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Biomedical subjects

J R Flanagan

Publications and source records attributed to J R Flanagan.

At least 19 recordsLinked to original sources
PubMed2005

Kinematic cues in perceptual weight judgement and their origins in box lifting.

When accepting a parcel from another person, we are able to use information about that person's movement to estimate in advance the weight of the parcel, that is, to judge its weight from observed action. Perceptual weight judgment provides a powerful method to study our interpretation of other people's actions, but it is not known what sources of information are used in judging weight. We have manipulated full form videos to obtain precise control of the perceived kinematics of a box lifting action, and use this technique to explore the kinematic cues that affect weight judgment. We find that observers rely most on the duration of the lifting movement to judge weight, and make less use of the durations of the grasp phase, when the box is first gripped, or the place phase, when the box is put down. These findings can be compared to the kinematics of natural box lifting behaviour, where we find that the duration of the grasp component is the best predictor of true box weight. The lack of accord between the optimal cues predicted by the natural behaviour and the cues actually used in the perceptual task has implications for our understanding of action observation in terms of a motor simulation. The differences between perceptual and motor behaviour are evidence against a strong version of the motor simulation hypothesis.

Adolescent↗
PubMed2002

Control of volitional and reflexive saccades in Tourette's syndrome.

We hypothesized that Tourette's syndrome (TS) patients would display abnormal control of saccades because of overlap between brain areas suspected in TS pathophysiology and those involved saccade control. Subjects were required to look toward (pro-saccade) or away from (anti-saccade) a visual target. Saccadic reaction times were elevated among TS subjects in all tasks. The occurrence of reflexive pro-saccades in the immediate anti-saccade task was normal, suggesting that the ability to inhibit reflexive saccades was not impaired in TS. However, timing errors (eye movements made prior to GO signal in delayed saccade tasks) were increased in TS indicating that ability to inhibit or delay planned motor programs is significantly impaired in TS.

Adolescent↗
PubMed2001

Motor prediction.

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Central Nervous System↗
PubMed2001

Eye-hand coordination in object manipulation.

We analyzed the coordination between gaze behavior, fingertip movements, and movements of the manipulated object when subjects reached for and grasped a bar and moved it to press a target-switch. Subjects almost exclusively fixated certain landmarks critical for the control of the task. Landmarks at which contact events took place were obligatory gaze targets. These included the grasp site on the bar, the target, and the support surface where the bar was returned after target contact. Any obstacle in the direct movement path and the tip of the bar were optional landmarks. Subjects never fixated the hand or the moving bar. Gaze and hand/bar movements were linked concerning landmarks, with gaze leading. The instant that gaze exited a given landmark coincided with a kinematic event at that landmark in a manner suggesting that subjects monitored critical kinematic events for phasic verification of task progress and subgoal completion. For both the obstacle and target, subjects directed saccades and fixations to sites that were offset from the physical extension of the objects. Fixations related to an obstacle appeared to specify a location around which the extending tip of the bar should travel. We conclude that gaze supports hand movement planning by marking key positions to which the fingertips or grasped object are subsequently directed. The salience of gaze targets arises from the functional sensorimotor requirements of the task. We further suggest that gaze control contributes to the development and maintenance of sensorimotor correlation matrices that support predictive motor control in manipulation.

Adult↗
PubMed2001

The inertial anisotropy of the arm is accurately predicted during movement planning.

An important theoretical concept in motor control is the idea that the CNS uses an internal model of the motor system and environment to predict the sensory consequences of motor commands. In arm movement control, a critical factor affecting the transformation from motor commands to sensory consequences is limb dynamics, including the inertial anisotropy of the arm, which refers to the fact that the inertial resistance of the arm depends on hand movement direction. Here we show that the CNS maintains an accurate internal model of the inertial anisotropy of the arm by demonstrating that the motor system can precisely predict direction-dependent variations in hand acceleration. Subjects slid an object, held beneath the index finger, across a frictionless horizontal surface to radially located targets. We recorded the normal (vertical) force exerted by the fingertip, as well as the tangential (horizontal) force proportional to hand acceleration. We found that normal force was precisely scaled in anticipation of tangential force, which, as expected, varied with direction. The peak rates of change of the normal and tangential forces, observed early in the movement, were highly correlated. Similar results were obtained regardless of whether the start position of the hand was located directly in front of the subject or rotated 45 degrees to the right. Finally, we observed reduced force correlations under reaction time conditions. This suggests that the process of prediction, based on an internal model of the limb, is not fully completed within the reaction time interval.

Acceleration↗
PubMed2001

Sensorimotor prediction and memory in object manipulation.

When people lift objects of different size but equal weight, they initially employ too much force for the large object and too little force for the small object. However, over repeated lifts of the two objects, they learn to suppress the size-weight association used to estimate force requirements and appropriately scale their lifting forces to the true and equal weights of the objects. Thus, sensorimotor memory from previous lifts comes to dominate visual size information in terms of force prediction. Here we ask whether this sensorimotor memory is transient, preserved only long enough to perform the task, or more stable. After completing an initial lift series in which they lifted equally weighted large and small objects in alternation, participants then repeated the lift series after delays of 15 minutes or 24 hours. In both cases, participants retained information about the weights of the objects and used this information to predict the appropriate fingertip forces. This preserved sensorimotor memory suggests that participants acquired internal models of the size-weight stimuli that could be used for later prediction.

Adolescent↗
PubMed2001

Control of volitional and reflexive saccades in Tourette's syndrome.

Tourette's syndrome is characterized by involuntary tics and, although the underlying pathogenesis and pathophysiology of Tourette's syndrome remains unclear, it is suspected that basal ganglia structures are involved. The basal ganglia also play an important role in the control of saccadic eye movements and we therefore hypothesize that Tourette's syndrome patients have abnormal control of saccadic eye movements. In this study, 10 subjects with Tourette's syndrome and 10 age- and sex-matched controls performed four different oculomotor paradigms requiring the execution and/or suppression of reflexive and/or voluntary saccades. In the immediate saccade tasks, subjects were required to look either toward (pro-saccade task) or away from (anti-saccade task) a peripheral target as soon as it appeared. In the delayed saccade tasks, subjects were instructed to wait for a central fixation point to disappear before initiating eye movements. Among Tourette's syndrome subjects, saccadic reaction times were longer in all tasks. Saccadic amplitudes were smaller in Tourette's syndrome subjects, and they made more saccades to reach the eccentric target. The occurrence of direction errors (i.e. reflexive pro-saccades on anti-saccade trials) was normal in the immediate anti-saccade task, suggesting that the ability to inhibit reflexive saccades towards novel stimuli was not impaired in Tourette's syndrome. Timing errors (i.e. eye movements made prior to disappearance of the central fixation point in delayed saccade tasks) were significantly greater among Tourette's syndrome subjects. Moreover, these errors were predominantly made towards the first target of the remembered sequence in a delayed memory-guided sequential saccade task. These results indicate that the ability to inhibit or delay planned motor programmes is significantly impaired in Tourette's syndrome. We hypothesize that altered cortical-basal ganglia circuitry leads to reduced cortical inhibition making it harder for Tourette's syndrome subjects to withhold the execution of planned motor programmes.

Adolescent↗
PubMed2001

Lightening the burden of the heavy regulatory hand an incentive for outpatient computer patient record.

However many benefits may be achieved for the organization, it is difficult to introduce a computer patient record (CPR) into an outpatient setting until the clinical practitioners themselves see direct benefit from the time invested. The ever increasing burden of regulation on health care in the outpatient setting includes (but is not limited to) guidelines for evaluation and management (E&M) coding, Local Medical Review Policy (LMRP) rules for diagnostic justification of tests and procedures and associated requirements for Advance Beneficiary Notification (ABN), and the rules for teaching physicians in academic settings. Achieving compliance with just the LMRP rules requires immediate access to an eight-inch-thick stack of manuals (ICD9, CPT, HCPCS, and LMRP), 4 inches of which is subject to update on a monthly basis. Accurate E&M coding is about as complicated as using the long form to do one s tax return. Without tools that can be provided by the CPR, these requirements add significant time to the patient encounter and significant risk of non-compliance and fines. We report our strategy for deploying the CPR as a strategy to keep clinicians from being overwhelmed by the rules, thereby allowing them to focus on healthcare. In the context of the CPR, and against all odds otherwise, the impact of the regulations can sometimes have beneficial and educational impacts on clinical care.

Attitude of Health Personnel↗
PubMed2000

Independence of perceptual and sensorimotor predictions in the size-weight illusion.

The smaller of two equally weighted objects is judged to be heavier when lifted. Here we disproved a leading hypothesis that this size-weight illusion is caused by a mismatch between predicted and actual sensory feedback. We showed that when subjects repeatedly lifted equally heavy large and small objects in alternation, they learned to scale their fingertip forces precisely for the true object weights and thus exhibited accurate sensorimotor prediction. The size-weight illusion nevertheless persisted, suggesting that the illusion can be caused by high-level cognitive and perceptual factors and indicating that the sensorimotor system can operate independently of the cognitive/perceptual system.

Adolescent↗
PubMed2000

Coming to grips with weight perception: effects of grasp configuration on perceived heaviness.

We investigated how changes in grasp configuration affect perceived heaviness in a weight discrimination task in which participants compared the weights of a series of test objects with the weight of a reference object. In different experiments, we varied the width of the grasp, the number of digits employed, the angle of the grasp surface, and the size of the contact area between the digits and the object. We show that objects are perceived to be lighter when lifting with (1) a wide grip in comparison with a narrow grip, (2) five digits in comparison with two digits, and (3) a large contact area in comparison with a small contact area. However, the angle of the contact surfaces did not influence perceived weight. We suggest that changes in central motor commands associated with grasp differences may influence perceived weight, at least under some conditions.

Adolescent↗
PubMed1999

Composition and decomposition of internal models in motor learning under altered kinematic and dynamic environments.

The learning process of reaching movements was examined under novel environments whose kinematic and dynamic properties were altered. We used a kinematic transformation (visuomotor rotation), a dynamic transformation (viscous curl field), and a combination of these transformations. When the subjects learned the combined transformation, reaching errors were smaller if the subject first learned the separate kinematic and dynamic transformations. Reaching errors under the kinematic (but not the dynamic) transformation were smaller if subjects first learned the combined transformation. These results suggest that the brain learns multiple internal models to compensate for each transformation and has some ability to combine and decompose these internal models as called for by the occasion.

Adult↗
PubMed1999

The influence of visual illusions on grasp position.

Visual size illusions have been shown to affect perceived object size but not the aperture of the hand when reaching to those same objects. Thus, vision for perception is said to be dissociated from vision for action. The present study examines the effect of visual-position and visual-shape illusions on both the visually perceived center of an object and the position of a grasp on that object when a balanced lift is required. The results for both experiments show that although the illusions influence both the perceived and the grasped estimates of the center position, the grasp position is more veridical. This partial dissociation is discussed in terms of its implications for streams of visual processing.

Adolescent↗
PubMed1999

Anticipatory grip adjustments are observed in both goal-directed movements and movement tics in an individual with Tourette's syndrome.

We examined grip force adjustments during movements of a hand-held object in a young man (BF) with Tourette's syndrome. We directly compared BF's voluntary up and down movements with tics in the same directions. Movement tics were elicited by cueing BF to move either up or down on a GO signal which appeared after a variable delay. During the delay period, we observed frequent tics which were almost always in the cued movement direction. BF's voluntary movements were well coordinated and featured precise and appropriate anticipatory grip force adjustments such that grip force was modulated in phase with movement-induced fluctuations in load. Precise anticipatory grip force adjustments were also observed in all of BF's movement tics. These results support the hypothesis that tics in Tourette's syndrome are purposeful voluntary movements that are well organized and coordinated.

Adaptation, Physiological↗
PubMed1999

Control of fingertip forces in multidigit manipulation.

Previous studies of control of fingertip forces in skilled manipulation have focused on tasks involving two digits, typically the thumb and index finger. Here we examine control of fingertip actions in a multidigit task in which subjects lifted an object using unimanual and bimanual grasps engaging the tips of the thumb and two fingers. The grasps resembled those used when lifting a cylindrical object from above; the two fingers were some 4.25 cm apart and the thumb was approximately 5.54 cm from either finger. The three-dimensional forces and torques applied by each digit and the digit contact positions were measured along with the position and orientation of the object. The vertical forces applied tangential to the grasp surfaces to lift the object were synchronized across the digits, and the contribution by each digit to the total vertical force reflected intrinsic object properties (geometric relationship between the object's center of mass and the grasped surfaces). Subjects often applied small torques tangential to the grasped surfaces even though the object could have been lifted without such torques. The normal forces generated by each digit increased in parallel with the local tangential load (force and torque), providing an adequate safety margin against slips at each digit. In the present task, the orientations of the force vectors applied by the separate digits were not fully constrained and therefore the motor controller had to choose from a number of possible solutions. Our findings suggest that subjects attempt to minimize (or at least reduce) fingertip forces while at the same time ensure that grasp stability is preserved. Subjects also avoid horizontal tangential forces, even at a small cost in total force. Moreover, there were subtle actions exerted by the digits that included changes in the distribution of vertical forces across digits and slight object tilt. It is not clear to what extent the brain explicitly controlled these actions, but they could serve, for instance, to keep tangential torques small and to compensate for variations in digit contact positions. In conclusion, we have shown that when lifting an object with a three-digit grip, the coordination of fingertip forces, in many respects, matches what has been documented previously for two-digit grasping. At the same time, our study reveals novel aspects of force control that emerge only in multidigit manipulative tasks.

Adult↗
PubMed1999

Control of grasp stability in humans under different frictional conditions during multidigit manipulation.

Control of grasp stability under different frictional conditions has primarily been studied in manipulatory tasks involving two digits only. Recently we found that many of the principles for control of forces originally demonstrated for two-digit grasping also apply to various three-digit grasps. Here we examine the control of grasp stability in a multidigit task in which subjects used the tips of the thumb, index, and middle finger to lift an object. The grasp resembled those used when lifting a cylindrical object from above. The digits either all contacted the same surface material or one of the digits contacted a surface material that was more, or less, slippery than that contacted by the other two digits. The three-dimensional forces and torques applied by each digit and the contact positions were measured along with the position and orientation of the object. The distribution of forces among the digits strongly reflected constraints imposed by the geometric relationship between the object's center of mass and the contact surfaces. On top of this distribution, we observed changes in force coordination related to changes in the combination of surface materials. When all digits contacted the same surface material, the ratio between the normal force and tangential load (F(n):L ratio) was similar across digits and scaled to provide an adequate safety margin against slip. With different contact surfaces subjects adapted the F(n):L ratios at the individual digits to the local friction with only small influences by the friction at the other two digits. They accomplished this by scaling the normal forces similarly at all digits and changing the distribution of load among the digits. The surface combination did not, however, influence digit position, tangential torque, or object tilting systematically. The change in load distribution, rather, resulted from interplay between these factors, and the nature of this interplay varied between trials. That is, subjects achieved grasp stability with various combinations of fingertip actions and appeared to exploit the many degrees of freedom offered by the multidigit grasp. The results extend previous findings based on two-digit tasks to multidigit tasks by showing that subjects adjust fingertip forces at each digit to the local friction. Moreover, our findings suggest that subjects adapted the load distribution to the current frictional condition by regulating the normal forces to allow slips to occur early in the lift task, prior to object lift-off.

Adult↗
PubMed1999

Randomized study of online vaccine reminders in adult primary care.

Online immunization reminders were implemented in an adult medicine setting in which all immunization history, vaccine ordering and charting were required online. Physicians were randomized to one of two arms in a cross-over design. Each arm was shown online recommendations for vaccines indicated by nationally accepted guidelines either during the first or during the second part of the study period. The main purpose of the study was to assess the impact of reminders on correct decisions related to prescribing vaccines. Online reminders had the following impact on physician behavior: 1) Physicians used the application almost 3 times as often when shown reminders. 2) Physicians in the reminder group were 27% less likely to order a vaccine in the reminder group (P- value 0.0005). 3) Compliance with guidelines was improved significantly for Tetanus and for Hepatitis B in several analyses. No such effects were found for Pneumoccocal, Measles, or Influenza vaccines.

Adult↗