The role of cutaneous feedback for anticipatory grip force adjustments during object movements and externally imposed variation of the direction of gravity

Highs and Lows in Motor Control Development

Motor control is classically described as relying on two components: anticipatory control (feedforward processing) and online control (feedback processing). Here we aimed to unveil the developmental steps of both feedback and feedforward control in 5-10 years old children, using a simple and ecological task. We manipulated object's weight in a reach-to-displace paradigm. When the weight was known before lifting it, anticipatory processes were quantifiable during the reaching phase. Conversely, an unknown weight triggered online corrections during the displacing phase. Movement kinematics revealed that children anticipate this objet property as young as 5 y-o. This anticipation becomes adequate around 7 y-o and is paralleled by poor online corrections. This simple yet relevant paradigm should allow quantifying deviations from neurotypical patterns in disorders of motor control.

Effects of cervical manipulation on pain, grip force control, and upper extremity muscle activity: a randomized controlled trial

Objectives

Individuals with neck pain experience disrupted grip force control when performing manipulative tasks. Manipulative physical therapy might decrease pain and change the activity of surrounding muscles; however, its effect on upper limb motor control remains undetermined. This study aims to analyze the effects of cervical manipulation on pressure pain threshold (PPT), upper extremity muscle activity along with grip force control in individuals with neck pain.

Methods

Thirty subjects with neck pain were instructed to grasp and lift an object before and after cervical (n = 15) or sham (n = 15) manipulation. The patients' PPT, electromyographic (EMG) activity of the upper extremity/scapular muscles, and grip force control were analyzed before and after one session of manipulation.

Results

No significant differences were found in the grip force control, PPT and EMG activity variables between groups.

Discussion

These results suggest that a single session of cervical manipulation may not modify upper limb motor control, more specifically grip force control and EMG activity, in patients with cervical pain. Future studies should investigate potential changes in grip force control in patients with different features of neck pain and/or by applying long-term treatment.

Level of Evidence

1b.

Taxonomy based analysis of force exchanges during object grasping and manipulation

The flexibility of the human hand in object manipulation is essential for daily life activities, but remains relatively little explored with quantitative methods. On the one hand, recent taxonomies describe qualitatively the classes of hand postures for object grasping and manipulation. On the other hand, the quantitative analysis of hand function has been generally restricted to precision grip (with thumb and index opposition) during lifting tasks. The aim of the present study is to fill the gap between these two kinds of descriptions, by investigating quantitatively the forces exerted by the hand on an instrumented object in a set of representative manipulation tasks. The object was a parallelepiped object able to measure the force exerted on the six faces and its acceleration. The grasping force was estimated from the lateral force and the unloading force from the bottom force. The protocol included eleven tasks with complementary constraints inspired by recent taxonomies: four tasks corresponding to lifting and holding the object with different grasp configurations, and seven to manipulating the object (rotation around each of its axis and translation). The grasping and unloading forces and object rotations were measured during the five phases of the actions: unloading, lifting, holding or manipulation, preparation to deposit, and deposit. The results confirm the tight regulation between grasping and unloading forces during lifting, and extend this to the deposit phase. In addition, they provide a precise description of the regulation of force exchanges during various manipulation tasks spanning representative actions of daily life. The timing of manipulation showed both sequential and overlapping organization of the different sub-actions, and micro-errors could be detected. This phenomenological study confirms the feasibility of using an instrumented object to investigate complex manipulative behavior in humans. This protocol will be used in the future to investigate upper-limb dexterity in patients with sensory-motor impairments.

Tactile feedback is an effective instrument for the training of grasping with a prosthesis at low- and medium-force levels

Grasping is a complex task routinely performed in an anticipatory (feedforward) manner, where sensory feedback is responsible for learning and updating the internal model of grasp dynamics. This study aims at evaluating whether providing a proportional tactile force feedback during the myoelectric control of a prosthesis facilitates learning a stable internal model of the prosthesis force control. Ten able-bodied subjects controlled a sensorized myoelectric prosthesis performing four blocks of consecutive grasps at three levels of target force (30, 50, and 70%), repeatedly closing the fully opened hand. In the first and third block, the subjects received tactile and visual feedback, respectively, while during the second and fourth block, the feedback was removed. The subjects also performed an additional block with no feedback 1 day after the training (Retest). The median and interquartile range of the generated forces was computed to assess the accuracy and precision of force control. The results demonstrated that the feedback was indeed an effective instrument for the training of prosthesis control. After the training, the subjects were still able to accurately generate the desired force for the low and medium target (30 and 50% of maximum force available in a prosthesis), despite the feedback being removed within the session and during the retest (low target force). However, the training was substantially less successful for high forces (70% of prosthesis maximum force), where subjects exhibited a substantial loss of accuracy as soon as the feedback was removed. The precision of control decreased with higher forces and it was consistent across conditions, determined by an intrinsic variability of repeated myoelectric grasping. This study demonstrated that the subject could rely on the tactile feedback to adjust the motor command to the prosthesis across trials. The subjects adjusted the mean level of muscle activation (accuracy), whereas the precision could not be modulated as it depends on the intrinsic myoelectric variability. They were also able to maintain the feedforward command even after the feedback was removed, demonstrating thereby a stable learning, but the retention depended on the level of the target force. This is an important insight into the role of feedback as an instrument for learning of anticipatory prosthesis force control.

Contribution of tactile dysfunction to manual motor dysfunction in type II diabetes

INTRODUCTION

Changes in sensory and motor functions of the hand in type II diabetes (T2D) patients have been reported; there is speculation that these changes are driven by tactile dysfunction. The purpose of this study was to evaluate the effects of tactile feedback on manual function in T2D patients.

METHODS

T2D patients and healthy controls underwent median nerve blocks at the wrist and elbow. All participants underwent traditional timed motor evaluations, force dynamometry, laboratory-based kinetic evaluations, and sensory evaluation.

RESULTS

Tactile sensation in the T2D group at baseline was found to be equivalent to tactile function of the control group after median nerve block. Traditional timed evaluation results were negatively impacted by anesthesia, but more sensitive kinetic measures were not impacted.

CONCLUSIONS

These data suggest that mechanisms outside of tactile dysfunction play a significant role in motor dysfunction in T2D. Muscle Nerve 54: 895-902, 2016.

The effect of finger joint hypomobility on precision grip force

STUDY DESIGN

Repeated measures experiment.

INTRODUCTION

Traumatic injuries and certain other diseases of the hand typically affect mobility of the finger joints. Decreased mobility may alter grip force control while one is grasping and lifting objects. However, the effect of finger joint hypomobility on grip force control has not yet been systematically investigated.

PURPOSE OF THE STUDY

The aim of this study was to investigate the effects of limited finger joint mobility, without other associated symptoms like pain, or sensory/proprioceptive deficits, on precision grip force control.

METHODS

Fifteen healthy subjects performed a pinching and lifting task of an object equipped with a force sensor and an accelerometer, via opposition of the thumb and index finger, in the following experimental conditions: unrestricted finger joint movement (UJM), restricted finger flexion (RFF), restricted finger extension (RFE), mock restricted flexion (MRF), mock restricted extension (MRE). The following pinch force variables were measured and analyzed: grip force at lift off, grip force peak, load force peak, latency, and static force.

RESULTS

A significant increase in latency (F = 4.41, p < 0.01) was noted during RFE relative to UJM and MRF conditions. There were no statistically-significant differences between the conditions among the other variables of precision grip force control.

CONCLUSIONS

Limited joint mobility of the thumb and index finger may cause temporal changes in precision grip force control, which can lead to reduced manual dexterity. Restoring range of motion might be an important priority to improve thumb-index pinch force control during manipulative tasks.

Active collisions in altered gravity reveal eye-hand coordination strategies

Most object manipulation tasks involve a series of actions demarcated by mechanical contact events, and gaze is usually directed to the locations of these events as the task unfolds. Typically, gaze foveates the target 200 ms in advance of the contact. This strategy improves manual accuracy through visual feedback and the use of gaze-related signals to guide the hand/object. Many studies have investigated eye-hand coordination in experimental and natural tasks; most of them highlighted a strong link between eye movements and hand or object kinematics. In this experiment, we analyzed gaze strategies in a collision task but in a very challenging dynamical context. Participants performed collisions while they were exposed to alternating episodes of microgravity, hypergravity and normal gravity. First, by isolating the effects of inertia in microgravity, we found that peak hand acceleration marked the transition between two modes of grip force control. Participants exerted grip forces that paralleled load force profiles, and then increased grip up to a maximum shifted after the collision. Second, we found that the oculomotor strategy adapted visual feedback of the controlled object around the collision, as demonstrated by longer durations of fixation after collision in new gravitational environments. Finally, despite large variability of arm dynamics in altered gravity, we found that saccades were remarkably time-locked to the peak hand acceleration in all conditions. In conclusion, altered gravity allowed light to be shed on predictive mechanisms used by the central nervous system to coordinate gaze, hand and grip motor actions during a mixed task that involved transport of an object and high impact loads.

Does visually induced self-motion affect grip force when holding an object?

Accurate control of grip force during object manipulation is necessary to prevent the object from slipping, especially to compensate for the action of gravitational and inertial forces resulting from hand/object motion. The goal of the current study was to assess whether the control of grip force was influenced by visually induced self-motion (i.e., vection), which would normally be accompanied by changes in object load. The main task involved holding a 400-g object between the thumb and the index finger while being seated within a virtual immersive environment that simulated the vertical motion of an elevator across floors. Different visual motions were tested, including oscillatory (0.21 Hz) and constant-speed displacements of the virtual scene. Different arm-loading conditions were also tested: with or without the hand-held object and with or without oscillatory arm motion (0.9 Hz). At the perceptual level, ratings from participants showed that both oscillatory and constant-speed motion of the elevator rapidly induced a long-lasting sensation of self-motion. At the sensorimotor level, vection compellingness altered arm movement control. Spectral analyses revealed that arm motion was entrained by the oscillatory motion of the elevator. However, we found no evidence that grip force used to hold the object was visually affected. Specifically, spectral analyses revealed no component in grip force that would mirror the virtual change in object load associated with the oscillatory motion of the elevator, thereby allowing the grip-to-load force coupling to remain unaffected. Altogether, our findings show that the neural mechanisms underlying vection interfere with arm movement control but do not interfere with the delicate modulation of grip force. More generally, those results provide evidence that the strength of the coupling between the sensorimotor system and the perceptual level can be modulated depending on the effector.

Grip force control in individuals with hand osteoarthritis

Individuals with hand osteoarthritis (OA) experience pain and stiffness that could result in significant limitations in the performance of everyday activities involving upper extremities. The purpose of the study was to evaluate grip force control in individuals with hand OA during the lifting of an object. The study design used was a case-control study. Ten females with hand OA and a group of age-matched females performed two functional tasks: lifting an instrumented object vertically while the load was suddenly changed and lifting and placing the object on a shelf. Load Force Peak, Grip force at liftoff, Grip Force Peak, Time Lag, and Latency were measured and analyzed. Individuals with hand OA were able to modulate the magnitude and temporal parameters of grip force; however, they applied higher grip forces (at liftoff [p=0.002]; Grip Force Peak [p=0.039]) and demonstrated a longer Latency (p=0.015) to manipulate the instrumented object when compared with the control subjects. The Load Force Peak and Time Lag were not significantly different between the two groups. Detailed information about how individuals with hand OA perform prehension activities of daily living will help to better understand the limitations of grip force control in these individuals.

Effects of carpal tunnel syndrome on adaptation of multi-digit forces to object weight for whole-hand manipulation

The delicate tuning of digit forces to object properties can be disrupted by a number of neurological and musculoskeletal diseases. One such condition is Carpal Tunnel Syndrome (CTS), a compression neuropathy of the median nerve that causes sensory and motor deficits in a subset of digits in the hand. Whereas the effects of CTS on median nerve physiology are well understood, the extent to which it affects whole-hand manipulation remains to be addressed. CTS affects only the lateral three and a half digits, which raises the question of how the central nervous system integrates sensory feedback from affected and unaffected digits to plan and execute whole-hand object manipulation. We addressed this question by asking CTS patients and healthy controls to grasp, lift, and hold a grip device (445, 545, or 745 g) for several consecutive trials. We found that CTS patients were able to successfully adapt grip force to object weight. However, multi-digit force coordination in patients was characterized by lower discrimination of force modulation to lighter object weights, higher across-trial digit force variability, the consistent use of excessively large digit forces across consecutive trials, and a lower ability to minimize net moments on the object. Importantly, the mechanical requirement of attaining equilibrium of forces and torques caused CTS patients to exert excessive forces at both CTS-affected digits and digits with intact sensorimotor capabilities. These findings suggest that CTS-induced deficits in tactile sensitivity interfere with the formation of accurate sensorimotor memories of previous manipulations. Consequently, CTS patients use compensatory strategies to maximize grasp stability at the expense of exerting consistently larger multi-digit forces than controls. These behavioral deficits might be particularly detrimental for tasks that require fine regulation of fingertip forces for manipulating light or fragile objects.

Grip Force Control in Individuals With Multiple Sclerosis

Background. Appropriate regulation of grip force is essential in performance of various activities of daily living such as drinking, eating, buttoning a shirt, and so on. The extent to which individuals with multiple sclerosis (MS) are able to regulate grip forces while performing elements of the activities of daily living is largely unknown. Objective. To investigate how individuals with MS control grip force during performance of functional tasks. Methods. This study evaluated the grip force control in selected individuals with MS (n = 9) and healthy control subjects (n = 9) while they performed the task of lifting and placing an instrumented object on a shelf and the task of lifting the object and bringing it close to the mouth to mimic drinking. The grip forces, object acceleration, force ratio, and time lag were recorded and analyzed. Results. The individuals with MS used significantly larger peak grip force and force ratio than control subjects while performing both tasks and for both hands. In addition, the time lag between the peaks of grip and load forces was significantly longer in individuals with MS. Conclusion. The application of excessive grip force could predispose individuals with MS to additional fatigue and musculoskeletal overuse trauma. Rehabilitation protocols for the MS population may need to account for increased levels of grip force applied during the performance of functional tasks.

Force coordination in static manipulation: discerning the contribution of muscle synergies and cutaneous afferents

Both an elaborate coordination of the hand grip force (G; normal component of force acting at the digits-object contact area) and load force (L; tangential component), and the role of cutaneous afferents in G-L coordination have been well documented in a variety of manipulation tasks. However, our recent studies revealed that G-L coordination deteriorates when L consecutively changes direction (bidirectional tasks; e.g., when vigorously shaking objects or using tools). The aim of the study was to distinguish between the possible role of the synergy of hand grip and arm muscles (exerting G and L, respectively) and the role of cutaneous afferent input in the observed phenomenon. Subjects (N=14) exerted sinusoidal L pattern in vertical direction against an externally fixed device in trials that gradually changed from uni- to fully bidirectional. In addition, a manipulation of an external arm support decoupled L measured by the device (and, therefore, recorded by the cutaneous receptors) from the action of arm muscles exerting L. The results revealed that switching from uni- to bidirectional tasks, no matter how low and brief L exertion was in the opposite direction, was associated with an abrupt decrease in G-L coordination. This coordination remained unaffected by the manipulation of external support. The first result corroborates our previous conclusion that the force coordination in uni- and bidirectional manipulation tasks could be based on partly different neural control mechanisms. However, the second finding suggests that the studied control mechanisms could depend more on the cutaneous afferent input, rather than on the synergy of the muscles exerting G and L.

Force coordination in static manipulation tasks: effects of the change in direction and handedness

A number of studies have demonstrated high coordination of the hand grip force (GF; normal component of force acting at the digits-object contact area) and load force (LF; tangential component) in a variety of manipulation tasks. The aim of the study was to explore the mainly neglected effect of the change in LF direction and the effect of handedness on GF and LF coordination in bimanual manipulation task. Subjects (N = 14) exerted a bimanual sinusoidal LF pattern against externally fixed handles in trials that gradually changed from unidirectional (LF exerted only in one direction) to fully bidirectional (equal LF peaks in two opposite directions). Despite the gradual change of LF, unidirectional trials demonstrated high indices of force coordination, while in all bidirectional trials, no matter how low and brief LF exertion was in the opposite direction, all indices of GF and LF coordination deteriorated to a considerably lower level. The non-dominant hand demonstrated both a higher directional accuracy of exerting LF and higher GF modulation than the dominant one. We concluded that manipulation tasks performed in a single and two alternating directions may be based on partly distinctive neural control mechanisms, as well as that a switching of muscle synergies required in bidirectional tasks could play a role in the observed phenomenon. Regarding the effect of hand dominance, the recorded advantage of the non-dominant hand could be considered as an addition to the current views of the non-dominant arm/hemisphere specialization in controlling limb position.

Different modes of grip force control: voluntary and externally guided arm movements with a hand-held load

OBJECTIVE

When we move hand-held objects that exhibit stable physical properties grip force is regulated in anticipation of movement-induced inertial loads. In contrast, when the object's behaviour is unpredictable, grip force is adjusted in response to sensory feedback with the consequence that grip tends to lag behind load. Previous studies analysed reactive and predictive grip force behaviour by systematically varying the predictability of the physical object properties.

METHODS

This study examines if anticipatory force control also depends on the predictability of the limb dynamics interfering with external objects. The coupling between grip and load force profiles was comparatively analysed during voluntary and externally guided vertical arm movements with an instrumented hand-held object. Voluntary and externally guided movements were performed with and without visual feedback.

RESULTS

During voluntary arm movements grip force was precisely regulated in anticipation of movement-induced inertial load fluctuations with grip force increasing in parallel with load force without an obvious time delay. In contrast, during externally guided movements grip force was regulated in reaction to the imposed load fluctuations. However, the reflex-mediated grip force responses were still flexible to account for the differential loading requirements of movement direction. There was no difference of grip force performance between movements performed with and without visual feedback.

CONCLUSIONS AND SIGNIFICANCE

The results suggest that predictability of both the external object and the dynamics of the own body is essential to establish an anticipatory mode of grip force regulation. Unpredictability of the own limb dynamics results in a reactive mode of grip force control. Reactive grip force control appears to be both highly automatised and flexible reflecting differential loading requirements of movement direction.

Coordination of fingertip forces in object transport during locomotion

Walking while carrying a hand-held object requires the generation of appropriate grip forces to offset the inertial forces produced during locomotion. The present study examined the interaction between grip forces and locomotion-induced inertial forces across the gait cycle. Eight subjects transported a container under three conditions: self-paced transport with and without accuracy constraints and a velocity-constrained condition. The results showed that the trunk and transported container moved in a synchronized, sinusoidal pattern during all conditions. Grip and inertial forces of the transporting hand were highly coupled in an anticipatory fashion, regardless of task demands. The inertial forces were higher and the coupling was greater in the faster, unconstrained condition. However, grip force modulation was observed even when the inertial forces acting on the container were small and applied indirectly to the container through the locomotor effects originating in the legs and trunk. We suggest that continuous grip force adjustment is used as a generalized strategy to maximize efficiency during object transport regardless of the size or origin of the inertial forces.

Importance of cutaneous feedback in maintaining a secure grip during manipulation of hand-held objects

Previous research has shown that grip and load forces are modulated simultaneously during manipulation of a hand-held object. This close temporal coupling suggested that both forces are controlled by an internal model within the CNS that predicts the changes in tangential force on the fingers. The objective of the present study was to examine how the internal model would compensate for the loss of cutaneous sensation through local anesthesia of the index and thumb. Ten healthy adult subjects (5 men and 5 women aged 20-57 yr) were asked to grasp, lift, and hold stationary, a 250 g object for 20 s. Next, the subjects were asked to perform vertical oscillatory movements over a distance of 20 cm at a rate of 1.0 Hz for 30 s. Eleven trials were performed with intact sensation, and 11 trials after a local ring-block anesthesia of the index and thumb with bupivacain (5 mg/ml). During static holding, loss of cutaneous sensation produced a significant increase in the safety margin. However, the grip force declined significantly over the 20-s static hold period. During oscillatory arm movements, grip and load forces were continuously modulated together in a predictive manner as suggested by Flanagan and Wing. Again, the grip force declined over the 30-s movement, and 7/10 subjects dropped the object at least once. With intact sensation, the object was never dropped; but with the fingers anesthetized, it was dropped on 36% of the trials, and a significant slip occurred on a further 12%. The mean correlation between the grip and load forces for all subjects deteriorated from 0.71 with intact sensation to 0.48 after digital anesthesia. However, a cross-correlation calculated between the grip and load forces indicated that the phase lag was approximately zero both with and without digital anesthesia. Taken together, the data from the present study suggest that cutaneous afferents are required for setting and maintaining the background level of the grip force in addition to their phasic slip-detection function and their role in adapting the grip force/load force ratio to the friction on initial contact with an object. Finally, at a more theoretical level, they correct and maintain an internal model of the physical properties of hand-held objects.