Advanced Outcomes: Upper Limbs

Project leads: László Demkó, PhD, Armin Curt, Prof. Dr., Spinal Cord Injury Center, Balgrist University Hospital, Zurich

The mechanisms underlying impairment of upper limb function are likely to differ between neurological disorders.
Whilst most clinically applied scoring systems focus on achieving activities of daily living (ADLs) or measures of
capacity (typically lab tests) they do not specifically address the underlying changes in the neural control of movements.
Therefore, development of readouts that can distinguish disturbances in neural control (e.g. motor planning,
coordination and fine control of complex movements which rely on multi-joint actuations and dynamic motions), as
opposed to impairment measures that score reduced ability in daily activities is needed. Using novel robotics, as well
as movement sensors (i.e. motion trajectory recordings without any constraints during normal daily activities outside
of defined sessions) during dedicated assessment and training sessions we will provide more detailed insights into
different features in the impaired neural control of upper limb movement. These features include levels of activity (activity
counts, REACT sensors), range of motion (ArmeoPower/ARMin), movement trajectories (ArmeoPower/ARMin),
co-activation of muscles (ArmeoPower/REACT) and fine motor control, under various conditions such as during perturbation/constraint and within variously applied force fields. The overall aim of this subproject is to investigate how
these neural control mechanisms are altered following stroke and spinal cord injury and ultimately to define which are
common to both conditions and which are disorder-specific.


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