The effect of a fatiguing exercise by the index finger on single- and multi-finger force production tasks

[Update on prosthesis for partial hand and finger amputations]

Partial hand and finger amputations are relatively rare but devastating due to the consequences they provoque. In addition, they are more likely than lower limb amputations in car accidents, work accidents and by certain weapons of war. Men are going to have a much higher risk of traumatic amputation than women, with a rate 6.6 times higher. Fitting can be a complex process and a challenge for professionals. For this reason, it is important to know all the options available on the market that can meet the needs of patients, from cosmetic to myoelectric prostheses. Fitting requires the coordinated activity of a multiassistant clinical work team, the center of the team being the person who has suffered the amputation, who must have all the information possible to be able to actively participate in decision-making.

The Nature of Finger Enslaving: New Results and Their Implications

We present a review on the phenomenon of unintentional finger action seen when other fingers of the hand act intentionally. This phenomenon (enslaving) has been viewed as a consequence of both peripheral (e.g., connective tissue links and multifinger muscles) and neural (e.g., projections of corticospinal pathways) factors. Recent studies have shown relatively large and fast drifts in enslaving toward higher magnitudes, which are not perceived by subjects. These and other results emphasize the defining role of neural factors in enslaving. We analyze enslaving within the framework of the theory of motor control with spatial referent coordinates. This analysis suggests that unintentional finger force changes result from drifts of referent coordinates, possibly reflecting the spread of cortical excitation.

Restoring Form and Function to the Partial Hand Amputee: Prosthetic Options from the Fingertip to the Palm

Partial hand amputations are the most common upper extremity amputations and affect individuals across a spectrum of socioeconomic and geographic backgrounds. Prosthetic devices can provide straightforward solutions to the devastating aesthetic, functional, psychological, and social deficits caused by these injuries. However, because of the recent development of multiple partial hand prosthetic devices, many hand providers remain unaware of their applicability in practice. This article highlights the various classes of partial hand prostheses currently available, including passive functional, body-powered, and externally powered options. Familiarity with these partial hand prostheses will better enable providers to care for partial hand amputees.

On the origin of finger enslaving: control with referent coordinates and effects of visual feedback

When a person tries to press with a finger, other fingers of the hand produce force unintentionally. We explored this phenomenon of enslaving during unintentional force drifts in the course of continuous force production by pairs of fingers of a hand. Healthy subjects performed accurate force production tasks by finger pairs Index-Middle, Middle-Ring, and Ring-Little with continuous visual feedback on the combined force of the instructed (master) fingers or of the noninstructed (enslaved) fingers. The feedback scale was adjusted to ensure that the subjects did not know the difference between these two, randomly presented, conditions. Across all finger pairs, enslaved force showed a drift upward under feedback on the master finger force, and master force showed a drift downward under feedback on the enslaved finger force. The subjects were unaware of the force drifts, which could reach over 50% of the initial force magnitude over 15 s. Across all conditions, the index of enslaving increased by ∼50% over the trial duration. The initial moment of force magnitude in pronation-supination was not a consistent predictor of the force drift magnitude. These results falsify the hypothesis that the counter-directional force drifts reflected drifts in the moment of force. They suggest that during continuous force production, enslaving increases with time, possibly due to the spread of excitation over cortical finger representations or other mechanisms, such as increased synchronization of firing of α-motoneurons innervating different compartments of extrinsic flexors. These changes in enslaving, interpreted at the level of control with referent coordinates for the fingers, can contribute to a variety of phenomena, including unintentional force drifts.NEW & NOTEWORTHY We report a consistent slow increase in finger enslaving (force production by noninstructed fingers) when visual feedback was presented on the force produced by either two instructed fingers or two noninstructed fingers of the hand. In contrast, force drifts could be in opposite directions depending on the visual feedback. We interpret enslaving and its drifts at the level of control with referent coordinates for the involved muscles, possibly reflecting spread of cortical excitation.

Multi-Finger Interaction and Synergies in Finger Flexion and Extension Force Production

The aim of this study was to discover finger interaction indices during single-finger ramp tasks and multi-finger coordination during a steady state force production in two directions, flexion, and extension. Furthermore, the indices of anticipatory adjustment of elemental variables (i.e., finger forces) prior to a quick pulse force production were quantified. It is currently unknown whether the organization and anticipatory modulation of stability properties are affected by force directions and strengths of in multi-finger actions. We expected to observe a smaller finger independency and larger indices of multi-finger coordination during extension than during flexion due to both neural and peripheral differences between the finger flexion and extension actions. We also examined the indices of the anticipatory adjustment between different force direction conditions. The anticipatory adjustment could be a neural process, which may be affected by the properties of the muscles and by the direction of the motions. The maximal voluntary contraction (MVC) force was larger for flexion than for extension, which confirmed the fact that the strength of finger flexor muscles (e.g., flexor digitorum profundus) was larger than that of finger extensor (e.g., extensor digitorum). The analysis within the uncontrolled manifold (UCM) hypothesis was used to quantify the motor synergy of elemental variables by decomposing two sources of variances across repetitive trials, which identifies the variances in the uncontrolled manifold (V_UCM) and that are orthogonal to the UCM (V_ORT). The presence of motor synergy and its strength were quantified by the relative amount of V_UCM and V_ORT. The strength of motor synergies at the steady state was larger in the extension condition, which suggests that the stability property (i.e., multi-finger synergies) may be a direction specific quantity. However, the results for the existence of anticipatory adjustment; however, no difference between the directional conditions suggests that feed-forward synergy adjustment (changes in the stability property) may be at least independent of the magnitude of the task-specific apparent performance variables and its direction (e.g., flexion and extension forces).

Grip force and force sharing in two different manipulation tasks with bottles

Grip force and force sharing during two activities of daily living were analysed experimentally in 10 right-handed subjects. Four different bottles, filled to two different levels, were manipulated for two tasks: transporting and pouring. Each test subject's hand was instrumented with eight thin wearable force sensors. The grip force and force sharing were significantly different for each bottle model. Increasing the filling level resulted in an increase in grip force, but the ratio of grip force to load force was higher for lighter loads. The task influenced the force sharing but not the mean grip force. The contributions of the thumb and ring finger were higher in the pouring task, whereas the contributions of the palm and the index finger were higher in the transport task. Mean force sharing among fingers was 30% for index, 29% for middle, 22% for ring and 19% for little finger. Practitioner Summary: We analysed grip force and force sharing in two manipulation tasks with bottles: transporting and pouring. The objective was to understand the effects of the bottle features, filling level and task on the contribution of different areas of the hand to the grip force. Force sharing was different for each task and the bottles features affected to both grip force and force sharing.

Effects of fatigue on synergies in a hierarchical system

We investigated the effect of fatigue produced by timed maximal voluntary contraction (MVC) of the index finger of one of the hands on performance in MVC and accurate cyclic force production tasks in right-handed subjects. Based on earlier studies, we hypothesized that fatigue would produce an increase in the indices of force-stabilizing synergies in both hands as well as between the hands in two-hand tasks. Synergies were defined as co-varied adjustments of commands to fingers (modes) across cycles that stabilized total force. Fatigue caused a significant reduction in the MVC of the exercised as well as the non-exercised hand. Indices of finger enslaving (lack of individuation) increased with fatigue in both hands, although the increase was significant in the exercised hand only. In contrast to the significant effects of fatigue on MVC forces performed by the non-exercised hand, there were no comparable transfer effects on the root mean square errors during accurate force production. During one-hand tasks, both hands showed high indices of force-stabilizing synergies. These indices were larger in the left hand. Fatigue led to a general increase in synergy indices. Exercise by the left hand had stronger effects on synergy indices seen in both hands. Exercise by the right hand showed ipsilateral effects only. Smaller effects of fatigue were observed on accuracy of performance of the force-down segments of the force cycles compared to the force-up segments. For the bimanual tasks, synergies were analyzed at two hierarchical levels, two-hand (four-finger) and within-a-hand (two-finger). An increase in the synergy index with fatigue was observed at the lower (two-finger) level of the hierarchy only. We interpret the lack of effects of fatigue at the upper (two-hand) level as a consequence of a trade-off between synergies at different levels of the hierarchy. The differences between the hands are discussed within the dynamic dominance hypothesis.

Optimality versus variability: effect of fatigue in multi-finger redundant tasks

We used two methods to address two aspects of multi-finger synergies and their changes after fatigue of the index finger. Analytical inverse optimization (ANIO) was used to identify cost functions and corresponding spaces of optimal solutions over a broad range of task parameters. Analysis within the uncontrolled manifold (UCM) hypothesis was used to quantify co-variation of finger forces across repetitive trials that helped reduce variability of (stabilized) performance variables produced by all the fingers together. Subjects produced steady-state levels of total force and moment of force simultaneously as accurately as possible by pressing with the four fingers of the right hand. Both before and during fatigue, the subjects performed single trials for many force-moment combinations covering a broad range; the data were used for the ANIO analysis. Multiple trials were performed at two force-moment combinations; these data were used for analysis within the UCM hypothesis. Fatigue was induced by 1-min maximal voluntary contraction exercise by the index finger. Principal component (PC) analysis showed that the first two PCs explained over 90% of the total variance both before and during fatigue. Hence, experimental observations formed a plane in the four-dimensional finger force space both before and during fatigue conditions. Based on this finding, quadratic cost functions with linear terms were estimated from the experimental data. The dihedral angle between the plane of optimal solutions and the plane of experimental observations (D (ANGLE)) was very small (a few degrees); it increased during fatigue. There was an increase in fatigue of the coefficient at the quadratic term for the index finger force balanced by a drop in the coefficients for the ring and middle fingers. Within each finger pair (index-middle and ring-little), the contribution of the "central" fingers to moment production increased during fatigue. An index of antagonist moment production dropped with fatigue. Fatigue led to higher co-variation indices during pronation tasks (index finger is an agonist) but opposite effects during supination tasks. The results suggest that adaptive changes in co-variation indices that help stabilize performance may depend on the role of the fatigued element, agonist or antagonist.

Update on the relation between pain and movement: consequences for clinical practice

It is generally thought that exercise is beneficial to alleviate pain. However, prolonged movement may lead to the development of painful injuries, because of the overload of low-threshold motor units. Especially in individuals with a pain condition, exercise prescription and the impact of fatigue is less clear. This may be because of the dual effects, aggravation and relief, which fatigue has on pain. The purpose of this review is to ascertain the relation between pain and the motor system, both in the development and management of pain. Recent studies show that fatigue alters pain-induced increases in corticomotor excitability and leads to within and between-muscle adaptations. Studies of acute pain have shown complex adaptations such as increased movement variability, which may be because of a search for motor solutions to prolong overall task performance. In contrast, chronic pain seems to limit movement duration, speed, and variability which could be protective in the short term but also counterproductive over time. Owing to these adaptations in movement strategies, pain chronicity may help to dictate exercise prescription. For example, the correct dosage of multimuscle, dynamic exercises would act to promote movement variability. Thus, it seems that exercise involving the use of different movement strategies could be effective in helping people to obtain exercise-induced benefits while avoiding injury and pain reaggravation.

Influence of fatigue on hand muscle coordination and EMG-EMG coherence during three-digit grasping

Fingertip force control requires fine coordination of multiple hand muscles within and across the digits. While the modulation of neural drive to hand muscles as a function of force has been extensively studied, much less is known about the effects of fatigue on the coordination of simultaneously active hand muscles. We asked eight subjects to perform a fatiguing contraction by gripping a manipulandum with thumb, index, and middle fingers while matching an isometric target force (40% maximal voluntary force) for as long as possible. The coordination of 12 hand muscles was quantified as electromyographic (EMG) muscle activation pattern (MAP) vector and EMG-EMG coherence. We hypothesized that muscle fatigue would cause uniform changes in EMG amplitude across all muscles and an increase in EMG-EMG coherence in the higher frequency bands but with an invariant heterogeneous distribution across muscles. Muscle fatigue caused a 12.5% drop in the maximum voluntary contraction force (P < 0.05) at task failure and an increase in the SD of force (P < 0.01). Although EMG amplitude of all muscles increased during the fatiguing contraction (P < 0.001), the MAP vector orientation did not change, indicating that a similar muscle coordination pattern was used throughout the fatiguing contraction. Last, EMG-EMG coherence (0-35 Hz) was significantly greater at the end than at the beginning of the fatiguing contraction (P < 0.01) but was heterogeneously distributed across hand muscles. These findings suggest that similar mechanisms are involved for modulating and sustaining digit forces in nonfatiguing and fatiguing contractions, respectively.

Adaptive increase in force variance during fatigue in tasks with low redundancy

We tested a hypothesis that fatigue of an element (a finger) leads to an adaptive neural strategy that involves an increase in force variability in the other finger(s) and an increase in co-variation of commands to fingers to keep total force variability relatively unchanged. We tested this hypothesis using a system with small redundancy (two fingers) and a marginally redundant system (with an additional constraint related to the total moment of force produced by the fingers, unstable condition). The subjects performed isometric accurate rhythmic force production tasks by the index (I) finger and two fingers (I and middle, M) pressing together before and after a fatiguing exercise by the I finger. Fatigue led to a large increase in force variance in the I-finger task and a smaller increase in the IM-task. We quantified two components of variance in the space of hypothetical commands to fingers, finger modes. Under both stable and unstable conditions, there was a large increase in the variance component that did not affect total force and a much smaller increase in the component that did. This resulted in an increase in an index of the force-stabilizing synergy. These results indicate that marginal redundancy is sufficient to allow the central nervous system to use adaptive increase in variability to shield important variables from effects of fatigue. We offer an interpretation of these results based on a recent development of the equilibrium-point hypothesis known as the referent configuration hypothesis.

Fatigue and motor redundancy: adaptive increase in finger force variance in multi-finger tasks

We studied the effects of fatigue of the index finger on indices of force variability in discrete and rhythmic accurate force production tasks performed by the index finger and by all four fingers pressing in parallel. An increase in the variance of the force produced by the fatigued index finger was expected. We hypothesized that the other fingers would also show increased variance of their forces, which would be accompanied by co-variation among the finger forces resulting in relatively preserved accuracy of performance. The subjects performed isometric tasks including maximal voluntary contraction (MVC) and accurate force production before and after a 1-min MVC fatiguing exercise by the index finger. During fatigue, there was a significant increase in the root mean square index of force variability during accurate force production by the index finger. In the four-finger tasks, the variance of the individual finger force increased for all four fingers, while the total force variance showed only a modest change. We quantified two components of variance in the space of hypothetical commands to fingers, finger modes. There was a large increase in the variance component that did not affect total force and a much smaller increase in the component that did. The results suggest an adaptive increase in force variance by nonfatigued elements as a strategy to attenuate effects of fatigue on accuracy of multi-element performance. These effects were unlikely to originate at the level of synchronization of motor units across muscle compartments but rather involved higher control levels.

Age-related changes in multi-finger interactions in adults during maximum voluntary finger force production tasks

This study aimed to continue our characterization of finger strength and multi-finger interactions across the lifespan to include those in their 60s and older. Building on our previous study of children, we examined young and elderly adults during isometric finger flexion and extension tasks. Sixteen young and 16 elderly, gender-matched participants produced maximum force using either a single finger or all four fingers in flexion and extension. The maximum voluntary finger force (MVF), the percentage contributions of individual finger forces to the sum of individual finger forces during four-finger MVF task (force sharing), and the non-task finger forces during a task finger MVF task (force enslaving), were computed as dependent variables. Force enslaving during finger extension was greater than during flexion in both young and elderly groups. The flexion-extension difference was greater in the elderly than the young adult group. The greater independency in flexion may result from more frequent use of finger flexion in everyday manipulation tasks. The non-task fingers closer to a task finger produced greater enslaving force than non-task fingers farther from the task finger. The force sharing pattern was not different between age groups. Our findings suggest that finger strength decreases over the aging process, finger independency for flexion increases throughout development, and force sharing pattern remains constant across the lifespan.

Enhanced muscle fatigue occurs in male but not female ASIC3-/- mice

Muscle fatigue is associated with a number of clinical diseases, including chronic pain conditions. Decreases in extracellular pH activates acid-sensing ion channel 3 (ASIC3), depolarizes muscle, protects against fatigue, and produces pain. We examined whether ASIC3-/- mice were more fatigable than ASIC3+/+ mice in a task-dependent manner. We developed two exercise protocols to measure exercise-induced muscle fatigue: (fatigue task 1, three 1-h runs; fatigue task 2, three 30-min runs). In fatigue task 1, male ASIC3+/+ mice muscle showed less fatigue than male ASIC3-/- mice and female ASIC3+/+ mice. No differences in fatigue were observed in fatigue task 2. We then tested whether the development of muscle fatigue was dependent on sex and modulated by testosterone. Female ASIC3+/+ mice that were ovariectomized and administered testosterone developed less muscle fatigue than female ASIC3+/+ mice and behaved similarly to male ASIC3+/+ mice. However, testosterone was unable to rescue the muscle fatigue responses in ovariectomized ASIC3-/- mice. Plasma levels of testosterone from male ASIC3-/- mice were significantly lower than in male ASIC3+/+ mice and were similar to female ASIC3+/+ mice. Muscle fiber types, measured by counting ATPase-stained whole muscle sections, were similar in calf muscles from male and female ASIC3+/+ mice. These data suggest that both ASIC3 and testosterone are necessary to protect against muscle fatigue in a task-dependent manner. Also, differences in expression of ASIC3 and the development of exercise-induced fatigue could explain the female predominance in clinical syndromes of pain that include muscle fatigue.

Hand digit control in children: age-related changes in hand digit force interactions during maximum flexion and extension force production tasks

We studied the finger interactions during maximum voluntary force (MVF) production in flexion and extension in children and adults. The goal of this study was to investigate the age-related changes and flexion-extension differences of MVF and finger interaction indices, such as finger inter-dependency (force enslaving (FE): unintended finger forces produced by non-instructed fingers during force production of an instructed finger), force sharing (FS; percent contributions of individual finger forces to the total force at four-finger MVF), and force deficit (FD; force difference between single-finger MVF and the force of the same finger at four-finger MVF). Twenty-five right-handed children of 6-10 years of age and 25 adults of 20-24 years of age participated as subjects in this study (five subjects at each age). During the experiments, the subjects had their forearms secured in armrests. The subjects inserted the distal phalanges of the right hand into C-shaped aluminum thimbles affixed to small force sensors with 200 of flexion about the metacarpophalangeal (MCP) joint. The subjects were instructed to produce their maximum isometric force with a single finger or all four fingers in flexion or extension. In order to examine the effects of muscle-force relationship on MVF and other digit interaction indices, six subjects were randomly selected from the group of 25 adult subjects and asked to perform the same experimental protocol described above. However, the MCP joint was at 800 of flexion. The results from the 20' of MCP joint flexion showed that (1) MVF increased and finger inter-dependency decreased with children's age, (2) the increasing and decreasing absolute slopes (N/year) from regression analysis were steeper in flexion than extension while the relative slopes (%/year) with respect to adults' maximum finger forces were higher in extension than flexion, (3) the larger MVF, FE, and FD were found in flexion than in extension, (4) the finger FS was very similar in children and adults, (5) the FS pattern of individual fingers was different for flexion and extension, and (6) the differences between flexion and extension found at 20 degrees MCP joint conditions were also valid at 80 degrees MCP joint conditions. We conclude that (a) the finger strength and independency increase from 6 to 10 years of age, and the increasing trends are more evident in flexion than in extension as indexed by the absolute slopes, (b) the finger strength and finger independency is greater in flexion than in extension, and (c) the sharing pattern in children appears to develop before 6 years of age or it is an inherent property of the hand neuromusculoskletal system. One noteworthy observation, which requires further investigation, was that FE was slightly smaller in the 80 degrees condition than in the 20 degrees condition for flexion, but larger for extension for all subjects. This may be interpreted as a greater FE when flexor or extensor muscles are stretched.

Learning effects on muscle modes and multi-mode postural synergies

We used the framework of the uncontrolled manifold hypothesis to explore the effects of practice on the composition of muscle groups (M-modes) and multi-M-mode synergies stabilizing the location of the center of pressure (COP). In particular, we tested a hypothesis that practice could lead to a transition from co-contraction muscle activation patterns to reciprocal patterns. We also tested a hypothesis that new sets of M-modes would form stronger synergies stabilizing COP location. Subjects practiced load release tasks for five days while standing on a board with a narrow support surface (unstable board). Their M-modes and indices of multi-M-mode synergies were computed during standing without instability and during standing on an unstable board before practice, in the middle of practice, and at the end of practice. During standing without instability, subjects showed two consistent M-modes uniting dorsal and ventral muscles of the body respectively (reciprocal modes). While standing on an unstable board, prior to practice, subjects commonly showed M-modes uniting muscle pairs with opposing actions at major leg joints-co-contraction modes. Such sets of M-modes failed to stabilize the COP location in the anterior-posterior direction. Practice led to better task performance reflected in fewer incidences of lost balance. This was accompanied by a drop in the occurrence of co-contraction M-modes and the emergence of multi-mode synergies stabilizing the COP location. We conclude that the central nervous system uses flexible sets of elemental variables (modes) to ensure stable trajectories of important performance variables (such as COP location). Practice can lead to adjustments in both the composition of M-modes and M-mode co-variation patterns resulting in stronger synergies stabilizing COP location.

Perception of finger forces within the hand after index finger fatiguing exercise

The effect of fatigue on finger force perception within a hand during ipsilateral finger force matching was examined. Thirteen subjects were instructed to match a reference force of an instructed finger using the same or different finger within the hand before and after index finger fatigue. Absolute reference force targets for the index or little finger were identical during pre- and post-fatigue sessions. Fatigue was induced by a 60-s sustained maximal voluntary contraction (MVC) of the index finger. Index finger MVC decreased approximately 29%, while there was a non-significant (about 5%) decrease in the little finger MVC. The results showed that: (1) the absolute reference and matching forces of the instructed fingers were not significantly changed after fatigue, while the total forces (sum of instructed and uninstructed finger forces) were increased after fatigue. (2) The relative forces (with respect to corresponding pre- and post-fatigue MVCs) of the index finger increased significantly in both reference and matching tasks, while the relative forces of the little finger remained unchanged after fatigue. (3) Matching errors remained unchanged after fatigue when the fatigued index finger produced the reference force, while the errors increased significantly when the fatigued index finger produced the matching force. (4) Enslaving (difference between total and instructed finger forces) increased significantly after fatigue, especially during force production by the fatigued index finger and when the little finger produced matching forces at higher force levels. (5) Enslaving significantly increased matching errors particularly after fatigue. Taken together, our results suggest that absolute finger forces within the hand are perceived within the CNS during ipsilateral finger force matching. Perception of absolute forces of the fatigued index finger is not altered after fatigue. The ability of the fatigued index finger to reproduce little finger forces is impaired to a certain degree, however. The impairment is likely to be attributable to altered afferent/efferent relationships of the fatigued index finger.

Error compensation during finger force production after one- and four-finger voluntarily fatiguing exercise

The effect of muscle fatigue on error compensation strategies during multi-finger ramp force production tasks was investigated. Thirteen young, healthy subjects were instructed to produce a total force with four fingers of the right hand to accurately match a visually displayed template. The template consisted of a 3-s waiting period, a 3-s ramp force production [from 0 to 30% maximal voluntary contraction (MVC)], and a 3-s constant force production. A series of 12 ramp trials was performed before and after fatigue. Fatigue was induced by a 60-s maximal isometric force production with either the index-finger only or with all four fingers during two separate testing sessions. The average percent of drop was 38.2% in the MVC of the index finger after index-finger fatiguing exercise and 38.3% in the MVC of all fingers after four-finger fatiguing exercise. The ability of individual fingers to compensate for each other's errors in order for the total force to match the preset template was quantified as the error compensation index (ECI), i.e., the ratio of the sum of variances of individual finger forces and the variance of the total force. By comparing pre- and post-fatigue performance during four-finger ramp force production, we observed that the variance of the total force was not significantly changed after one- or four-finger fatiguing exercise. The ECI significantly decreased after four-finger fatiguing exercise, especially during the last second of the ramp; while the ECI remained unchanged after index finger single-finger fatiguing exercise. These results suggest that the central nervous system is able to utilize the abundant degrees of freedom to compensate for partial impairment of the motor apparatus induced by muscle fatigue to maintain the desired performance. However, this ability is significantly decreased when all elements of the motor apparatus are impaired.

Differences in multi-joint kinematic patterns of repetitive hammering in healthy, fatigued and shoulder-injured individuals

BACKGROUND

Work-related musculo-skeletal disorders have been previously related to movement repetition, inadequate postures, non-ergonomic environments, muscular imbalance and fatigue. However, no direct link between fatigue and injury has been experimentally shown. To address this problem, we compared the effects of fatigue and injury on the kinematics of repetitive hammering.

METHODS

Healthy subjects (n=30) hammered repetitively both before and after fatigue. Fatigue was induced by a combination of static and dynamic procedures. Shoulder-injured subjects (n=15) hammered for 30s without fatigue. Kinematics of motion was recorded.

FINDINGS

The movement time and shoulder range of motion during hammering were not affected by either fatigue or shoulder injury. When fatigued, the healthy subjects displayed decreased range of joint motion, peak velocity and peak acceleration of elbow motion during hammering as well as reduced grip strength. Shoulder-injured individuals had a smaller hammer trajectory amplitude than healthy controls with or without fatigue. They also had lower wrist range of motion, elbow peak velocity, and peak wrist and elbow acceleration compared to healthy subjects hammering without fatigue but only lower wrist peak acceleration compared to healthy subjects hammering with fatigue.

INTERPRETATION

Results showed that fatigue affects elbow motion while shoulder injury affects both wrist and elbow motions during hammering. However, shoulder kinematics were not changed by either fatigue or shoulder injury. These changes at the wrist and elbow may reflect strategies used by individuals with shoulder injury to maintain constant movement duration and shoulder kinematics during movement.

Is the thumb a fifth finger? A study of digit interaction during force production tasks

We studied indices of digit interaction in single- and multi-digit maximal voluntary contraction (MVC) tests when the thumb acted either in parallel or in opposition to the fingers. The peak force produced by the thumb was much higher when the thumb acted in opposition to the fingers and its share of the total force in the five-digit MVC test increased dramatically. The fingers showed relatively similar peak forces and unchanged sharing patterns in the four-finger MVC task when the thumb acted in parallel and in opposition to the fingers. Enslaving during one-digit tasks showed relatively mild differences between the two conditions, while the differences became large when enslaving was quantified for multi-digit tasks. Force deficit was pronounced when the thumb acted in parallel to the fingers; it showed a monotonic increase with the number of explicitly involved digits up to four digits and then a drop when all five digits were involved. Force deficit all but disappeared when the thumb acted in opposition to the fingers. However, for both thumb positions, indices of digit interaction were similar for groups of digits that did or did not include the thumb. These results suggest that, given a certain hand configuration, the central nervous system treats the thumb as a fifth finger. They provide strong support for the hypothesis that indices of digit interaction reflect neural factors, not the peripheral design of the hand. An earlier formal model was able to account for the data when the thumb acted in parallel to the fingers. However, it failed for the data with the thumb acting in opposition to the fingers.

Effects of motor imagery on finger force responses to transcranial magnetic stimulation

The purpose of this study was to investigate whether characteristics of finger interaction seen in voluntary finger force production tasks could also be observed during motor imagery. Transcranial magnetic stimulation (TMS) was applied over the contralateral M1 hand area. Three conditions were tested in eight young healthy volunteers: At rest, during motor imagery of maximal force production by the index finger (ImIn), and during motor imagery of maximal force production by all four fingers simultaneously (ImAll). We obtained measures of motor threshold (MT), motor-evoked potentials (MEP) from the contralateral flexor digitorium superficialis, and TMS-induced forces from individual fingers. Increased MEP and decreased MT during motor imagery tasks suggested enhanced excitability of structures involved in the generation of TMS-induced responses. TMS-induced forces were larger during motor imagery tasks than at rest. This effect was present, albeit significantly smaller, in the middle, ring, and little fingers during ImIn as compared to ImAll. This finding has been interpreted as a correlate of the phenomenon of unintended finger force production (enslaving). The motor imagery effect on finger forces evoked by TMS was significantly larger during ImIn (4% MVC) than during ImAll (2.8% MVC) tasks, corresponding to the phenomenon of force deficit. These results provide direct evidence of the neural origin of the main phenomena of finger interaction. Furthermore, the similarities between characteristics of finger interaction during motor imagery and during voluntary movement suggest the involvement of similar neural structures (including M1).

The effects of stroke and age on finger interaction in multi-finger force production tasks

OBJECTIVE

The main purpose of this study was to investigate changes in finger interaction after stroke with strongly unilateral motor effects. Effects of age on finger interaction were also analyzed.

METHODS

Sixteen stroke subjects and 16 control subjects produced maximal voluntary contractions with different finger combinations by one hand and by two hands simultaneously. Individual finger forces were measured. In multi-finger tasks, force deficit (FD) was quantified as the difference between the peak finger forces in single-finger tasks and in multi-finger tasks, while enslaving (ENSL) was quantified as forces produced by fingers that were not required to produce force.

RESULTS

In stroke subjects, the peak forces produced by the fingers of the impaired hand (IH) were about 36% less than those produced by the unimpaired hand. Stroke resulted in higher ENSL and decreased FD in the IH, particularly when the index and middle fingers produced force together, while aging led to higher FD and no change in ENSL. Two-hand tasks were accompanied by an additional drop in the force of individual fingers, i.e. bilateral deficit (BD). No changes in BD were observed with age or after stroke.

CONCLUSIONS

We conclude that IH function in persons after stroke is accompanied not only by a general loss of finger force but also by changes in indices of multi-finger interaction. The contrast between the significantly changed indices of one-hand multi-finger interaction and unchanged BD implies that cortical neurons mediating interhemispheric inhibition are relatively spared in unilateral stroke.

SIGNIFICANCE

The study shows that stroke leads to changes not only in finger force but also in finger interaction. The conclusion on relatively spared interhemispheric projections is potentially important for therapy of hand function in stroke survivors.

Finger interactions studied with transcranial magnetic stimulation during multi-finger force production tasks

OBJECTIVE

We used transcranial magnetic stimulation (TMS) to investigate interactions among neuromuscular complexes involved in force production by individual fingers of a hand during single- and multi-finger tasks.

METHODS

Subjects were asked to press with the fingertips at various levels of force using different finger combinations. TMS was applied over the M1 cortical hand area during constant force production. TMS-induced increments in fingertip forces were analyzed, as well as motor evoked potentials (MEPs) in flexor digitorum superficialis.

RESULTS

Both MEP size and individual force increments had inverted U-shaped dependences on the background force (peak responses were seen at about 50% of the maximal force). Similar relationships were obtained when subjects were asked to produce different forces with the same finger combination or the same total force with different finger combinations. The relationships were similar when the force was produced by explicitly instructed fingers or by other fingers of the hand. Effects of TMS on the force of a finger showed a strong dependence on the background force produced by this finger and minimal or no dependence on forces produced by other fingers of the hand.

CONCLUSIONS

Overall, TMS applied over M1 revealed little interaction among fingers. This supports the notion of digit-specific compartments in multi-digit extrinsic muscles of the hand and suggests that these compartments possess a high degree of physiological independence.

In vivo load sharing among the quadriceps components

Knee extension is always performed with coordinated contractions of multiple quadriceps muscle components; however, how the load is shared among them under normal and pathological conditions is unclear. We hypothesized that: the absolute moment generated by each quadriceps component increases with the total knee extension moment; the relative contribution and its dependence on the total knee extension moment are different for different quadriceps components; and the centrally located large vastus intermedius (VI) is favored by the central nervous system at low levels of activation. Electrical stimulation was used to activate each quadriceps component selectively in six human subjects. The relationship between the knee extension moment generated by an individual quadriceps component and the corresponding compound muscular action potential (M-wave) over various contraction levels was established for each quadriceps component. This relationship was used to calibrate the corresponding EMG signal and determine load sharing among quadriceps components during submaximal isometric voluntary knee extension. The VI contributed the most (51.8-39.6%) and vastus medialis the least (9.5-12.2%) to knee extension moment (P<0.05). As the knee extension moment increased, the relative contribution of the VI decreased (P=0.017) while the relation contribution of the vastus lateralis and medialis increased (P</=0.012). The absolute moment generated by each quadriceps component always increased with the total knee extension moment (P<0.002). Our in vivo approach determined subject- and condition-specific load sharing among individual muscles and showed that the central nervous system utilized the centrally located, uniarticular VI in submaximal isometric knee extension.

Effects of age and gender on finger coordination in MVC and submaximal force-matching tasks

The objective of the study is to examine the effects of age and gender on finger coordination. Twelve young (24 +/- 8 yr; 6 men and 6 women) and 12 elderly (75 +/- 5 yr; 6 men and 6 women) subjects performed single-finger maximal contraction [maximal voluntary contraction (MVC)], four-finger MVC, and four-finger ramp force production tasks by pressing on individual force transducers. A drop in the force of individual fingers during four-finger MVC tasks compared with single-finger MVC tasks (force deficit) was larger, whereas unintended force production by other fingers during single-finger MVC tasks (enslaving) was smaller, in elderly than in young subjects and in women than in men. Force deficit was smaller and enslaving was larger in subjects with higher peak force. During the ramp task, the difference between the variance of total force and the sum of variances of individual forces showed a logarithmic relation to the level of total force, across all subject groups. These findings suggest that indexes of finger coordination scale with force-generating capabilities across gender and age groups.

Dependence of finger flexion force on the posture of the nonperforming fingers during key pressing tasks

The influence of different positions of the nonperforming (idle) fingers on the maximal force contraction of flexion (master) fingers during key pressing tasks was investigated. Ten participants performed maximal voluntary flexion contractions with various combinations of the index, middle, ring, and little fingers while the idle fingers rested on or were lifted away from the supporting surface. The effect of idle finger posture on total finger force production of master fingers was dependent on finger combination. In general, force production by master fingers was higher when the idle fingers were lifted away from the supporting surface than when they rested on it. The average increase in total force production by master fingers caused by the lifting of idle fingers was +12.4% (from -8.3% to +30.2%). Force-production capability of individual master fingers can be facilitated (as high as 34.1%), unchanged, or depressed (as high as -29.0%) by lifting the idle fingers. The effect of idle finger posture on finger force production of master fingers led to changes in force deficit. Neural, anatomical, and mechanical factors might account for the dependence of finger flexion force of master fingers on the posture of the idle fingers.