The effect of finger extensor mechanism on the flexor force during isometric tasks

Sensing, Actuating, and Interacting Through Passive Body Dynamics: A Framework for Soft Robotic Hand Design

Robotic hands have long strived to reach the performance of human hands. The physical complexity and extraordinary capabilities of the human hand, in terms of sensing, actuation, and cognitive abilities, make achieving this goal challenging. At the heart of the physical structure of the hand is its' passive behaviors. Seen most clearly in soft robotic hands, these behaviors influence and affect the mechanical, sensing, and control functionalities. With this perspective, we present a framework through which passivity in robot hands can be understood, by concretely identifying the role of passivity in the design, fabrication, and control of soft hands. In this framework we focus on the interactions between the physical hand and the: environment, internal actuation, sensor morphology, and wrist control. Taking these surrounding systems away, we are left with a passive soft hand whose behaviors emerge from external interactions. Inspired by the human hand, we define the role of these four key interacting pillars and review how state-of-the art robot hands utilize these four elements to aid functionality. We show how these pillars promote hybrid soft-rigid hands with rich behaviors, providing benefits in terms of the increased adaptability to uncertain environments, improved scalability and reduction in the cost of actuation, sensing, and control. This review provides a conceptual framework for approaching hand design and analysis through consideration of the passive behaviors. This highlights not only the advances that can be made by approaching the problem in this way but also the outstanding challenges that stem from this outlook.

Analysis on synergistic cocontraction of extrinsic finger flexors and extensors during flexion movements: A finite element digital human hand model

Fine hand movements require the synergistic contraction of intrinsic and extrinsic muscles to achieve them. In this paper, a Finite Element Digital Human Hand Model (FE-DHHM) containing solid tendons and ligaments and driven by the Muscle-Tendon Junction (MTJ) displacements of FDS, FDP and ED measured by ultrasound imaging was developed. The synergistic contraction of these muscles during the finger flexion movements was analyzed by simulating five sets of finger flexion movements. The results showed that the FDS and FDP contracted together to provide power during the flexion movements, while the ED acted as an antagonist. The peak stresses of the FDS, FDP and ED were all at the joints. In the flexion without resistance, the FDS provided the main driving force, and the FDS and FDP alternated in a "plateau" of muscle force. In the flexion with resistance, the muscle forces of FDS, FDP, and ED were all positively correlated with fingertip forces. The FDS still provided the main driving force, but the stress maxima occurred in the FDP at the DIP joint.

Metabolomic signatures for the longitudinal reduction of muscle strength over 10 years

Background

Skeletal muscles are essential components of the neuromuscular skeletal system that have an integral role in the structure and function of the synovial joints which are often affected by osteoarthritis (OA). The aim of this study was to identify the baseline metabolomic signatures for the longitudinal reduction of muscle strength over 10 years in the well-established community-based Tasmanian Older Adult Cohort (TASOAC).

Methods

Study participants were 50–79 year old individuals from the TASOAC. Hand grip, knee extension, and leg strength were measured at baseline, 2.6-, 5-, and 10-year follow-up points. Fasting serum samples were collected at 2.6-year follow-up point, and metabolomic profiling was performed using the TMIC Prime Metabolomics Profiling Assay. Generalized linear mixed effects model was used to identify metabolites that were associated with the reduction in muscle strength over 10 years after controlling for age, sex, and BMI. Significance level was defined at α=0.0004 after correction of multiple testing of 129 metabolites with Bonferroni method. Further, a genome-wide association study (GWAS) analysis was performed to explore if genetic factors account for the association between the identified metabolomic markers and the longitudinal reduction of muscle strength over 10 years.

Results

A total of 409 older adults (50% of them females) were included. The mean age was 60.93±6.50 years, and mean BMI was 27.12±4.18 kg/m² at baseline. Muscle strength declined by 0.09 psi, 0.02 kg, and 2.57 kg per year for hand grip, knee extension, and leg strength, respectively. Among the 143 metabolites measured, 129 passed the quality checks and were included in the analysis. We found that the elevated blood level of asymmetric dimethylarginine (ADMA) was associated with the reduction in hand grip (p=0.0003) and knee extension strength (p=0.008) over 10 years. GWAS analysis found that a SNP rs1125718 adjacent to WISP1gene was associated with ADMA levels (p=4.39*10^-8). Further, we found that the increased serum concentration of uric acid was significantly associated with the decline in leg strength over 10 years (p=0.0001).

Conclusion

Our results demonstrated that elevated serum ADMA and uric acid at baseline were associated with age-dependent muscle strength reduction. They might be novel targets to prevent muscle strength loss over time.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13395-022-00286-9.

Biomechanical analysis of the effect of the finger extensor mechanism on hand grasping performance

Quantifying the effect of routing and topology of the inter-connected finger extensor mechanism on hand grasping performances is a long-standing research problem for the better clinical diagnosis, surgical planning and biomimetic hand development. However, it is technically demanding to measure the hand performance parameters such as the contact forces and contact area during hand manipulation. It is also difficult to replicate human hand performance through the physical hand model due to its sophisticated musculotendinous structure. In this study, an experimental validated subject-specific finite element (FE) human hand model was used for the first time to quantify the influence of different tendon topologies and material properties on hand grasping quality. It is found that the grasping quality is reduced by 15.94% and 8.54% if there are no extensor hood and lateral band respectively, and the former plays a more important role in transmitting forces and maintaining grasping qualities than the latter. Excluding extensor hood in the topology causes more reductions in hand contact pressure and contact area than omitting lateral band. 7.5% of the grasping quality is lost due to a softened tendon with half of its original Young's Modulus. Hardened extensor tendon does increase the grasping quality, but the enhancing effect tends to level off once the tendon Young's Modulus is increased by more than 50%. These results prove that the lateral band and extensor hood are critical components for maintaining grasping quality. The dexterity and grasping quality of robotic and prosthetic hands could be improved by integrating these two components. There is also no need to use very stiff tendon material as it won't help to effectively enhance the grasping quality.

A four-tendon robotic finger with tendon transmission inspired by the human extensor mechanism

This paper presents a tendon-driven robotic finger with its inspiration derived from the human extensor mechanism. The analytical model presented relates the contractions of the intrinsic muscles of the human hand to abduction-adduction and coordinated motion of proximal and distal interphalangeal joints. The design presented is simplified from the complex webs of fibers appearing in prior works, but preserves the dual role the interossei have of abducting/adducting the finger and flexing it at the metacarpal-phalangeal joint with the finger outstretched. The anatomical feature in our design is that the proximal interphalangeal joint passes through a set of lateral bands as the finger flexes. We discovered that by including a mechanical stop that causes the lateral bands to 'fold' at large enough flexion aids coordinated movements of the two interphalangeal joints as the finger flexes. Because it involves engineering running and sliding fits, this finger admits a concise kinematic model, which accurately predicts the tendon excursions from a known pose. In this work, however, we evaluate what happens when the model is used to search for a sequence of tendon excursions corresponding to a desired movement. We perform several such sequences of tendon excursions experimentally and present the poses that result using motion capture. We also demonstrate executing several types of grasps on an underactuated robotic hand that incorporates this finger design.

A Finite Element Model for Trigger Finger

The aim of this study was to develop a finite element model to investigate the forces on tendons which ensue due to trigger finger. The model was used to simulate both flexor and extensor tendons within the index finger; two test cases were defined, simulating a “mildly” and “severely” affected tendon by applying constraints. The finger was simulated in three different directions: extension, abduction and hyper-extension. There was increased tension during hyper-extension, with tension in the mildly affected tendon increasing from 1.54 to 2.67 N. Furthermore, there was a consistent relationship between force and displacement, with a substantial change in the gradient of the force when the constraints of the condition were applied for all movements. The intention of this study is that the simulation framework is used to enable the in silico development of novel prosthetic devices to aid with treatment of trigger finger, given that, currently, the non-surgical first line of treatment is a splint.

A Learning Scheme for EMG Based Decoding of Dexterous, In-Hand Manipulation Motions

Electromyography (EMG) based interfaces are the most common solutions for the control of robotic, orthotic, prosthetic, assistive, and rehabilitation devices, translating myoelectric activations into meaningful actions. Over the last years, a lot of emphasis has been put into the EMG based decoding of human intention, but very few studies have been carried out focusing on the continuous decoding of human motion. In this work, we present a learning scheme for the EMG based decoding of object motions in dexterous, in-hand manipulation tasks. We also study the contribution of different muscles while performing these tasks and the effect of the gender and hand size in the overall decoding accuracy. To do that, we use EMG signals derived from 16 muscle sites (8 on the hand and 8 on the forearm) from 11 different subjects and an optical motion capture system that records the object motion. The object motion decoding is formulated as a regression problem using the Random Forests methodology. Regarding feature selection, we use the following time-domain features: root mean square, waveform length and zero crossings. A 10-fold cross validation procedure is used for model assessment purposes and the feature variable importance values are calculated for each feature. This study shows that subject specific, hand specific, and object specific decoding models offer better decoding accuracy that the generic models.

Stability of steady hand force production explored across spaces and methods of analysis

We used the framework of the uncontrolled manifold (UCM) hypothesis and explored the reliability of several outcome variables across different spaces of analysis during a very simple four-finger accurate force production task. Fourteen healthy, young adults performed the accurate force production task with each hand on 3 days. Small spatial finger perturbations were generated by the "inverse piano" device three times per trial (lifting the fingers 1 cm/0.5 s and lowering them). The data were analyzed using the following main methods: (1) computation of indices of the structure of inter-trial variance and motor equivalence in the space of finger forces and finger modes, and (2) analysis of referent coordinates and apparent stiffness values for the hand. Maximal voluntary force and the index of enslaving (unintentional finger force production) showed good to excellent reliability. Strong synergies stabilizing total force were reflected in both structure of variance and motor equivalence indices. Variance within the UCM and the index of motor equivalent motion dropped over the trial duration and showed good to excellent reliability. Variance orthogonal to the UCM and the index of non-motor equivalent motion dropped over the 3 days and showed poor to moderate reliability. Referent coordinate and apparent stiffness indices co-varied strongly and both showed good reliability. In contrast, the computed index of force stabilization showed poor reliability. The findings are interpreted within the scheme of neural control with referent coordinates involving the hierarchy of two basic commands, the r-command and c-command. The data suggest natural drifts in the finger force space, particularly within the UCM. We interpret these drifts as reflections of a trade-off between stability and optimization of action. The implications of these findings for the UCM framework and future clinical applications are explored in the discussion. Indices of the structure of variance and motor equivalence show good reliability and can be recommended for applied studies.

Performance drifts in two-finger cyclical force production tasks performed by one and two actors

We explored changes in the cyclical two-finger force performance task caused by turning visual feedback off performed either by the index and middle fingers of the dominant hand or by two index fingers of two persons. Based on an earlier study, we expected drifts in finger force amplitude and midpoint without a drift in relative phase. The subjects performed two rhythmical tasks at 1 Hz while paced by an auditory metronome. One of the tasks required cyclical changes in total force magnitude without changes in the sharing of the force between the two fingers. The other task required cyclical changes in the force sharing without changing total force magnitude. Subjects were provided with visual feedback, which showed total force magnitude and force sharing via cursor motion along the vertical and horizontal axes, respectively. Further, visual feedback was turned off, first on the variable that was not required to change and then on both variables. Turning visual feedback off led to a mean force drift toward lower magnitudes while force amplitude increased. There was a consistent drift in the relative phase in the one-hand task with the index finger leading the middle finger. No consistent relative phase drift was seen in the two-person tasks. The shape of the force cycle changed without visual feedback reflected in the lower similarity to a perfect cosine shape and in the higher time spent at lower force magnitudes. The data confirm findings of earlier studies regarding force amplitude and midpoint changes, but falsify predictions of an earlier proposed model with respect to the relative phase changes. We discuss factors that could contribute to the observed relative phase drift in the one-hand tasks including the leader-follower pattern generalized for two-effector tasks performed by one person.

Force illusions and drifts observed during muscle vibration

We explored predictions of a scheme that views position and force perception as a result of measuring proprioceptive signals within a reference frame set by ongoing efferent process. In particular, this hypothesis predicts force illusions caused by muscle vibration and mediated via changes in both afferent and efferent components of kinesthesia. Healthy subjects performed accurate steady force production tasks by pressing with the four fingers of one hand (the task hand) on individual force sensors with and without visual feedback. At various times during the trials, subjects matched the perceived force using the other hand. High-frequency vibration was applied to one or both of the forearms (over the hand and finger extensors). Without visual feedback, subjects showed a drop in the task hand force, which was significantly smaller under the vibration of that forearm. Force production by the matching hand was consistently higher than that of the task hand. Vibrating one of the forearms affected the matching hand in a manner consistent with the perception of higher magnitude of force produced by the vibrated hand. The findings were consistent between the dominant and nondominant hands. The effects of vibration on both force drift and force mismatching suggest that vibration led to shifts in both signals from proprioceptors and the efferent component of perception, the referent coordinate and/or coactivation command. The observations fit the hypothesis on combined perception of kinematic-kinetic variables with little specificity of different groups of peripheral receptors that all contribute to perception of forces and coordinates. NEW & NOTEWORTHY We show that vibration of hand/finger extensors produces consistent errors in finger force perception. Without visual feedback, finger force drifted to lower values without a drift in the matching force produced by the other hand; hand extensor vibration led to smaller finger force drift. The findings fit the scheme with combined perception of kinematic-kinetic variables and suggest that vibration leads to consistent shifts of the referent coordinate and, possibly, of coactivation command to the effector.

Investigation of index finger triggering force using a cadaver experiment: Effects of trigger grip span, contact location, and internal tendon force

A cadaver study was conducted to investigate the effects of triggering conditions (trigger grip span, contact location, and internal tendon force) on index finger triggering force and the force efficiency of involved tendons. Eight right human cadaveric hands were employed, and a motion simulator was built to secure and control the specimens. Index finger triggering forces were investigated as a function of different internal tendon forces (flexor digitorum profundus + flexor digitorum superficialis = 40, 70, and 100 N), trigger grip spans (40, 50, and 60 mm), and contact locations between the index finger and a trigger. Triggering forces significantly increased when internal tendon forces increased from 40 to 100 N. Also, trigger grip spans and contact locations had significant effects on triggering forces; maximum triggering forces were found at a 50 mm span and the most proximal contact location. The results revealed that only 10-30% of internal tendon forces were converted to their external triggering forces.

Stability of hand force production. I. Hand level control variables and multifinger synergies

We combined the theory of neural control of movement with referent coordinates and the uncontrolled manifold hypothesis to explore synergies stabilizing the hand action in accurate four-finger pressing tasks. In particular, we tested a hypothesis on two classes of synergies, those among the four fingers and those within a pair of control variables, stabilizing hand action under visual feedback and disappearing without visual feedback. Subjects performed four-finger total force and moment production tasks under visual feedback; the feedback was later partially or completely removed. The "inverse piano" device was used to lift and lower the fingers smoothly at the beginning and at the end of each trial. These data were used to compute pairs of hypothetical control variables. Intertrial analysis of variance within the finger force space was used to quantify multifinger synergies stabilizing both force and moment. A data permutation method was used to quantify synergies among control variables. Under visual feedback, synergies in the spaces of finger forces and hypothetical control variables were found to stabilize total force. Without visual feedback, the subjects showed a force drift to lower magnitudes and a moment drift toward pronation. This was accompanied by disappearance of the four-finger synergies and strong attenuation of the control variable synergies. The indexes of the two types of synergies correlated with each other. The findings are interpreted within the scheme with multiple levels of abundant variables.NEW & NOTEWORTHY We extended the idea of hierarchical control with referent spatial coordinates for the effectors and explored two types of synergies stabilizing multifinger force production tasks. We observed synergies among finger forces and synergies between hypothetical control variables that stabilized performance under visual feedback but failed to stabilize it after visual feedback had been removed. Indexes of two types of synergies correlated with each other. The data suggest the existence of multiple mechanisms stabilizing motor actions.

Organization of the motor-unit pool for different directions of isometric contraction of the first dorsal interosseous muscle

INTRODUCTION

Muscle force generation involves recruitment and firing rate modulation of motor units (MUs). The control of MUs in producing multidirectional forces remains unclear.

METHODS

We studied MU recruitment and firing properties, recorded from the first dorsal interosseous muscle, for 3 different directions of contraction: abduction; abduction/flexion combination; and flexion.

RESULTS

MUs were recruited systematically at higher threshold force during flexion. Larger MUs were recruited and firing rates of MUs were lower during abduction. There was an orderly recruitment of MUs according to MU size regardless of contraction direction, obeying the "size principle." Firing rates of earlier-recruited MUs were consistently higher than later-recruited MUs, affirming the "onion-skin" property.

DISCUSSION

Our findings suggest that the size principle and onion-skin organization together provide a general description of MU recruitment patterns and firing properties. The directional alternations of MU control properties likely reflect changes in neural drive to the muscle. Muscle Nerve 57: E85-E93, 2018.

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).

The effect of the extensor mechanism on maximum isometric fingertip forces: A numerical study on the index finger

The extensor mechanism is a tendinous network connecting intrinsic and extrinsic muscles of the finger and its function has not yet been fully understood. The goal of this study was to assess the effect of the extensor mechanism on the maximum isometric fingertip forces - a parameter which is essential for grasping. For this purpose, maximum fingertip forces in all directions (i.e. feasible force sets) of two musculoskeletal models of the index finger were compared: the wEM model included a full representation of the extensor mechanism, whereas in the noEM model the extensor mechanism was replaced by a single extensor tendon without connectivity to intrinsic muscles. The feasible force sets were computed in the flexion-extension plane for nine postures. Forces in four predefined directions (palmar, proximal, dorsal, and distal), and the peak resultant forces were evaluated. Averaged forces in all four predefined directions were considerably larger in the wEM model (+187.6%). However, peak resultant forces were slightly lower in the wEM model (-4.3% on average). The general advantage of the wEM model could be explained by co-contraction of intrinsic and extrinsic extensor muscles which allowed reaching larger activation levels of the extrinsic flexors. Only within a narrow range of force directions the co-contraction of intrinsic muscles limited the fingertip forces and lead to lower peak resultant forces in the wEM model. Rather than maximizing peak resultant forces, it appears that the extensor mechanism is a sophisticated tool for increasing maximum fingertip forces over a broad range of postures and force directions - making the finger more versatile during grasping.

Assessing Finger Joint Biomechanics by Applying Equal Force to Flexor Tendons In Vitro Using a Novel Simultaneous Approach

Background

The flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) are critical for finger flexion. Although research has recently focused on these tendons’ coactivity, their contributions in different tasks remain unclear. This study created a novel simultaneous approach to investigate the coactivity between the tendons and to clarify their contributions in different tasks.

Methods

Ten human cadaveric hands were mounted on our custom frame with the FDS and FDP of the third finger looped through a mechanical pulley connected to a force transducer. Joint range of motion, tendon excursion and loading force were recorded during individual joint motion and free joint movement from rest to maximal flexion. Each flexor tendon’s moment arm was then calculated.

Results

In individual motions, we found that the FDP contributed more than the FDS in proximal interphalangeal (PIP) joint motion, with an overall slope of 1.34 and all FDP-to-FDS excursion (P/S) ratios greater than 1.0 with force increase. However, the FDP contributed less than the FDS in metacarpophalangeal (MCP) joint motion, with an overall slope of 0.95 and P/S ratios smaller than 1.0 throughout the whole motion except between 1.9% and 13.1% force. In free joint movement, the FDP played a greater role than the FDS, with an overall ratio of 1.37 and all P/S ratios greater than 1.0.

Conclusions

The new findings include differences in finger performance and excursion amounts between the FDS and FDP throughout flexion. Such findings may provide the basis for new hand models and treatments.

Altered phalanx force direction during power grip following stroke

Many stroke survivors with severe impairment can grasp only with a power grip. Yet, little knowledge is available on altered power grip after stroke, other than reduced power grip strength. This study characterized stroke survivors' static power grip during 100 and 50 % maximum grip. Each phalanx force angular deviation from the normal direction and its contribution to total normal force was compared for 11 stroke survivors and 11 age-matched controls. Muscle activities and skin coefficient of friction were additionally compared for another 20 stroke and 13 age-matched control subjects. The main finding was that stroke survivors gripped with a 34 % greater phalanx force angular deviation of 19° ± 2° compared to controls of 14° ± 1° (p < .05). Stroke survivors' phalanx force angular deviation was closer to the 23° threshold of slippage between the phalanx and grip surface, which may explain increased likelihood of object dropping in stroke survivors. In addition, this altered phalanx force direction decreases normal grip force by tilting the force vector, indicating a partial role of phalanx force angular deviation in reduced grip strength post-stroke. Greater phalanx force angular deviation may biomechanically result from more severe underactivation of stroke survivors' first dorsal interosseous and extensor digitorum communis muscles compared to their flexor digitorum superficialis or somatosensory deficit. While stroke survivors' maximum power grip strength was approximately half of the controls, the distribution of their remaining strength over the fingers and phalanges did not differ, indicating evenly distributed grip force reduction over the entire hand.

Biomechanical analysis of force distribution in human finger extensor mechanisms

The complexities of the function and structure of human fingers have long been recognised. The in vivo forces in the human finger tendon network during different activities are critical information for clinical diagnosis, surgical treatment, prosthetic finger design, and biomimetic hand development. In this study, we propose a novel method for in vivo force estimation for the finger tendon network by combining a three-dimensional motion analysis technique and a novel biomechanical tendon network model. The extensor mechanism of a human index finger is represented by an interconnected tendinous network moving around the phalanx's dorsum. A novel analytical approach based on the "Principle of Minimum Total Potential Energy" is used to calculate the forces and deformations throughout the tendon network of the extensor mechanism when subjected to an external load and with the finger posture defined by measurement data. The predicted deformations and forces in the tendon network are in broad agreement with the results obtained by previous experimental in vitro studies. The proposed methodology provides a promising tool for investigating the biomechanical function of complex interconnected tendon networks in vivo.

Biomechanical analysis of the human finger extensor mechanism during isometric pressing

This study investigated the effects of the finger extensor mechanism on the bone-to-bone contact forces at the interphalangeal and metacarpal joints and also on the forces in the intrinsic and extrinsic muscles during finger pressing. This was done with finger postures ranging from very flexed to fully extended. The role of the finger extensor mechanism was investigated by using two alternative finger models, one which omitted the extensor mechanism and another which included it. A six-camera three-dimensional motion analysis system was used to capture the finger posture during maximum voluntary isometric pressing. The fingertip loads were recorded simultaneously using a force plate system. Two three-dimensional biomechanical finger models, a minimal model without extensor mechanism and a full model with extensor mechanism (tendon network), were used to calculate the joint bone-to-bone contact forces and the extrinsic and intrinsic muscle forces. If the full model is assumed to be realistic, then the results suggest some useful biomechanical advantages provided by the tendon network of the extensor mechanism. It was found that the forces in the intrinsic muscles (interosseus group and lumbrical) are significantly reduced by 22% to 61% due to the action of the extensor mechanism, with the greatest reductions in more flexed postures. The bone-to-bone contact force at the MCP joint is reduced by 10% to 41%. This suggests that the extensor mechanism may help to reduce the risk of injury at the finger joints and also to moderate the forces in intrinsic muscles. These apparent biomechanical advantages may be a result of the extensor mechanism's distinctive interconnected fibrous structure, through which the contraction of the intrinsic muscles as flexors of the MCP joint can generate extensions at the DIP and PIP joints.

Integration of marker and force data to compute three-dimensional joint moments of the thumb and index finger digits during pinch

This study presents methodology to determine joint moments of the digits of the hand during pinch function. This methodology incorporates steps to identify marker-based kinematic data defining aligned coordinate systems for individual digit segments and joint centre locations. The kinematic data are then transformed to a common reference frame along with the force data collected at pinch contact of a customised apparatus in three dimensions. These methods were demonstrated with a pilot investigation to examine the static joint moments occurring during two-digit oppositional precision pinch at a particular end point force level applied at the digit pads. Notable abduction joint moments at the proximal joints of both digits were observed, which implicate the role of respective intrinsic and extrinsic muscles in maintaining pinch grasp. Examining differences in joint moment results when substituting selected steps of this methodological approach suggested greater relative importance for joint centre identification and segment coordinate system alignment.

Quantifying catch-and-release: the extensor tendon force needed to overcome the catching flexors in trigger fingers

The extensor tendon forces required to overcome the catching flexors in trigger fingers are unknown. A biomechanical model with moment equilibrium equations and method of least squares was developed for estimating the tendon force at triggering in trigger fingers. Trigger fingers that exhibited significant catching and sudden release during finger extension were tested. A customized "pulling tester" was used to pull the finger from flexion to extension and provide synchronic measurement of the pulling force. The displacement of the tested finger was measured by a motion capture system. This preliminary study presents kinematic and kinetic data at triggering of 10 trigger fingers. The distal and proximal interphalangeal (PIP) joints presented sudden release while the metacarpophalangeal (MCP) joint started extension in the early phase of finger extension. The tendon tension of flexor digitorum profundus was greater than that of flexor digitorum superficialis (FDS) in six fingers, and less than that of FDS in three fingers. The tension of two flexor tendons was almost equal in one finger. At the PIP and MCP joints, 1.54 times the force of flexors was needed for the extensors to overcome the catching flexors in trigger fingers. This biomechanical model provides clinicians with a clearer idea of the tendon force at triggering. The quantitative results may help in the understanding of movement characteristics of trigger fingers. These findings are useful to better understand the etiology and nature of trigger finger development, and thus aid in further development of better assessments and treatments related to this.

Computing motor unit number index of the first dorsal interosseous muscle with two different contraction tasks

Motor unit number index (MUNIX) is a recently developed novel neurophysiological technique providing an index proportional to the number of motor units in a muscle. The MUNIX is derived from maximum M wave and voluntary surface electromyogram (EMG) recordings. The objective of this study was to address a practical question for computing MUNIX in the first dorsal interosseous (FDI), a multifunctional muscle that generates torque about the second metacarpophalangeal joint, i.e., how will different lines of muscle activation influence its MUNIX estimates? To address this question, the MUNIX technique was applied in the FDI muscle of 15 neurologically intact subjects, using surface EMG signals from index finger abduction and flexion, respectively, while the maximum M wave remained the same. Across all subjects, the average MUNIX value of the FDI muscle was 228 ± 45 for index finger abduction, slightly smaller than the MUNIX estimate of 251 ± 56 for index finger flexion. Different FDI muscle activation patterns resulted in an approximately 10% difference in MUNIX estimates. The findings from this study suggest that appropriate definition of voluntary activation of the FDI muscle should be kept to ensure consistency in measurements and avoid source of error. The current study is limited by only assessing neurologically intact muscles. It is important to perform a similar analysis for patients with amyotrophic lateral sclerosis (ALS), given that ALS is the primary intention of the MUNIX method as a potential follow-up measurement for motor unit loss.

IMPACT OF FINGERTIP ACTIONS ON TOTAL POWER OF SURFACE ELECTROMYOGRAPHY FROM EXTRINSIC HAND MUSCLES

Quantizing the relationship between finger force and multitendoned extrinsic hand muscles could be useful for understanding the control strategies that underlie the coordination of finger movements and forces. The objective of this study is to explore the relationship of fingertip force production and total power of surface electromyography (sEMG) recorded on extrinsic hand muscles under isometric voluntary contraction. Thirteen healthy volunteers were recruited to participate in this study. In the designed force-tracking tasks, all volunteers were required to produce a certain force with either index finger or middle finger to match the target force for 5 s. Meanwhile, the sEMG signals were acquired from two extrinsic hand muscles: extensor digitorum (ED) and flexor digitorum superficialis (FDS). For each trial, sEMG of the effective force segment was extracted; then, the power spectrum was estimated based on autoregressive (AR) model and from which the corresponding total power of sEMG was computed. The experimental results reveal that the total power of sEMG linearly increases with force level regardless of the task finger and extrinsic hand muscle. It is also found that the total power obtained from index finger is significantly less than that of middle finger for FDS at the same force level (p < 0.05), while this kind of statistical significance cannot be found for ED. However, with respect to the measurement of total power, the type of extrinsic hand muscle has not exhibited significantly different contribution to the task finger under a certain fingertip force level. The findings of this study indicate that the total power of the extrinsic hand muscle's sEMG can be used to characterize finger's activities.

Motor control theories improve biomechanical model of the hand for finger pressing tasks

BACKGROUND

Biomechanical models are a useful tool to estimate tendon tensions. Unfortunately, in previous fingers' models, each finger acts independently from the others. This is contradictory with hand motor control theories which show that fingers are functionally linked in order to balance the wrist/forearm joint with minimal tendon tensions. (i.e. principle of minimization of the secondary moments). We propose to adapt a hand biomechanical model according to this principle by including the wrist joint. We will determine whether the finger tendon tensions changed with the wrist joint added to the model.

METHODS

Two models have been tested: one considering fingers independently (model A) and one with the fingers mechanically linked by the inclusion of the wrist balance (model B). A single set of data, additional results from the literature and in-vivo values have been used to compare the results.

RESULTS

Model A corroborates previous results in the literature. Contrast results were obtained with model B, especially for the Ring and Little fingers. Different tendon tensions were obtained, particularly, in finger extensor muscles critical to balance the wrist.

DISCUSSION

We discuss the biomechanical results in accordance with the hand/finger motor control theories. It appears that the wrist joint balance is critical for finger tendon tension estimation. When including the wrist joint into finger models, the tendon tension estimations agree well with the minimization of secondary moments and the force deficit.

BIOMECHANICS OF THE NORMAL AND DISEASED METACARPOPHALANGEAL JOINT: IMPLICATIONS ON THE DESIGN OF JOINT REPLACEMENT IMPLANTS

The metacarpophalangeal (MCP) joint is crucial for hand function, but is frequently affected by arthritis, leading to pain and disability. This paper reviews the biomechanics of the normal and diseased joint in order to help consider the design of improved MCP joint replacement implants. The normal MCP joint enables a large range of motion in flexion/extension and abduction/adduction as well as a few degrees of rotation. A normal joint typically allows 90° flexion, with a grip strength of up to 672 N. The diseased joint has a reduced range of motion (typically 30° flexion) and reduced hand strength compared to the normal joint. Current MCP joint replacement implants generally try to recreate the range of motion of the normal joint; however, many designs are prone to fracture, as they are unable to withstand the conditions of the diseased joint. It may be beneficial for future implant designs to provide just a functional range of motion. Future designs of MCP joint replacement implants need to be more durable and last longer. Careful consideration of the diseased joint, rather than the normal joint, may help to better define the requirements for such implants.

Ultrasound assessment of the motion patterns of human flexor digitorum superficialis and profundus tendons with speckle tracking

The purposes of our study were to correlate ultrasonographically measured and joint angle estimated excursions of the flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) tendons of the hand and to estimate the relative motion of FDS and FDP while gripping cylinders of standard diameter in normal human subjects. Thirty wrists from 15 human subjects were imaged with an ultrasound scanner. Speckle tracking was used to measure the excursion of the FDS and FDP tendons. The tendon excursions necessary to grip three differently sized acrylic tubes were measured and correlated with the corresponding finger joint angles. The FDP/FDS excursion ratio was calculated. The Pearson's correlation coefficient between the FDS excursion and MP + PIP joint angle was 0.61. The Pearson's correlation coefficient between the FDP + FDS excursion and the DIP + PIP + MP joint angle was 0.67. The FDP/FDS excursion ratio was smaller for larger excursions (gripping a smaller diameter tube) and larger for small excursions (gripping a larger diameter tube, P < 0.01). These data suggest that speckle tracking may be a useful method to discriminate the relative motion of flexor tendons, which in turn may be relevant in evaluating tendon function, for example after tendon injury.

Surface electromyogram analysis of the direction of isometric torque generation by the first dorsal interosseous muscle

The objective of this study was to determine whether a novel technique using high density surface electromyogram (EMG) recordings can be used to detect the directional dependence of muscle activity in a multifunctional muscle, the first dorsal interosseous (FDI). We used surface EMG recordings with a two-dimensional electrode array to search for inhomogeneous FDI activation patterns with changing torque direction at the metacarpophalangeal joint, the locus of action of the FDI muscle. The interference EMG distribution across the whole FDI muscle was recorded during isometric contraction at the same force magnitude in five different directions in the index finger abduction-flexion plane. The electrode array EMG activity was characterized by contour plots, interpolating the EMG amplitude between electrode sites. Across all subjects the amplitude of the flexion EMG was consistently lower than that of the abduction EMG at the given force. Pattern recognition methods were used to discriminate the isometric muscle contraction tasks with a linear discriminant analysis classifier, based on the extraction of two different feature sets of the surface EMG signal: the time domain (TD) feature set and a combination of autoregressive coefficients and the root mean square amplitude (AR+RMS) as a feature set. We found that high accuracies were obtained in the classification of different directions of the FDI muscle isometric contraction. With a monopolar electrode configuration, the average overall classification accuracy from nine subjects was 94.1 ± 2.3% for the TD feature set and 95.8 ± 1.5% for the AR+RMS feature set. Spatial filtering of the signal with bipolar electrode configuration improved the average overall classification accuracy to 96.7 ± 2.7% for the TD feature set and 98.1 ± 1.6% for the AR+RMS feature set. The distinct EMG contour plots and the high classification accuracies obtained from this study confirm distinct interference EMG pattern distributions as a function of task direction, suggesting that high density surface EMG is a useful tool for understanding the activation of multifunctional muscles.

Voluntary breathing influences corticospinal excitability of nonrespiratory finger muscles

The present study aimed to investigate neurophysiologic mechanisms mediating the newly discovered phenomenon of respiratory-motor interactions and to explore its potential clinical application for motor recovery. First, young and healthy subjects were instructed to breathe normally (NORM); to exhale (OUT) or inhale (IN) as fast as possible in a self-paced manner; or to voluntarily hold breath (HOLD). In experiment 1 (n = 14), transcranial magnetic stimulation (TMS) was applied during 10% maximal voluntary contraction (MVC) finger flexion force production or at rest. The motor-evoked potentials (MEPs) were recorded from flexor digitorum superficialis (FDS), extensor digitorum communis (EDC), and abductor digiti minimi (ADM) muscles. Similarly, in experiment 2 (n = 11), electrical stimulation (ES) was applied to FDS or EDC during the described four breathing conditions while subjects maintained 10%MVC of finger flexion or extension and at rest. In the exploratory clinical experiments (experiment 3), four patients with chronic neurological disorders (three strokes, one traumatic brain injury) received a 30-min session of breathing-controlled ES to the impaired EDC. In experiment 1, the EDC MEP magnitudes increased significantly during IN and OUT at both 10%MVC and rest; the FDS MEPs were enhanced only at 10%MVC, whereas the ADM MEP increased only during OUT, compared with NORM for both at rest and 10%MVC. No difference was found between NORM and HOLD for all three muscles. In experiment 2, when FDS was stimulated, force response was enhanced during both IN and OUT, but only at 10%MVC. When EDC was stimulated, force response increased at both 10%MVC and rest, only during IN, but not OUT. The averaged response latency was 83 ms for the finger extensors and 79 ms for the finger flexors. After a 30-min intervention of ES to EDC triggered by forced inspiration in experiment 3, we observed a significant reduction in finger flexor spasticity. The spasticity reduction lasted for ≥ 4 wk in all four patients. TMS and ES data, collectively, support the phenomenon that there is an overall respiration-related enhancement on the motor system, with a strong inspiration-finger extension coupling during voluntary breathing. As such, breathing-controlled electrical stimulation (i.e., stimulation to finger extensors delivered during the voluntary inspiratory phase) could be applied for enhancing finger extension strength and finger flexor spasticity reduction in poststroke patients.

Development of a finger biomechanical model and its considerations

The development of a biomechanical model for a human finger is faced with many challenges, such as extensor mechanism complexity, statistical indeterminacy and suitability of computational processes. Motivation for this work was to develop a computer model that is able to predict the internal loading patterns of tendons and joint surfaces experienced by the human finger, while mitigating these challenges. Proposed methodology was based on a non-linear optimising mathematical technique with a criterion of boundary conditions and equality equations, maximised against unknown parameters to reduce statistical indeterminacy. Initial validation was performed via the simulation of one dynamic and two static postures case studies. Past models and experiments were used, based on published literature, to verify the proposed model's methodology and results. The feasibility of the proposed methodology was deemed satisfactory as the simulated results were concordant with in-vivo results for the extrinsic flexors.

Finger joint motion generated by individual extrinsic muscles: a cadaveric study

BACKGROUND

Our understanding of finger functionality associated with the specific muscle is mostly based on the functional anatomy, and the exact motion effect associated with an individual muscle is still unknown. The purpose of this study was to examine phalangeal joints motion of the index finger generated by each extrinsic muscle.

METHODS

Ten (6 female and 4 male) fresh-frozen cadaveric hands (age 55.2 +/- 5.6 years) were minimally dissected to establish baseball sutures at the musculotendinous junctions of the index finger extrinsic muscles. Each tendon was loaded to 10% of its force potential and the motion generated at the metacarpophalangeal (MCP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints was simultaneously recorded using a marker-based motion capture system.

RESULTS

The flexor digitorum profundus (FDP) generated average flexion of 19.7, 41.8, and 29.4 degrees at the MCP, PIP, and DIP joints, respectively. The flexor digitorum superficialis (FDS) generated average flexion of 24.8 and 47.9 degrees at the MCP and PIP joints, respectively, and no motion at the DIP joints. The extensor digitorum communis (EDC) and extensor indicis proprius (EIP) generated average extension of 18.3, 15.2, 4.0 degrees and 15.4, 13.2, 3.7 degrees at the MCP, PIP and DIP joints, respectively. The FDP generated simultaneous motion at the PIP and DIP joints. However, the motion generated by the FDP and FDS, at the MCP joint lagged the motion generated at the PIP joint. The EDC and EIP generated simultaneous motion at the MCP and PIP joints.

CONCLUSION

The results of this study provide novel insights into the kinematic role of individual extrinsic muscles.

A new method for estimating hand internal loads from external force measurements

This study examines using force vectors measured using a directional strain gauge grip dynamometer for estimating finger flexor tendon tension. Fifty-three right-handed participants (25 males and 28 females) grasped varying-sized instrumented cylinders (2.54, 3.81, 5.08, 6.35 and 7.62 cm diameter) using a maximal voluntary power grip. The grip force vector magnitude and direction, referenced to the third metacarpal, was resolved by taking two orthogonal grip force measurements. A simple biomechanical model incorporating the flexor tendons was used to estimate long finger tendon tension during power grip. The flexor digitorum superficialis and the flexor digitorum profundus were assumed to create a moment about the metacarpal phalange (MCP) joint that equals and counteracts a moment around the MCP joint measured externally by the dynamometer. The model revealed that tendon tension increased by 130% from the smallest size handle to the largest, even though grip force magnitude decreased 36% for the same handles. The study demonstrates that grip force vectors may be useful for estimating internal hand forces.

Using EMG data to constrain optimization procedure improves finger tendon tension estimations during static fingertip force production

Determining tendon tensions of the finger muscles is crucial for the understanding and the rehabilitation of hand pathologies. Since no direct measurement is possible for a large number of finger muscle tendons, biomechanical modelling presents an alternative solution to indirectly evaluate these forces. However, the main problem is that the number of muscles spanning a joint exceeds the number of degrees of freedom of the joint resulting in mathematical under-determinate problems. In the current study, a method using both numerical optimization and the intra-muscular electromyography (EMG) data was developed to estimate the middle finger tendon tensions during static fingertip force production. The method used a numerical optimization procedure with the muscle stress squared criterion to determine a solution while the EMG data of three extrinsic hand muscles serve to enforce additional inequality constraints. The results were compared with those obtained with a classical numerical optimization and a method based on EMG only. The proposed method provides satisfactory results since the tendon tension estimations respected the mechanical equilibrium of the musculoskeletal system and were concordant with the EMG distribution pattern of the subjects. These results were not observed neither with the classical numerical optimization nor with the EMG-based method. This study demonstrates that including the EMG data of the three extrinsic muscles of the middle finger as inequality constraints in an optimization process can yield relevant tendon tensions with regard to individual muscle activation patterns, particularly concerning the antagonist muscles.

An integrative approach to the biomechanical function and neuromuscular control of the fingers

The exquisite mechanical functionality and versatility of the human hand emerges from complex neuro-musculo-skeletal interactions that are not completely understood. I have found it useful to work within a theoretical/experimental paradigm that outlines the fundamental neuro-musculo-skeletal components and their interactions. In this integrative paradigm, the laws of mechanics, the specifications of the manipulation task, and the sensorimotor signals define the interactions among hand anatomy, the nervous system, and manipulation function. Thus, our collaborative research activities emphasize a firm grounding in the mechanics of finger function, insistence on anatomical detail, and meticulous characterization of muscle activity. This overview of our work on precision pinch (i.e., the ability to produce and control fingertip forces) presents some of our findings around three Research Themes: Mechanics-based quantification of manipulation ability; Anatomically realistic musculoskeletal finger models; and Neural control of finger muscles. I conclude that (i) driving the fingers to some limit of sensorimotor performance is instrumental to elucidating motor control strategies; (ii) that the cross-over of tendons from flexors to extensors in the extensor mechanism is needed to produce force in every direction, and (iii) the anatomical routing of multiarticular muscles makes co-contraction unavoidable for many tasks. Moreover, creating realistic and clinically useful finger models still requires developing new computational means to simulate the viscoelastic tendinous networks of the extensor mechanism, and the muscle-bone-ligament interactions in complex articulations. Building upon this neuromuscular biomechanics paradigm is of immense clinical relevance: it will be instrumental to the development of clinical treatments to preserve and restore manual ability in people suffering from neurological and orthopedic conditions. This understanding will also advance the design and control of robotic hands whose performance lags far behind that of their biological counterparts.

The safety of pumpkin carving tools

BACKGROUND

Even with optimal treatment, injuries from pumpkin carving accidents may leave people with compromised hand function. Pumpkin carving tools may reduce the incidence and/or magnitude of these injuries. However, evidence that they are safer is required before these knives can be recommended.

METHODS

Two pumpkin carving knives were compared to a serrated and a plain kitchen knife. The forces required to cut and pierce a pumpkin were determined and then applied by a servo-hydraulic machine to each knife placed against cadaver hands in a manner designed to either lacerate Zone 2 of the finger (six tests for each knife) or to puncture the hand. Inspection and dissection determined the extent of injury.

RESULTS

The pumpkin knives produced some injuries, however, they were fewer and less severe than those caused by the kitchen knives.

CONCLUSIONS

Tools designed specifically for pumpkin carving may indeed be safer. Use of these products, and increased overall awareness of the risks of pumpkin carving in general, which clinicians could help promote, might reduce the frequency and severity of pumpkin carving injuries.

New instrumental set for the assessment of the hand functionality

Hand motor deficits have been widely investigated, and several devices have been proposed for the selective and accurate study of specific hand motor tasks. Most studies have focused on the four, long fingers. The thumb function, although extremely important for the performance of most daily activities involving the hand, has scarcely been documented. A set of general-purpose, instrumental measuring devices has been designed and constructed at the authors' laboratory to measure and monitor the force each finger exerts separately, under isometric conditions, during pressing tasks. More generally, it is meant for the functional evaluation of the normal hand in different postures, but it also provides reliable measurements of the injured or deformed hand. The instrumental set is suitable for both biomechanical research and clinical applications. Effectively integrated with a visual feedback tool, it could be exploited in delivering and monitoring custom-designed rehabilitation programmes. The characteristics of the force transducers (range 0-100 N) were: inter-axis crosstalk < 4%; non-linearity < +/- 0.4% f.s.; hysteresis < 0.3% f.s.; overall accuracy +/- 1% f.s. The overall measurement system resolution was better than 0.1 N, and the keys response to the mechanical shock (acquired at 10 kHz) showed a resonance frequency of about 1 kHz. It was observed that the thumb contributed more than 30% of the overall pressing force.

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

We studied the effects of fatigue, induced by a 60-s maximal isometric force production with the index finger, on multi-finger coordination and force production by the other fingers of the hand. Finger forces were measured during single- and multi-finger maximal voluntary force production (MVC) at two sites, the middle of the distal or the middle of the proximal phalanges. Two fatiguing exercises involving force production by the index finger were used, one at the distal phalanx and the other at the proximal phalanx. The MVC of the index finger dropped by about 33% when it was produced at the site involved in the fatiguing exercise. In addition, large transfer effects of fatigue were observed across sites of force application and across fingers. Force deficit increased under fatigue, especially due to a drop in the recruitment of the index finger. Under fatigue, the index finger was less enslaved during force production by other fingers. During multi-finger tasks, the percentage of total force produced by the index finger was significantly reduced after the fatiguing exercise. The principle of minimization of secondary moments was violated under fatigue. We suggest that the most impaired (fatigued) finger shows less interaction with other fingers or, in other words, is being progressively removed from the multi-finger synergy. Some of the observed changes in finger coordination suggest effects of fatigue at a central (neural) level.

The effect of fatigue on multifinger co-ordination in force production tasks in humans

1. This study investigated the effects of fatigue, induced by production of maximal isometric force for 60 s with four fingers, upon indices of multifinger co-ordination. 2. Measurements of individual finger forces were performed during single- and multifinger maximal force production (maximal voluntary contraction, MVC) for two sites of force application, the middle of the distal or the middle of the proximal phalanxes. Two fatiguing exercises were used, involving force production at the distal phalanxes and at the proximal phalanxes. Fourteen subjects were tested. 3. The total force in four-finger tasks dropped by about 43 % when it was produced at the site involved in the fatiguing exercise. During force production at the other site, MVC dropped by 23 %. During single-finger MVC tests, force drop with fatigue was similar across all four fingers (about -25 % of their corresponding MVCs). 4. Force production by one finger was accompanied by involuntary force production by other fingers (enslaving). Enslaving remained unchanged by fatigue when measured during force generation at the site involved in the fatiguing exercise, but increased during force production at the other site. 5. The total MVC of four fingers acting in parallel was smaller than the sum of the MVCs of these fingers in single-finger tasks (force deficit). The force deficit increased with fatigue. Force-sharing patterns during four-finger tasks showed only minor changes under fatigue. 6. These results indicate that the effects of fatigue were not limited to changes in the force-generating capabilities of the muscles. In particular, fatigue could lead to a reorganisation at a neural level that defines commands to individual fingers.