Hand digit control in children: age-related changes in hand digit force interactions during maximum flexion and extension force production tasks.

ABSTRACT

We studied the finger interactions during maximum voluntary force (MVF) production in flexion and extension in children and adults. The goal of this study was to investigate the age-related changes and flexion-extension differences of MVF and finger interaction indices, such as finger inter-dependency (force enslaving (FE) unintended finger forces produced by non-instructed fingers during force production of an instructed finger), force sharing (FS; percent contributions of individual finger forces to the total force at four-finger MVF), and force deficit (FD; force difference between single-finger MVF and the force of the same finger at four-finger MVF). Twenty-five right-handed children of 6-10 years of age and 25 adults of 20-24 years of age participated as subjects in this study (five subjects at each age). During the experiments, the subjects had their forearms secured in armrests. The subjects inserted the distal phalanges of the right hand into C-shaped aluminum thimbles affixed to small force sensors with 200 of flexion about the metacarpophalangeal (MCP) joint. The subjects were instructed to produce their maximum isometric force with a single finger or all four fingers in flexion or extension. In order to examine the effects of muscle-force relationship on MVF and other digit interaction indices, six subjects were randomly selected from the group of 25 adult subjects and asked to perform the same experimental protocol described above. However, the MCP joint was at 800 of flexion. The results from the 20' of MCP joint flexion showed that (1) MVF increased and finger inter-dependency decreased with children's age, (2) the increasing and decreasing absolute slopes (N/year) from regression analysis were steeper in flexion than extension while the relative slopes (%/year) with respect to adults' maximum finger forces were higher in extension than flexion, (3) the larger MVF, FE, and FD were found in flexion than in extension, (4) the finger FS was very similar in children and adults, (5) the FS pattern of individual fingers was different for flexion and extension, and (6) the differences between flexion and extension found at 20 degrees MCP joint conditions were also valid at 80 degrees MCP joint conditions. We conclude that (a) the finger strength and independency increase from 6 to 10 years of age, and the increasing trends are more evident in flexion than in extension as indexed by the absolute slopes, (b) the finger strength and finger independency is greater in flexion than in extension, and (c) the sharing pattern in children appears to develop before 6 years of age or it is an inherent property of the hand neuromusculoskletal system. One noteworthy observation, which requires further investigation, was that FE was slightly smaller in the 80 degrees condition than in the 20 degrees condition for flexion, but larger for extension for all subjects. This may be interpreted as a greater FE when flexor or extensor muscles are stretched.