Control of fingertip forces in young and older adults pressing against fixed low- and high-friction surfaces

Visual feedback and declines in attention are associated with altered visual strategy during a force-steadiness task in older adults

Greater heterogeneity exists in older adults relative to young adults when performing highly skilled manual tasks. The purpose of this study was to assess the influence of visual feedback and attentional demand on visual strategy during a submaximal force-steadiness task in young and older adults. Eye movements of 21 young (age 20-38 yr; 11 females, 10 males) and 21 older (age 65-90 yr; 11 females, 10 males) adults were recorded during a pinch force-steadiness task while viewing feedback with higher and lower gain and while performing a visuospatial task. For the visuospatial task, participants imagined a star moving around four boxes and reported the final location after a series of directions. Performance on standardized tests of attention was measured. All participants gazed near the target line and made left-to-right saccadic eye movements during the force-steadiness tasks without the visuospatial task. Older adults made fewer saccades than young adults (21.0 ± 2.9 and 23.6 ± 4.4 saccades, respectively) and with higher versus lower gain (20.9 ± 4.0 and 23.7 ± 3.5 saccades, respectively). Most participants used the same visual strategy when performing the visuospatial task though seven older adults used an altered strategy; gaze did not stay near the target line nor travel exclusively left to right. Performance on standardized measures of attention was impaired in this subset compared with older adults who did not use the altered visual strategy. Results indicate that visual feedback influences visual strategy and reveals unique eye movements in some older adults when allocating attention across tasks.NEW & NOTEWORTHY This study contributes novel findings of age-related changes in visual strategy and associations with attentional deficits during hand motor tasks. Older adults used fewer saccades than young adults and with higher versus lower gain visual feedback during a force-steadiness task. A subset of older adults used an altered visual strategy when allocating attention across multiple tasks. Given that this subset demonstrated attentional deficits, the altered visual strategy could serve to indicate motor and/or cognitive impairments.

The role of eye movements, attention, and hand movements on age-related differences in pegboard tests

Well-documented manual dexterity impairments in older adults may critically depend on the processing of visual information. The purpose of this study was to determine age-related changes in eye and hand movements during commonly used pegboard tests and the association with manual dexterity impairments in older adults. The relationship between attentional deficits and manual dexterity was also assessed. Eye movements and hand kinematics of 20 young (20-38 yr) and 20 older (65-85 yr) adults were recorded during 9-Hole Pegboard, Grooved Pegboard, and a visuospatial dual test. Results were compared with standardized tests of attention (The Test of Everyday Attention and Trail Making Test) that assess visual selective attention, sustained attention, attentional switching, and divided attention. Hand movement variability was 34% greater in older versus young adults when placing the pegs into the pegboard and this was associated with decreased pegboard performance, providing further evidence that increased movement variability plays a role in dexterity impairments in older adults. Older adults made more corrective saccades and spent less time gazing at the pegboard than young adults, suggesting altered visual strategies in older compared with young adults. The relationship between pegboard completion time and Trail Making Test B demonstrates an association between attentional deficits and age-related pegboard impairments. Results contribute novel findings of age-associated changes in eye movements during a commonly used manual dexterity task and offer insight into potential mechanisms underlying hand motor impairments in older adults.NEW & NOTEWORTHY This eye tracking study contributes novel findings of age-associated changes in eye movements during the commonly used pegboard tests of manual dexterity, including a greater number of corrective saccades and lesser time gazing at the pegboard holes in older compared with young adults. An association between attentional deficits and dexterity impairments in older adults is also highlighted. Results shed light on potential mechanisms underlying well-documented motor deficits in older adults.

A TRIZ-driven conceptualisation of finger grip enhancer designs for the elderly

Background: Elderly people with severe finger weakness may need assistive health technology interventions. Finger weakness impedes the elderly in executing activities of daily living such as unbuttoning shirts and opening clothes pegs. While studies have related finger weakness with ageing effects, there appears to be no research that uses an algorithmic problem-solving approach such as the theory of inventive problem-solving (TRIZ) to recommend finger grip assistive technologies that resolve the issue of finger weakness among the elderly. Using TRIZ, this study aims to conceptualise finger grip enhancer designs for elderly people. Methods: Several TRIZ tools such as the cause-and-effect chain (CEC) analysis, engineering contradiction, physical contradiction, and substance-field analysis are used to conceptualise solutions that assist elderly people in their day-to-day pinching activities. Results: Based on the segmentation principle, a finger assistant concept powered by a miniature linear actuator is recommended. Specific product development processes are used to further conceptualise the actuation system. The study concluded that the chosen concept should use a DC motor to actuate fingers through tendon cables triggered by a push start button. Conclusions: Finger pinch degradation worsens the quality of life of the elderly. A finger grip enhancer that assists in day-to-day activities may be an effective option for elderly people, not only for their physical but also their mental well-being in society.

Modulation of finger muscle activation patterns across postures is coordinated across all muscle groups

Successful grasp requires that grip forces be properly directed between the fingertips and the held object. Changes in digit posture significantly affect the mapping between muscle force and fingertip force. Joint torques must subsequently be altered to maintain the desired force direction at the fingertips. Our current understanding of the roles of hand muscles in force production remains incomplete, as past studies focused on a limited set of postures or force directions. To thoroughly examine how hand muscles adapt to changing external (force direction) and internal (posture) conditions, activation patterns of six index finger muscles were examined with intramuscular electrodes in 10 healthy subjects. Participants produced submaximal isometric forces in each of six orthogonal directions at nine different finger postures. Across force directions, participants significantly altered activation patterns to accommodate postural changes in the interphalangeal joint angles but not changes in the metacarpophalangeal joint angles. Modulation of activation levels of the extrinsic hand muscles, particularly the extensors, were as great as those of intrinsic muscles, suggesting that both extrinsic and intrinsic muscles were involved in creating the desired forces. Despite considerable between-subject variation in the absolute activation patterns, principal component analysis revealed that participants used similar strategies to accommodate the postural changes. The changes in muscle coordination also helped increase joint impedance in order to stabilize the end-point force direction. This effect counteracts the increased signal-dependent motor noise that arises with greater magnitude of muscle activation as interphalangeal joint flexion is increased. These results highlight the role of the extrinsic muscles in controlling fingertip force direction across finger postures.NEW & NOTEWORTHY We examined how hand muscles adapt to changing external (force direction) and internal (posture) conditions. Muscle activations, particularly of the extrinsic extensors, were significantly affected by postural changes of the interphalangeal, but not metacarpophalangeal, joints. Joint impedance was modulated so that the effects of the signal-dependent motor noise on the force output were reduced. Comparisons with theoretical solutions showed that the chosen activation patterns occupied a small portion of the possible solution space, minimizing the maximum activation of any one muscle.

Reduced corticospinal responses in older compared with younger adults during submaximal isometric, shortening, and lengthening contractions

The aim of this study was to assess differences in motor performance, as well as corticospinal and spinal responses to transcranial magnetic and percutaneous nerve stimulation, respectively, during submaximal isometric, shortening, and lengthening contractions between younger and older adults. Fifteen younger [26 yr (SD 4); 7 women, 8 men] and 14 older [64 yr (SD 3); 5 women, 9 men] adults performed isometric and shortening and lengthening dorsiflexion on an isokinetic dynamometer (5°/s) at 25% and 50% of contraction type-specific maximums. Motor evoked potentials (MEPs) and H reflexes were recorded at anatomical zero. Maximal dorsiflexor torque was greater during lengthening compared with shortening and isometric contractions ( P < 0.001) but was not age dependent ( P = 0.158). However, torque variability was greater in older compared with young adults ( P < 0.001). Background electromyographic (EMG) activity was greater in older compared with younger adults ( P < 0.005) and was contraction type dependent ( P < 0.001). As evoked responses are influenced by both the maximal level of excitation and background EMG activity, the responses were additionally normalized {[MEP/maximum M wave (M_max)]/root-mean-square EMG activity (RMS) and [H reflex (H)/M_max]/RMS}. (MEP/M_max)/RMS and (H/M_max)/RMS were similar across contraction types but were greater in young compared with older adults ( P < 0.001). Peripheral motor conduction times were prolonged in older adults ( P = 0.003), whereas peripheral sensory conduction times and central motor conduction times were not age dependent ( P ≥ 0.356). These data suggest that age-related changes throughout the central nervous system serve to accommodate contraction type-specific motor control. Moreover, a reduction in corticospinal responses and increased torque variability seem to occur without a significant reduction in maximal torque-producing capacity during older age. NEW & NOTEWORTHY This is the first study to have explored corticospinal and spinal responses with aging during submaximal contractions of different types (isometric, shortening, and lengthening) in lower limb musculature. It is demonstrated that despite preserved maximal torque production capacity corticospinal responses are reduced in older compared with younger adults across contraction types along with increased torque variability during dynamic contractions. This suggests that the age-related corticospinal changes serve to accommodate contraction type-specific motor control.

Spiral tracing on a touchscreen is influenced by age, hand, implement, and friction

Dexterity impairments are well documented in older adults, though it is unclear how these influence touchscreen manipulation. This study examined age-related differences while tracing on high- and low-friction touchscreens using the finger or stylus. 26 young and 24 older adults completed an Archimedes spiral tracing task on a touchscreen mounted on a force sensor. Root mean square error was calculated to quantify performance. Root mean square error increased by 29.9% for older vs. young adults using the fingertip, but was similar to young adults when using the stylus. Although other variables (e.g., touchscreen usage, sensation, and reaction time) differed between age groups, these variables were not related to increased error in older adults while using their fingertip. Root mean square error also increased on the low-friction surface for all subjects. These findings suggest that utilizing a stylus and increasing surface friction may improve touchscreen use in older adults.

Altered visual strategies and attention are related to increased force fluctuations during a pinch grip task in older adults

The purpose of the study was to determine the visual strategies used by older adults during a pinch grip task and to assess the relations between visual strategy, deficits in attention, and increased force fluctuations in older adults. Eye movements of 23 older adults (>65 yr) were monitored during a low-force pinch grip task while subjects viewed three common visual feedback displays. Performance on the Grooved Pegboard test and an attention task (which required no concurrent hand movements) was also measured. Visual strategies varied across subjects and depended on the type of visual feedback provided to the subjects. First, while viewing a high-gain compensatory feedback display (horizontal bar moving up and down with force), 9 of 23 older subjects adopted a strategy of performing saccades during the task, which resulted in 2.5 times greater force fluctuations in those that exhibited saccades compared with those who maintained fixation near the target line. Second, during pursuit feedback displays (force trace moving left to right across screen and up and down with force), all subjects exhibited multiple saccades, and increased force fluctuations were associated (r_s = 0.6; P = 0.002) with fewer saccades during the pursuit task. Also, decreased low-frequency (<4 Hz) force fluctuations and Grooved Pegboard times were significantly related (P = 0.033 and P = 0.005, respectively) with higher (i.e., better) attention z scores. Comparison of these results with our previously published results in young subjects indicates that saccadic eye movements and attention are related to force control in older adults.NEW & NOTEWORTHY The significant contributions of the study are the addition of eye movement data and an attention task to explain differences in hand motor control across different visual displays in older adults. Older participants used different visual strategies across varying feedback displays, and saccadic eye movements were related with motor performance. In addition, those older individuals with deficits in attention had impaired motor performance on two different hand motor control tasks, including the Grooved Pegboard test.

Fingertip forces and completion time for index finger and thumb touchscreen gestures

Users actuate touchscreen computers by applying forces with their fingers to the touchscreen, although the amount and direction of the force is unknown. Our aim was to characterize the magnitude, direction and impulse of the force applied during single finger (tapping and sliding in four directions) and two finger gestures (stretch and pinch). Thirteen subjects performed repeated trials of each gesture. Mean(±SD) resultant force was 0.50(0.09)N for tap, 0.79(0.32)N to 1.18(0.47)N for sliding gestures, 1.47(0.63)N for pinch and 2.05(1.13)N for stretch. Mean resultant force was significantly less (p<0.04) for tap than for all gestures except slide right. The direction of force application was more vertical for the two-finger gestures as compared to the single- finger gestures. Tap was the fastest gesture to complete at 133(83)ms, followed by slide right at 421(181)ms. On average, participants took the longest to complete the stretch gesture at 920(398)ms. Overall, there are differences in forces, force direction, and completion times among touchscreen gestures that could be used to estimate musculoskeletal exposure and help forge guidelines to reduce risk of musculoskeletal injury.

The aging neuromuscular system and motor performance

Age-related changes in the basic functional unit of the neuromuscular system, the motor unit, and its neural inputs have a profound effect on motor function, especially among the expanding number of old (older than ∼60 yr) and very old (older than ∼80 yr) adults. This review presents evidence that age-related changes in motor unit morphology and properties lead to impaired motor performance that includes 1) reduced maximal strength and power, slower contractile velocity, and increased fatigability; and 2) increased variability during and between motor tasks, including decreased force steadiness and increased variability of contraction velocity and torque over repeat contractions. The age-related increase in variability of motor performance with aging appears to involve reduced and more variable synaptic inputs that drive motor neuron activation, fewer and larger motor units, less stable neuromuscular junctions, lower and more variable motor unit action potential discharge rates, and smaller and slower skeletal muscle fibers that coexpress different myosin heavy chain isoforms in the muscle of older adults. Physical activity may modify motor unit properties and function in old men and women, although the effects on variability of motor performance are largely unknown. Many studies are of cross-sectional design, so there is a tremendous opportunity to perform high-impact and longitudinal studies along the continuum of aging that determine 1) the influence and cause of the increased variability with aging on functional performance tasks, and 2) whether lifestyle factors such as physical exercise can minimize this age-related variability in motor performance in the rapidly expanding numbers of very old adults.

Force fluctuations while pressing and moving against high- and low-friction touch screen surfaces

The purpose of this study was to identify the influence of a high- and low-friction surface on the ability to maintain a steady downward force during an index finger pressing and moving task. Fifteen right-handed subjects (24-48 years) performed a static force pressing task and a hybrid pressing and moving task on the surface of an iPad mini while holding a steady 2-N force on high- and low-friction surfaces. Variability of force was quantified as the standard deviation (SD) of normal force (F z) and shear force (F xy) across friction conditions and tasks. The SD of F z was 227 % greater during the hybrid task as compared to the static task (p < .001) and was 19 % greater for the high- versus low-friction condition (p = .033). There were positive correlations between SD of F z and F xy during the hybrid force/motion tasks on the high- and low-friction conditions (r (2) = 0.5 and 0.86, respectively), suggesting significant associations between normal and shear forces for this hybrid task. The correlation between the SD of F z for static and hybrid tasks was r (2) = 0.44, indicating that the common practice of examining the control of static tasks may not sufficiently explain performance during hybrid tasks, at least for the young subjects tested in the current study. As activities of daily living frequently require hybrid force/motion tasks (e.g., writing, doing the dishes, and cleaning counters), the results of this study emphasize the need to study motor performance during hybrid tasks in addition to static force tasks.

A robot hand testbed designed for enhancing embodiment and functional neurorehabilitation of body schema in subjects with upper limb impairment or loss

Many upper limb amputees experience an incessant, post-amputation "phantom limb pain" and report that their missing limbs feel paralyzed in an uncomfortable posture. One hypothesis is that efferent commands no longer generate expected afferent signals, such as proprioceptive feedback from changes in limb configuration, and that the mismatch of motor commands and visual feedback is interpreted as pain. Non-invasive therapeutic techniques for treating phantom limb pain, such as mirror visual feedback (MVF), rely on visualizations of postural changes. Advances in neural interfaces for artificial sensory feedback now make it possible to combine MVF with a high-tech "rubber hand" illusion, in which subjects develop a sense of embodiment with a fake hand when subjected to congruent visual and somatosensory feedback. We discuss clinical benefits that could arise from the confluence of known concepts such as MVF and the rubber hand illusion, and new technologies such as neural interfaces for sensory feedback and highly sensorized robot hand testbeds, such as the "BairClaw" presented here. Our multi-articulating, anthropomorphic robot testbed can be used to study proprioceptive and tactile sensory stimuli during physical finger-object interactions. Conceived for artificial grasp, manipulation, and haptic exploration, the BairClaw could also be used for future studies on the neurorehabilitation of somatosensory disorders due to upper limb impairment or loss. A remote actuation system enables the modular control of tendon-driven hands. The artificial proprioception system enables direct measurement of joint angles and tendon tensions while temperature, vibration, and skin deformation are provided by a multimodal tactile sensor. The provision of multimodal sensory feedback that is spatiotemporally consistent with commanded actions could lead to benefits such as reduced phantom limb pain, and increased prosthesis use due to improved functionality and reduced cognitive burden.

Effect of prior experience and task stability on the intrinsic muscle activity of the thumb

Manual techniques involving the use of the thumb are commonly employed by physical therapists for treating patients with vertebral disorders. The demands on the intrinsic muscles of the thumb in these manual tasks are very different from those of the pinch tasks. The aim of this study was to investigate the influence of clinical experience and different mobilization techniques on the electromyographic activity (EMG) of thumb intrinsic muscles. Fifteen participants without exposure to manual techniques (the Novice Group) and fifteen physical therapists with at least 3 years of orthopaedic experience (the Experienced Group) participated. Each participant exerted thumb tip forces with 3 different posterioanterior (PA) glide techniques including unsupported, with digital support and with thumb interphalangeal joint supported by the index finger. The exerted force was increased from 25% to 100% maximum force at 25% increments on a 6 component load cell. The thumb tip force and EMG activity of four intrinsic muscles (flexor pollicis brevis, adductor pollicis, abductor pollicis brevis, first dorsal interosseus) were recorded with surface electrodes. Both experience and technique influenced intrinsic muscle activity of the thumb. While participants of both groups generated the same magnitude of force, experienced participants generated less intrinsic muscle activity while performing PA glide through practice. However, novice participants increased activity of the intrinsic muscles in accordance with the stability status of the technique. PA glide with thumb interphalangeal joint supported by the index finger was a more stable technique as evidenced by smallest relative errors of thumb tip force.