Coordination in adults with neurological impairment: a systematic review of uncontrolled manifold studies

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dc.creatorDaniela Virgínia Vaz
dc.creatorValéria Andrade Pinto
dc.creatorRicardo Rodrigues de Sousa Junior
dc.creatorDaniela Junckes Silva Mattos
dc.creatorSuvobrata Mitra
dc.date.accessioned2022-03-03T22:28:55Z
dc.date.accessioned2025-09-08T23:56:48Z
dc.date.available2022-03-03T22:28:55Z
dc.date.issued2019
dc.identifier.doihttps://doi.org/10.1016/j.gaitpost.2019.01.003
dc.identifier.issn0966-6362
dc.identifier.urihttps://hdl.handle.net/1843/39788
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofGait & posture
dc.rightsAcesso Restrito
dc.subjectCapacidade motora
dc.subjectNeurofisiologia
dc.subject.otherNeurological impairment
dc.subject.otherSynergy
dc.subject.otherUncontrolled manifold
dc.titleCoordination in adults with neurological impairment: a systematic review of uncontrolled manifold studies
dc.typeArtigo de periódico
local.citation.epage78
local.citation.spage66
local.citation.volume69
local.description.resumoBackground: Analysis of sensorimotor synergies has been greatly advanced by the Uncontrolled Manifold (UCM) approach. The UCM method is based on partitioning inter-trial variance displayed by elemental variables into 'good' (VUCM) and 'bad' (VORT) variability that, respectively, indicate maintenance or loss of task stability. In clinical populations, these indices can be used to investigate the strength, flexibility, stereotypy and agility of synergistic control. Research question: How are synergies affected by neurological impairment in adults? Specifically, this study aimed to determine i) the impact of pathology on VUCM, VORT, and their ratio (synergy index); ii) the relationship between synergy indices and functional performance; iii) changes in anticipatory synergy adjustments (ASAs); and iv) the effects of interventions on synergies. Methods: Systematic review of UCM studies on adults with neurological impairment. Results: Most of the 17 studies had moderate to high quality scores in the adapted Critical Review Form and the UCM reporting quality checklist developed for this review. i) Most of the studies found reduced synergy indices for patients with Parkinson's disease (PD), olivo-ponto-cerebellar atrophy, multiple sclerosis and spinocerebellar degeneration, with variable levels of change in VUCM and VORT. Reduction in synergy indices was not as consistent for stroke, in three out of six studies it was unchanged. ii) Five of seven studies found no significant correlations between scores on motor function scales and UCM indices. iii) Seven studies consistently reported ASAs that are smaller in magnitude, delayed, or both, for patients compared to healthy controls. iv) Two studies reported increased synergy indices, either via increase in VUCM or decrease in VORT, after dopaminergic drugs for patients with PD. There were similar synergy indices but improved ASAs after deep brain stimulation for patients with PD. Significance: UCM can provide reliable and sensitive indicators of altered synergistic control in adults with neurological impairment.
local.identifier.orcidhttps://orcid.org/0000-0003-0470-6361
local.identifier.orcidhttps://orcid.org/0000-0003-3396-1951
local.identifier.orcidhttps://orcid.org/0000-0001-7620-4809
local.publisher.countryBrasil
local.publisher.departmentEEF - DEPARTAMENTO DE FISIOTERAPIA
local.publisher.initialsUFMG
local.url.externahttps://reader.elsevier.com/reader/sd/pii/S0966636219300013?token=4423DB6EA149897CF30CCEAC4685AF2A2AA0EB38A5C0E7C60242F4EDFAA8EB81385BCBB5B65A9F9840E6C7F76E933244&originRegion=us-east-1&originCreation=20220303145233

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