand orientation in order to ensure attainable joint trajectories. Furthermore, it is conceivable that some of the correlations observed between joint angles in the course of natural reaching movements result from geometric constraints.

Arm↗

PubMed1999

A low-cost, portable system for the assessment of the postural response of wheelchair users to perturbations.

Maintaining seated postural stability presents a serious challenge to wheelchair users in vehicles, even during normal driving conditions. The purpose of this research was to develop a system for the study of seated postural control in response to perturbations similar to those that might be experienced during vehicle turning and braking. A servo-controlled tilt platform was constructed to provide a low-cost, small, and easily transportable device for generating precise and repeatable perturbations. Tilt platform operation was examined for accuracy and reproducibility of a desired perturbation. Repeatability was high with a mean signal-to-noise ratio (SNR) of 45.4 for a given perturbation measured across 11 subjects. An initial comparison of stability results obtained on the tilt platform and in a vehicle showed a correspondence, although differences were apparent. The tilt platform has been used successfully to assess balance in spinal cord-injured subjects and to test wheelchair securement systems.

Acceleration↗

PubMed1977

Alterations of postural and Valsalva responses in coronary heart disease.

Patients in congestive heart failure are known to have altered autonomic responses to circulatory stress. In this study, two different age groups of male coronary heart disease (CHD) patients, not in failure, as well as normal male subjects, underwent standard 20-min 70 degrees head-up tilt and Valsalva tests. Responses were monitored by noninvasive methods and cardiac output was estamated with a transthoracic impedance method. During tilt, the CHD patients and control subjects had similar heart rate and diastolic pressure responses. However, the CHD patients had a greater decline in pulse pressure during tilt, mainly due to a decrease in systolic pressure. CHD patients had lesser declines in stroke volume and cardiac index and lesser increases in total vascular resistance than did control subjects. In the Valsalva, the heart rate phase increments (and decrements) from control and rate increments (and decrements) between successive phases were less in the coronary patients. The results indicate that coronary patients, not in failure, have diminished circulatory responses to the tilt and Valsalva maneuver and suggest that these tests may be useful functional indices of cardiovascular capability in coronary disease.

Adult↗

PubMedDate not supplied

A technique for quantifying the response of seated individuals to dynamic perturbations.

A technique is presented for monitoring the seated postural stability and control of human subjects. Estimates are made of the locations of the subject's center of pressure (CP(S)) and projection of the center of mass (CM(NP)) from moment balance equations using measured force and acceleration data. The CP(S) and CM(NP) indices describe the stability of the subject, independent of the chair, even in the presence of perturbations. The measurement system was evaluated for both rigid objects and human subjects situated in a wheelchair undergoing displacement. Estimated CM(NP) was within +/-5 mm of the actual value for static loads. For human subjects, the average correlation coefficient between the estimated CM(NP) signal and that computed from video data was 0.90; however, transient overestimation of displacement was seen during subject acceleration. The technique could help to better assess seated stability in dynamic environments, such as those experienced by wheelchair users in motor vehicles.

Algorithms↗