Nowak Dennis A, Hermsdörfer Joachim
Abteilung für Neurologie und Klinische Neurophysiologie, Städtisches Krankenhaus Bogenhausen, Lehrkrankenhaus der Technischen Universität München, München, Deutschland.
Nervenarzt. 2004 Aug;75(8):725-33. doi: 10.1007/s00115-003-1676-1.
The control of prehensile finger forces is an essential feature of all skilled manual performance. The basic aspects of healthy grip force control have been well documented within the past two decades. In healthy subjects, grip force is accurately adjusted to the mechanical object properties such as weight, surface friction, and shape: when we move a hand-held object, grip force is modulated in parallel with movement-induced load fluctuations without an apparent temporal delay. At all phases of the movement, grip force is always slightly higher than the minimum necessary to prevent the object from slipping. The absence of a temporal delay between grip and load force profiles implies that the central nervous system is able to predict load variations precisely before the intended manipulation, and consequently regulates grip force in anticipation. Feedback from the grasping fingertips is used to adjust the force level efficiently to the actual load requirements. Pathologic grip force control affects the efficiency of the forces produced and the predictive temporal coupling between grip and load force profiles. Here we demonstrate pathologic grip force control in various neurologic disorders. The analysis of grip force control is simple and highly sensitive for detecting healthy and pathologic motor behaviour. The examination of grip force control is well suited for an objective evaluation of therapy during sensorimotor rehabilitation of deficient hand function.
对可抓握手指力量的控制是所有熟练手部动作的一个基本特征。在过去二十年中,健康抓握力控制的基本方面已有充分记录。在健康受试者中,抓握力会根据物体的机械特性(如重量、表面摩擦力和形状)进行精确调整:当我们移动手持物体时,抓握力会与运动引起的负载波动同步调节,且没有明显的时间延迟。在运动的所有阶段,抓握力始终略高于防止物体滑落所需的最小值。抓握力和负载力曲线之间不存在时间延迟,这意味着中枢神经系统能够在预期操作之前精确预测负载变化,从而提前调节抓握力。来自抓握指尖的反馈用于根据实际负载需求有效调整力的水平。病理性抓握力控制会影响所产生力量的效率以及抓握力和负载力曲线之间的预测性时间耦合。在这里,我们展示了各种神经系统疾病中的病理性抓握力控制。抓握力控制分析简单,对检测健康和病理性运动行为高度敏感。抓握力控制检查非常适合在手部功能缺陷的感觉运动康复期间对治疗进行客观评估。