Hand Motor Skills Research Articles

The Effectiveness of Using the HandTutor Hand Simulator and Stabilometric Postural Control Using the Biofeedback Tear in Preschool and Primary School Children with Cerebral Palsy

Background. Currently, mechanotherapy is widely used in the rehabilitation of mainly adult patients and adolescents. The possibilities of using this technique in children of early, preschool and primary school age are limited due to the minimal presence of specialized devices. The aim of the study is the assessment of the effectiveness of a comprehensive rehabilitation program with the inclusion of a HandTutor hand simulator and stabilometrical postural control using the biofeedback method in preschool and primary school age children suffering from infantile cerebral palsy (ICP). Materials and methods. 40 children aged 3 to 7 years with motor disorders with a diagnosis of ICP were under observation. The effectiveness of the program was evaluated using scales and hardware measurement data (HandTutor, “Amblyotron”). Results. According to goniometric changes and data on the Ashworth scale, after rehabilitation, patients demonstrate a greater range of movements than before treatment (p < 0.05). The indicators of the area of the pressure center and its fluctuations have significantly improved in the form of improved stability (p £ 0.01), the pattern of vertical posture, walking and postural control in general. Conclusion. After treatment, patients showed a marked decrease in the degree of muscle spasticity of the affected limb, an increase in muscle strength, an improvement in fine and large hand motor skills, and manual skills. Thus, the results of the study demonstrate the high effectiveness of biomechanical methods of influence, namely HandTutor and “Amblyotron”, on the motor sphere of patients with severe motor disorders.

Toward biologically realistic models of the motor system

In this issue of Neuron, Chiappa etal.1 describe how neural networks can be trained to perform complex hand motor skills. A key to their approach is curriculum learning, breaking learning into stages, leading to good control.

Enhancing Hand Motor Recovery Post-Stroke: A Comparative Study of Robotic vs. Conventional Mirror Therapy

This study aimed to evaluate the therapeutic effect of using a robotic exoskeletal hand (RMT) combined with mirror therapy (MT) in hand rehabilitation for post-stroke patients, compared to conventional MT. Randomized controlled trial. Conducted from November 2023 to February 2024. 40 post-stroke subjects. Participants were divided into two groups: one received robotic exoskeletal hand therapy combined with mirror therapy (RMT+MT), and the other received conventional mirror therapy (MT). The intervention lasted for 6 weeks. Hand motor function abilities were assessed using the Fugl-Meyer Assessment for Upper Extremities (FMA-UE) - Hand Motor Domain, and finger dexterity was evaluated with the Nine-Hole Peg Test (NHPT). The RMT group showed significant improvement in hand motor function, with a median FMA-UE-Hand Motor Domain score increasing from 6 to 14 (p = 0.000). Finger dexterity also improved significantly in the RMT group (p = 0.000). The conventional MT group demonstrated significant improvements in both the FMA-UE-Hand Motor Domain (p = 0.001) and NHPT (p = 0.000). However, the RMT group achieved greater improvements, with significant differences between the two groups in both FMA-UE-Hand Motor Domain (p = 0.038) and NHPT (p = 0.026) scores. RMT is significantly more effective in restoring hand motor skills and improving finger dexterity in post-stroke rehabilitation patients compared to conventional MT.

ВЛИЯНИЕ ИНТЕРАКТИВНОГО ФИЗКУЛЬТУРНОГО КОМПЛЕКСА НА РЕАБИЛИТАЦИЮ ДЕТЕЙ С ЗАДЕРЖКОЙ ПСИХИЧЕСКОГО РАЗВИТИЯ

An urgent issue today is the increase in the number of children with mental retardation. Statistics from the last five years show that more than 20% of children are born with lesions of the central nervous system. Perinatal pathology leads to a delay in mental and motor development and subsequently contributes to the risk of children's academic failure, maladjustment and social deviation. For a comprehensive solution to the problem, rehabilitation methods should be correctly selected, aimed at improving mental functions, developing physical qualities and forming motor skills. The purpose of the study is to study the effectiveness of an interactive physical education complex in the rehabilitation of children with mental retardation. The results obtained made it possible to identify the effectiveness of the use of a non–drug rehabilitation method - an interactive physical education complex for the development of cognitive functions and physical qualities of primary school children with mental retardation. To identify the level of logical thinking, the "Exclusion of excess" method was used, dexterity of movements was assessed by the "Darts" test, communicative activity was identified using a questionnaire for parents using the Makarchuk A.V., Gorinova E.V. method, large hand motor skills were assessed by a functional motor test, fine hand motor skills were assessed by the Grizik T.I., Tymoshchuk L.F. method. In the study of logical thinking in children after the rehabilitation course, an increase in the average values of the indicator was revealed in the main group, there were no changes in the control group. The results of the dexterity assessment test showed that after rehabilitation, the average values of the indicator increased only in the main group where the interactive complex was used. When evaluating communicative activity, it was revealed that when comparing groups, no changes were found in the average values of the indicator, however, the level of social interaction in the main group moved from "average" to "high" on a point scale, in the control group the level remained the same. When evaluating large hand motor skills, it was revealed that after rehabilitation in the main group, in which an interactive physical education complex was used, the average values of the indicator increased and began to correspond to the assessment "good", in the control group the indicator did not change – the assessment "satisfactory". In the study of fine motor skills, an increase in the average values in the main group was revealed: from the level of "poor development" to the level of "insufficiently good development", there were no changes in the control group. Thus, the interactive physical education complex increases the indicators of logical thinking, dexterity of movements, large and small hand motor skills and improves the level of communicative activity.

Comparing Real and Imitative Practice with No Practice during Observational Learning of Hand Motor Skills from Animations

In two experiments, we compared the effects of practice (real and imitative) with no practice on the observational learning of hand motor skills from animated videos. Experiment 1 investigated learning to play a series of piano clips of varying complexity. Results demonstrated improved learning efficiency with imitative practice compared to no practice. Experiment 2 featured a paper-folding task, and results indicated that real practice led to significantly greater learning than no practice. Furthermore, a significant interaction was found with gender and practice, where females learned best with both real and imitative practice, but males did not benefit from these interventions. However, males outperformed females in the no practice condition. Overall, we found benefits of practice versus no practice for both tasks. However, the most effective type of practice was dependent upon the task: imitative practice for piano playing, and real practice for paper folding. Task complexity and gender were also found to be moderating factors.

The Role of the Simulation Center in Conducting and Preparing for the Olympiads in Surgical Specialties Among Residents

The simulation center plays an important role in training medical personnel. The All-Russian Interdisciplinary Olympiad among residents has been held for two years at the A.V. Vishnevsky National Medical Research Center of Surgery. Pros: immersion in the specialty, working through surgical interventions, improving hand motor skills, communication between educational institutions. Cons: high workload for students, high costs for preparing competitions. Organizing and holding Olympiads in a simulation center is a progressive stage in training medical personnel in surgical specialties.

Terapi Genggam Bola Karet Pada Lansia yang Mengalami Stroke di Taman Bodhi Asri Binjai

Muscle weakness in the upper extremities is a common consequence of stroke that can impede daily activities such as eating, bathing, dressing, and controlling incontinence. Stroke patients with muscle weakness are highly dependent on assistance from others for their daily routines. An effective intervention to enhance muscle strength in stroke patients is the use of rubber ball grasping therapy. This therapy involves using an elastic rubber ball that can be easily compressed with minimal force, making it safe and user-friendly. The primary objective of this therapy is to stimulate hand motor skills by repeatedly clenching the rubber ball. This method aims to increase muscle strength by stimulating muscle fibers to contract. The advantage of using a rubber ball for this therapy lies in its availability and the ease with which it can be conducted in various settings, offering flexibility for implementation. This study aims to evaluate the effectiveness of rubber ball grasping therapy for elderly stroke patients at Taman Bodhi Asri Binjai.

Ηand dexterities assessment in stroke patients based on augmented reality and machine learning through a box and block test

A popular and widely suggested measure for assessing unilateral hand motor skills in stroke patients is the box and block test (BBT). Our study aimed to create an augmented reality enhanced version of the BBT (AR-BBT) and evaluate its correlation to the original BBT for stroke patients. Following G-power analysis, clinical examination, and inclusion–exclusion criteria, 31 stroke patients were included in this study. AR-BBT was developed using the Open Source Computer Vision Library (OpenCV). The MediaPipe's hand tracking library uses a palm and a hand landmark machine learning model to detect and track hands. A computer and a depth camera were employed in the clinical evaluation of AR-BBT following the principles of traditional BBT. A strong correlation was achieved between the number of blocks moved in the BBT and the AR-BBT on the hemiplegic side (Pearson correlation = 0.918) and a positive statistically significant correlation (p = 0.000008). The conventional BBT is currently the preferred assessment method. However, our approach offers an advantage, as it suggests that an AR-BBT solution could remotely monitor the assessment of a home-based rehabilitation program and provide additional hand kinematic information for hand dexterities in AR environment conditions. Furthermore, it employs minimal hardware equipment.

Implementasi Alat Permainan Edukatif (APE) Keterampilan Meronce untuk Menumbuhkan Perkembangan Sensorik dan Motorik Anak Usia Dini

Meronce is the process of arranging or assembling objects by inserting perforated objects into a string or thread to create beautiful works. This meronce skill not only develops the sensory and motor aspects of children, but also enhances focus on the senses, such as concentration, training social-emotional skills, cognitive skills, as well as introducing colors and shapes to children aged 5-6 years. By taking beads and arranging them according to desired patterns or shapes, children can practice hand movements, eye coordination, and motor skills. The use of meronce skills in learning is very effective in developing various aspects of early childhood development, both in kindergarten and early childhood education. Therefore, this article discusses the use of Educational Play Equipment (APE) Meronce Skills to enhance sensory and motor development in early childhood. This study uses a qualitative approach with field research, which aims to determine the background, social groups, individuals, and community institutions. The results show that meronce skill learning in classroom B1 of TK Muslimat Nurul Ulum 2 Pegiringan is conducted with enthusiasm, creativity, and high spirits. Children are able to follow their teacher's instructions well.

Hand Injuries Onboard an Aircraft Carrier – A Case Series

Abstract Hand injuries comprise a large part of all the injuries coming to the emergency department of the hospitals. Being the most important asset to man after the brain, any injury to the hands can cause lasting consequences. The importance of gross and fine motor skills of hands can hardly be stressed upon. The cases although common in a general scenario are not easily managed onboard a mobile platform with limited resources in terms of expertise, equipment, and manpower. In this case series, we describe the management of five injuries which took place onboard an aircraft carrier during sailing over a period of 9 months.

Dynamics of motor and functional disorders in the early recovery period after ischemic stroke

To study the dynamics and degrees of motor and functional disorders in patients with hemiparesis during the first 6 months after ischemic stroke under the impact of medical rehabilitation, including kinesiotherapy, physiotherapy and transcranial magnetic stimulation. Motor disorders and functional limitations were assessed using validated scales (Fugl-Meyer, Medical Research Committee Scale, Modified Ashworth Scale of muscle spasticity, Modified Frenchay scale, Wolf Motor Function Test, Action Research Arm Test, Rivermead mobility index, Hauser ambulation index, Functional Independence Measurement). Diagnostic and therapeutic transcranial magnetic stimulation was performed using the «Neuro-MS/D» magnetic stimulator. The dynamics of types and degrees of motor and functional disorders were evaluated in 113 patients with hemiparesis in the first 6 months after ischemic stroke. Severe disorders of the tone and strength characteristics of paretic muscles and limitation of movement in the joints of paretic extremities have been found in 2/3 of patients. The balance function (it is difficult to maintain a vertical position of the body) was impaired in 1/2 of patients. The correlations of electrophysiological indicators (diagnostic transcranial magnetic stimulation and surface electromyography) with clinical ones (degree of paresis, tone of paretic muscles, motor abilities and motor skills of the paretic hand, independence in daily living) have been determined. Positive impact of medical rehabilitation, including kinesiotherapy, physiotherapy and transcranial magnetic stimulation, on the strength of paretic muscles of the hand and leg, mobility of patients, walking function, activity of the paretic hand (transfer by the hands, manipulation of extremities' segments and objects) has been revealed. Electrophysiological investigation has shown that the functional activity of the paretic muscles increased. Severe motor and functional disorders, most pronounced in distal segments of the extremities (lack of movements in 14-26% of cases), are prevalent in the first six months after ischemic stroke in the carotid system. The regression of motor disorders leads to an enhancement of functional abilities (use of the paretic extremities for the realization of various motor actions) under the impact of rehabilitation.

Characterization of central manifestations in patients with Niemann-Pick disease type C

PurposeNiemann-Pick disease type C (NPC) is a rare lysosomal storage disease characterized by progressive neurodegeneration and neuropsychiatric symptoms. This study investigated pathophysiological mechanisms underlying motor deficits, particularly speech production, and cognitive impairment. MethodsWe prospectively phenotyped 8 adults with NPC and age-sex-matched healthy controls using a comprehensive assessment battery, encompassing clinical presentation, plasma biomarkers, hand-motor skills, speech production, cognitive tasks, and (micro-)structural and functional central nervous system properties through magnetic resonance imaging. ResultsPatients with NPC demonstrated deficits in fine-motor skills, speech production timing and coordination, and cognitive performance. Magnetic resonance imaging revealed reduced cortical thickness and volume in cerebellar subdivisions (lobule VI and crus I), cortical (frontal, temporal, and cingulate gyri) and subcortical (thalamus and basal ganglia) regions, and increased choroid plexus volumes in NPC. White matter fractional anisotropy was reduced in specific pathways (intracerebellar input and Purkinje tracts), whereas diffusion tensor imaging graph theory analysis identified altered structural connectivity. Patients with NPC exhibited altered activity in sensorimotor and cognitive processing hubs during resting-state and speech production. Canonical component analysis highlighted the role of cerebellar-cerebral circuitry in NPC and its integration with behavioral performance and disease severity. ConclusionThis deep phenotyping approach offers a comprehensive systems neuroscience understanding of NPC motor and cognitive impairments, identifying potential central nervous system biomarkers.

23 Musical Training May Not Enhance Cognitive-Motor Integration in Healthy Young Adults

Objective:Hand and arm functions have been associated with cognition in healthy young and older adults (Vasylenko et al., 2018) and in patients with Parkinson's disease (Bezdicek et al., 2014). Music training has been proposed to integrate motor and cognitive functions by engaging motoric, sensory, perceptual, and various cognitive domains (Wan & Schlaug, 2010). In this study, we examined if performance on fine and gross motor tasks is predicted by cognitive measures of memory, attention, and executive functions, and whether this relationship varies by the extent of musical training in healthy young participants.Participants and Methods:Forty five healthy young participants were recruited (M = 22.32, SD = 4.10; 78% female). Participants completed fine (Grooved pegboard) and gross motor (Box and Blocks) measures as well as cognitive measures (Rey auditory verbal learning test, Stroop, Trail making, and D2 cancellation), and the musical training subscale of the Goldsmith Musical Sophistication Index. Two multiple regression models were conducted assessing cognitive measures as predictors of fine and gross motor functions, with musical training as a covariate in both models.Results:Musical training was normally distributed across participants (M = 23.47, SD = 10.28). The results of the first model assessing the role of cognitive measures as predictors of fine motor function indicate a moderate fit (F(5,36) = 3.32, R = 0.55, explaining .32 of variance, p < .05), with memory (B = 2.75, SE = 0.82, p < .005) and sustained attention (B = 0.09, SE = 0.03, p < .01) as moderate predictors. These cognitive measures were also found to predict gross motor function (F(5,36) = 3.06, p < .05, R = 0.55, explaining .30 of the variance), with memory retention (B = 2.49, SE = 0.83, p < .001) and sustained attention (B = 0.07, SE = 0.03, p < .05) as moderate predictors. In both models, musical training was not a significant predictor.Conclusions:We found that both fine and gross hand motor functions are predicted by cognitive measures of memory retention and sustained attention. Our results support previous findings associating cognition and motor function, with attention being relevant in young adults and memory a predictor in older adults (Vasylenko et al., 2018). We corroborate these findings for hand function, but did not find executive functions to be implicated, which were previously reported as a predictor only for older adults. While musical training has been suggested to enhance the cognitive-motor relationship as it involves motor skills as well as engages various cognitive domains (Wan & Schlaug, 2010), prior musical training was not found to affect this relationship. While music background did not predict better hand motor function, it did account for more interpersonal variance. The results suggest that for most amateur musicians, including those with years of experience, musical training may not affect the association between cognition and both fine and gross hand motor skill. The current findings indicate that while musical training can be an enriching experience, it may not (exclusively) enhance motor-cognitive integration. Different outcomes may be found with more extreme levels of music training, or a different age group.

ПСИХИКАЛЫҚ ДАМУЫ ТЕЖЕЛГЕН БАЛАЛАРДЫҢ ЛОГИКАСЫН ДАМЫТУ

The article deals with the problem of logic development in children with mental retardation in a comprehensive school, as the modern education system is designed to create conditions that meet the capabilities and needs of students with special educational needs. The development of thinking, including logical thinking, plays a special role in the senior preschool and school age. With the beginning of school, thinking becomes one of the key aspects among other cognitive processes. The lack of consistency of logical thinking leads to the fact that the knowledge acquired by the child turns out to be incomplete, which complicates the learning process and reduces its effectiveness. The greatest difficulties arise in children with mental retardation, who have a lag in visual-figurative and verbal-logical forms of thinking. The practical significance of our research lies in the fact that we have developed a set of joint classes for this category of children, aimed at teaching methods of logical thinking (analysis, comparison, classification, analogy, generalization, establishment of causal relationships), the development of memory, attention, fine motor skills of hands, interest in solving puzzles.

Motor development of first born compared to later born children in the first two years of life – A replication

PurposeThe motor development of firstborns compared to children having an older sibling in the first two years of life was examined. MethodThe data of the study come from an ongoing research project with citizen participation, which is investigating the development of motor milestones in the first and second years of life. Parents report online their children's developmental progress using a development calendar. 18 motor skills from birth until children manage walking alone are recorded, 14 relate to gross motor skills and four to hand motor skills. ResultsChildren with siblings achieved higher values at birth in terms of Apgar-score, height, weight, BMI and parental satisfaction with the health and development of the child compared to firstborns. However, no differences could be found at the ages of 10–12 months and 14 months. Firstborns reached five fine motor and manual dexterity milestones earlier than children with siblings. In contrast, when mastering 13 gross motor milestones, no differences could be found between firstborns and children with siblings. ConclusionMotor development at an early age is considered to be largely genetically controlled, analogous to physical development. However, the faster development of the fine motor skills of the firstborns could be related to the fact that parents interact more intensively with their firstborn than with later born children and – unlike gross motor skills – in fine motor skills not only genetic factors but also learning processes are effective from a very early age.

Multi-focal Stimulation of the Cortico-cerebellar Loop During the Acquisition of a Novel Hand Motor Skill in Chronic Stroke Survivors

Impairment of hand motor function is a frequent consequence after a stroke and strongly determines the ability to regain a self-determined life. An influential research strategy for improving motor deficits is the combined application of behavioral training and non-invasive brain stimulation of the motor cortex (M1). However, a convincing clinical translation of the present stimulation strategies has not been achieved yet. One alternative and innovative approach is to target the functionally relevant brain network-based architecture, e.g., the dynamic interactions within the cortico-cerebellar system during learning. Here, we tested a sequential multifocal stimulation strategy targeting the cortico-cerebellar loop. Anodal transcranial direct current stimulation (tDCS) was applied simultaneously to a hand-based motor training in N = 11 chronic stroke survivors during four training sessions on two consecutive days. The tested conditions were: sequential multifocal (M1-cerebellum (CB)-M1-CB) vs. monofocal control stimulation (M1-sham-M1-sham). Additionally, skill retention was assessed 1 and 10 days after the training phase. Paired-pulse transcranial magnetic stimulation data were recorded to characterize stimulation response determining features. The application of CB-tDCS boosted motor behavior in the early training phase in comparison to the control condition. No faciliatory effects on the late training phase or skill retention were detected. Stimulation response variability was related to the magnitude of baseline motor ability and short intracortical inhibition (SICI). The present findings suggest a learning phase-specific role of the cerebellar cortex during the acquisition of a motor skill in stroke and that personalized stimulation strategies encompassing several nodes of the underlying brain network should be considered.

Accuracy and feasibility of a novel fine hand motor skill assessment using computer vision object tracking

We developed a computer vision-based three-dimension (3D) motion capture system employing two action cameras to examine fine hand motor skill by tracking an object manipulated by a hand. This study aimed to examine the accuracy and feasibility of this approach for detecting changes in a fine hand motor skill. We conducted three distinct experiments to assess the system's accuracy and feasibility. We employed two high-resolution, high-frame-rate action cameras. We evaluated the accuracy of our system in calculating the 3D locations of moving object in various directions. We also examined the system's feasibility in identifying improvement in fine hand motor skill after practice in eleven non-disabled young adults. We utilized color-based object detection and tracking to estimate the object's 3D location, and then we computed the object's kinematics, representing the endpoint goal-directed arm reaching movement. Compared to ground truth measurements, the findings demonstrated that our system can adequately estimate the 3D locations of a moving object. We also showed that the system can be used to measure the endpoint kinematics of goal-directed arm reaching movements to detect changes in fine hand motor skill after practice. Future research is needed to confirm the system's reliability and validity in assessing fine hand motor skills in patient populations.

Neurodata Tracker: Software for computational assessment of hand motor skills based on optical motion capture in a virtual environment.

Deficits affecting hand motor skills negatively impact the quality of life of patients. The NeuroData Tracker platform has been developed for the objective and precise evaluation of hand motor deficits. We describe the design and development of the platform and analyse the technological feasibility and usability in a relevant clinical setting. A software application was developed in Unity (C#) to obtain kinematic data from hand movement tracking by a portable device with two cameras and three infrared sensors (leap motion®). Four exercises were implemented: (a) wrist flexion-extension (b) finger-grip opening-closing (c) finger spread (d) fist opening-closing. The most representative kinematic parameters were selected for each exercise. A script in Python was integrated in the platform to transform real-time kinematic data into relevant information for the clinician. The application was tested in a pilot study comparing the data provided by the tool from ten healthy subjects without any motor impairment and ten patients diagnosed with a stroke with mild to moderate hand motor deficit. The NeuroData Tracker allowed the parameterization of kinematics of hand movement and the issuance of a report with the results. The comparison of the data obtained suggests the feasibility of the tool for detecting differences between patients and healthy subjects. This new platform based on optical motion capturing provides objective measurement of hand movement allowing quantification of motor deficits. These findings require further validation of the tool in larger trials to verify its usefulness in the clinical setting.

Multi-focal stimulation of the cortico-cerebellar loop during the acquisition of a novel hand motor skill in chronic stroke survivors

Multi-focal stimulation of the cortico-cerebellar loop during the acquisition of a novel hand motor skill in chronic stroke survivors

Comparison of the effectiveness of a selected exercise program and rehabilitation and a selected exercise program with rehabilitation on the motor skills of unhealthy hand in children with hemiplegia

Comparison of the effectiveness of a selected exercise program and rehabilitation and a selected exercise program with rehabilitation on the motor skills of unhealthy hand in children with hemiplegia