Physiotherapy Department, School of Health Sciences, Ariel University, Ariel, Israel.
Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Exp Brain Res. 2019 Jul;237(7):1655-1672. doi: 10.1007/s00221-019-05498-y. Epub 2019 Apr 11.
To evaluate normal and impaired control of anticipatory grip force (GF) modulation, we compared GF production during horizontal arm movements in healthy and post-stroke subjects, and, based on a physiologically feasible dynamic model, determined referent control variables underlying the GF-arm motion coordination in each group. 63% of 13 healthy and 48% of 13 stroke subjects produced low sustained initial force (< 10 N) and increased GF prior to arm movement. Movement-related GF increases were higher during fast compared to self-paced arm extension movements only in the healthy group. Differences in the patterns of anticipatory GF increases before the arm movement onset between groups occurred during fast extension arm movement only. In the stroke group, longer delays between the onset of GF change and elbow motion were related to clinical upper limb deficits. Simulations showed that GFs could emerge from the difference between the actual and the referent hand aperture (R) specified by the CNS. Similarly, arm movement could result from changes in the referent elbow position (R) and could be affected by the co-activation (C) command. A subgroup of stroke subjects, who increased GF before arm movement, could specify different patterns of the referent variables while reproducing the healthy typical pattern of GF-arm coordination. Stroke subjects, who increased GF after arm movement onset, also used different referent strategies than controls. Thus, altered anticipatory GF behavior in stroke subjects may be explained by deficits in referent control.
为了评估预期抓握力(GF)调节的正常和受损控制,我们比较了健康受试者和中风受试者在水平手臂运动期间的 GF 产生情况,并基于生理上可行的动态模型,确定了每组 GF-手臂运动协调的参考控制变量。在 13 名健康受试者中有 63%,在 13 名中风受试者中有 48%,在手臂运动之前产生了低持续初始力(<10 N)和增加的 GF。与自我调节手臂伸展运动相比,快速手臂伸展运动中与运动相关的 GF 增加幅度更高。仅在健康组中,在快速手臂伸展运动中,GF 增加的模式与手臂运动起始之间存在差异。在中风组中,GF 变化和肘部运动之间的延迟时间较长与上肢临床缺陷有关。模拟表明,GF 可以从 CNS 指定的实际和参考手开口(R)之间的差异中出现。同样,手臂运动可以由参考肘部位置(R)的变化引起,并且可以受到协同激活(C)命令的影响。中风组的一个亚组在手臂运动之前增加了 GF,他们可以指定参考变量的不同模式,同时再现健康受试者典型的 GF-手臂协调模式。在手臂运动开始后增加 GF 的中风受试者也比对照组使用了不同的参考策略。因此,中风受试者中预期 GF 行为的改变可以用参考控制的缺陷来解释。