Bioinspired adaptable multiplanar mechano-vibrotactile haptic system.

Several gaps persist in haptic device development due to the multifaceted nature of the sense of touch. Existing gaps include challenges enhancing touch feedback fidelity, providing diverse haptic sensations, and ensuring wearability for delivering tactile stimuli to the fingertips. Here, we introduce the Bioinspired Adaptable Multiplanar Haptic system, offering mechanotactile/steady and vibrotactile pulse stimuli with adjustable intensity (up to 298.1 mN) and frequencies (up to 130 Hz). This system can deliver simultaneous stimuli across multiple fingertip areas. The paper includes a full characterisation of our system. As the device can play an important role in further understanding human touch, we performed human stimuli sensitivity and differentiation experiments to evaluate the capability of delivering mechano-vibrotactile, variable intensity, simultaneous, multiplanar and operator agnostic stimuli. Our system promises to accelerate the development of touch perception devices, providing painless, operator-independent data crucial for researching and diagnosing touch-related disorders.

Interference haptic stimulation and consistent quantitative tactility in transparent electrotactile screen with pressure-sensitive transistors.

Integrating tactile feedback through haptic interfaces enhances experiences in virtual and augmented reality. However, electrotactile systems, which stimulate mechanoreceptors directly, often yield inconsistent tactile results due to variations in pressure between the device and the finger. In this study, we present the integration of a transparent electrotactile screen with pressure-sensitive transistors, ensuring highly consistent quantitative haptic sensations. These transistors effectively calibrate tactile variations caused by touch pressure. Additionally, we explore remote-distance tactile stimulations achieved through the interference of electromagnetic waves. We validated tactile perception using somatosensory evoked potentials, monitoring the somatosensory cortex response. Our haptic screen can stimulate diverse electrotactile sensations and demonstrate various tactile patterns, including Morse code and Braille, when integrated with portable smart devices, delivering a more immersive experience. Furthermore, interference of electric fields allows haptic stimulation to facilitate diverse stimulus positioning at lower current densities, extending the reach beyond direct contact with electrodes of our screen.

Monte Carlo simulation of the effect of melanin concentration on light-tissue interactions for transmittance pulse oximetry measurement.

Significance: Questions about the accuracy of pulse oximeters in measuring arterial oxygen saturation ( SpO 2 ) in individuals with darker skin pigmentation have resurfaced since the COVID-19 pandemic. This requires investigation to improve patient safety, clinical decision making, and research. Aim: We aim to use computational modeling to identify the potential causes of inaccuracy in SpO 2 measurement in individuals with dark skin and suggest practical solutions to minimize bias. Approach: An in silico model of the human finger was developed to explore how changing melanin concentration and arterial oxygen saturation ( SaO 2 ) affect pulse oximeter calibration algorithms using the Monte Carlo (MC) technique. The model generates calibration curves for Fitzpatrick skin types I, IV, and VI and an SaO 2 range between 70% and 100% in transmittance mode. SpO 2 was derived by inputting the computed ratio of ratios for light and dark skin into a widely used calibration algorithm equation to calculate bias ( SpO 2 - SaO 2 ). These were validated against an experimental study to suggest the validity of the Monte Carlo model. Further work included applying different multiplication factors to adjust the moderate and dark skin calibration curves relative to light skin. Results: Moderate and dark skin calibration curve equations were different from light skin, suggesting that a single algorithm may not be suitable for all skin types due to the varying behavior of light in different epidermal melanin concentrations, especially at 660 nm. The ratio between the mean bias in White and Black subjects in the cohort study was 6.6 and 5.47 for light and dark skin, respectively, from the Monte Carlo model. A linear multiplication factor of 1.23 and exponential factor of 1.8 were applied to moderate and dark skin calibration curves, resulting in similar alignment. Conclusions: This study underpins the careful re-assessment of pulse oximeter designs to minimize bias in SpO 2 measurements across diverse populations.

Unsupervised Domain Adaptation for Inter-Session Re-Calibration of Ultrasound-Based HMIs.

Human-Machine Interfaces (HMIs) have gained popularity as they allow for an effortless and natural interaction between the user and the machine by processing information gathered from a single or multiple sensing modalities and transcribing user intentions to the desired actions. Their operability depends on frequent periodic re-calibration using newly acquired data due to their adaptation needs in dynamic environments, where test-time data continuously change in unforeseen ways, a cause that significantly contributes to their abandonment and remains unexplored by the Ultrasound-based (US-based) HMI community. In this work, we conduct a thorough investigation of Unsupervised Domain Adaptation (UDA) algorithms for the re-calibration of US-based HMIs during within-day sessions, which utilize unlabeled data for re-calibration. Our experimentation led us to the proposal of a CNN-based architecture for simultaneous wrist rotation angle and finger gesture prediction that achieves comparable performance with the state-of-the-art while featuring 87.92% less trainable parameters. According to our findings, DANN (a Domain-Adversarial training algorithm), with proper initialization, offers an average 24.99% classification accuracy performance enhancement when compared to no re-calibration setting. However, our results suggest that in cases where the experimental setup and the UDA configuration may differ, observed enhancements would be rather small or even unnoticeable.

Effectiveness of mixed reality-based rehabilitation on hands and fingers by individual finger-movement tracking in patients with stroke.

BACKGROUND: Mixed reality (MR) is helpful in hand training for patients with stroke, allowing them to fully submerge in a virtual space while interacting with real objects. The recognition of individual finger movements is required for MR rehabilitation. This study aimed to assess the effectiveness of updated MR-board 2, adding finger training for patients with stroke. METHODS: Twenty-one participants with hemiplegic stroke (10 with left hemiplegia and 11 with right hemiplegia; nine female patients; 56.7 ± 14.2 years of age; and onset of stroke 32.7 ± 34.8 months) participated in this study. MR-board 2 comprised a board plate, a depth camera, plastic-shaped objects, a monitor, a palm-worn camera, and seven gamified training programs. All participants performed 20 self-training sessions involving 30-min training using MR-board 2. The outcome measurements for upper extremity function were the Fugl-Meyer assessment (FMA) upper extremity score, repeated number of finger flexion and extension (Repeat-FE), the thumb opposition test (TOT), Box and Block Test score (BBT), Wolf Motor Function Test score (WMFT), and Stroke Impact Scale (SIS). One-way repeated measures analysis of variance and the post hoc test were applied for the measurements. MR-board 2 recorded the fingers' active range of motion (AROM) and Dunnett's test was used for pairwise comparisons. RESULTS: Except for the FMA-proximal score (p = 0.617) and TOT (p = 0.005), other FMA scores, BBT score, Repeat-FE, WMFT score, and SIS stroke recovery improved significantly (p < 0.001) during MR-board 2 training and were maintained until follow-up. All AROM values of the finger joints changed significantly during training (p < 0.001). CONCLUSIONS: MR-board 2 self-training, which includes natural interactions between humans and computers using a tangible user interface and real-time tracking of the fingers, improved upper limb function across impairment, activity, and participation. MR-board 2 could be used as a self-training tool for patients with stroke, improving their quality of life. TRIAL REGISTRATION NUMBER: This study was registered with the Clinical Research Information Service (CRIS: KCT0004167).

Soft pneumatic actuators for pushing fingers into extension.

BACKGROUND: Compliant pneumatic actuators possess many characteristics that are desirable for wearable robotic systems. These actuators can be lightweight, integrated with clothing, and accommodate uncontrolled degrees of freedom. These attributes are especially desirable for hand exoskeletons, where the soft actuator can conform to the highly variable digit shape. In particular, locating the pneumatic actuator on the palmar side of the digit may have benefits for assisting finger extension and resisting unwanted finger flexion, but this configuration requires suppleness to allow digit flexion while retaining sufficient stiffness to assist extension. METHODS: To meet these needs, we designed an actuator consisting of a hollow chamber long enough to span the joints of each digit while sufficiently narrow not to inhibit finger adduction. We explored the geometrical design parameter space for this chamber in terms of shape, dimensions, and wall thickness. After fabricating an elastomer-based prototype for each actuator design, we measured active extension force and passive resistance to bending for each chamber using a mechanical jig. We also created a finite element model for each chamber to enable estimation of the impact of chamber deformation, caused by joint rotation, on airflow through the chamber. Finally, we created a prototype hand exoskeleton with the chamber parameters yielding the best outcomes. RESULTS: A rectangular cross-sectional area was preferable to a semi-obround shape for the chamber; wall thickness also impacted performance. Extension joint torque reached 0.33 N-m at a low chamber pressure of 48.3 kPa. The finite element model confirmed that airflow for the rectangular chamber remained high despite deformation resulting from joint rotation. The hand exoskeleton created with the rectangular chambers enabled rapid movement, with a cycle time of 1.1 s for voluntary flexion followed by actuated extension. CONCLUSIONS: The developed soft actuators are feasible for use in promoting finger extension from the palmar side of the hand. This placement utilizes pushing rather than pulling for digit extension, which is more comfortable and safer. The small chamber volumes allow rapid filling and evacuation to facilitate relatively high frequency finger movements.

Time-independent relationship between digits closure velocity and hand transport acceleration during reach-to-grasp movements.

Prehension movements in primates have been extensively studied for decades, and hand transport and hand grip adjustment are usually considered as the main components of any object reach-to-grasp action. Evident temporal patterns were found for the velocity of the hand during the transport phase and for the digits kinematics during pre-shaping and enclosing phases. However, such kinematics were always analysed separately in regard to time, and never studied in terms of dependence one from another. Nevertheless, if a reliable one-to-one relationship is proven, it would allow reconstructing the digit velocity (and position) simply by knowing the hand acceleration during reaching motions towards the target object, ceasing the usual dependence seen in literature from time of movement and distance from the target. In this study, the aim was precisely to analyse reach-to-grasp motions to explore if such relationship exists and how it can be formulated. Offline and real-time results not only seem to suggest the existence of a time-independent, one-to-one relationship between hand transport and hand grip adjustment, but also that such relationship is quite resilient to the different intrinsic and extrinsic properties of the target objects such as size, shape and position.

Towards higher load capacity: innovative design of a robotic hand with soft jointed structure.

In this paper, the innovative design of a robotic hand with soft jointed structure is carried out and a tendon-driven mechanism, a master-slave motor coordinated drive mechanism, a thumb coupling transmission mechanism and a thumb steering mechanism are proposed. These innovative designs allow for more effective actuation in each finger, enhancing the load capacity of the robotic hand while maintaining key performance indicators such as dexterity and adaptability. A mechanical model of the robotic finger was made to determine the application limitations and load capacity. The robotic hand was then prototyped for a set of experiments. The experimental results showed that the proposed theoretical model were reliable. Also, the fingertip force of the robotic finger could reach up to 10.3 N, and the load force could reach up to 72.8 N. When grasping target objects of different sizes and shapes, the robotic hand was able to perform the various power grasping and precision grasping in the Cutkosky taxonomy. Moreover, the robotic hand had good flexibility and adaptability by means of adjusting the envelope state autonomously.

Validity and reliability of a finger training tool for assessing metacarpal phalangeal joint ranges of motion in asymptomatic participants.

This pilot study aims to evaluate concurrent validity using the goniometer as a reference tool and test-retest reliability of flexion of metacarpal phalangeal joint (MCP) measurements taken from a finger training device (air-guitar system) in healthy participants. There were ten self -reported asymptomatic participants recruited to test the devices. The measurements of all metacarpophangeal joints of the dominant hands were conducted using a finger goniometer and the air-guitar system. Two measuring sessions were conducted on the same day. The concurrent validity of the air-guitar indicated by strong concordance correlation coefficient (0.62-0.90) with the goniometer and mean difference (approximately 1°) between the two instruments are well below the limit of 5°. The test-retest reliability of MCP measurements from the air-guitar glove (0.82-0.99) was acceptable as a clinically meaningful measurement tool as the intraclass correlation coefficients were higher than 0.7. The standard error of measurement and minimal detectable change of the air-guitar are similar to those of the goniometer. The air-guitar tracking features, when used as a home-based therapy tool, may assist in monitoring change of MCP flexion over a time course with good reliability and strongly associated with the measurements from the goniometer.

Force reflections of auditory and tactile action-effect weighting in motor planning.

Most voluntary actions have only few goals, which provides considerable freedom in the selection of action parameters. Recent studies showed that task-irrelevant aspects of the task context influence the motor parameters of the actions in a way which seems to reflect the relative importance of these aspects within the underlying action representation. The present study investigated how the intensity of auditory action-effects affected force exertion patterns in a self-paced action production task. Participants applied force impulses with their index finger on a force-sensitive resistor every three seconds. In four separate conditions, force impulses elicited no sound, or elicited tones with 69, 59 or 49 dB intensity. The results showed that participants applied more force when tone intensity was lower, and when tones were absent. These force differences were also present in the first 60 ms following tone onset, implying that these reflected differences in motor planning. The results are compatible with the notion that actions are represented in terms of their sensory effects, which are weighted differently-presumably to maintain an optimal level of overall auditory and tactile stimulation in the present case. These results hint at the potential usefulness of motor parameters as readouts of action intentions.

Effects of Different Test Positions on Quantitative Muscle Strength of Wrist and Finger Flexor Muscle Groups and Its Standardization.

OBJECTIVES: To explore the effects of different test positions on quantitative muscle strength of wrist and finger flexor muscle groups and to establish a standardized muscle strength test protocol for each muscle group. METHODS: Forty healthy subjects (12 males and 28 females) were recruited. A portable digital quantitative muscle strength tester, Micro FET2TM, was used to measure the flexor muscle strength of each finger and the wrist joint at the 30° extension, 0° neutral, and 30° flexion, respectively. Palmar abduction strength of the thumb was measured at 30° and 60°, respectively. Ten subjects were randomly selected from the 40 subjects, and the quantitative muscle strength of each muscle group was tested again by the same operator after an interval of 10 to 15 days. RESULTS: Except for the fact that in males, there was no significant difference in flexor muscle strength of thumb and wrist joint between 30° of wrist extension and neutral 0° position, the muscle strength of the other fingers flexion and wrist palmar flexor showed the following characteristics：30° of wrist extension > neutral 0° position > 30° of flexion, and the PAST was 30°>60°; The flexor muscle strength of all the subjects was thumb > index finger > middle finger > ring finger > little finger; All muscle strength values of male were greater than those of female, and the difference was statistically significant (P<0.05); There was no significant difference between the left and right side muscle strength values of all subjects (P>0.05). The reliability of muscle strength values measured at different times in 10 subjects was good. CONCLUSIONS: The quantitative muscle strength of each muscle group of the hand and wrist is affected by the test position, and a standardized and uniformed test position should be adopted in the actual identification. Micro FET2TM has good reliability for hand and wrist quantitative muscle strength testing. The 30° extension of the wrist can be used as the best standardized test position for the flexion muscle strength of each finger and wrist joint. The 30° position can be used as the best standardized test position for PAST.

Temporal properties of preparation phase for arm-pointing movements in various directions and distances.

In this study, we investigated how the temporal properties of the preparation phase for upper limb movements are affected by the reaching direction and distance. Twelve right-handed participants performed three motor tasks: two types of reaching movements and one finger-lifting movement. The reaching movements were performed from the home position to 15 target locations (five directions and three distances) as quickly and precisely as possible under two conditions: pre-cueing the target to allocate the sufficient time for the motor-planning process before movement initiation, and no-cuing. The finger lifting movement was performed by lifting the index finger (from the home position) upward in the air as quickly as possible. The reaction time (RT), movement time (MT), and kinematics of the index finger were obtained for each condition. In addition, differential RTs (DRT) were calculated by subtracting the RT for no-cue lifting from that for no-cue reaching, thereby implicitly representing the time required for the motor-planning process for reaching movements. The results indicated the anisotropy of the DRTs being larger in the forward and left-forward directions than that in the right-forward direction, and larger in the forward direction than that in the right direction for the middle distance. It is suggested that the temporal costs of the motor-planning process depend on the movement direction and distance. In the kinematic analysis, the MTs showed the anisotropy being the largest in the left-forward among all directions. Meanwhile, the time from peak velocity to terminate the movement (TFPV) was significantly longer in the left-forward direction when no-cueing the target than when pre-cueing. These results suggest that reaching movement is refined during the online-control process to accomplish the intended performance if a reaching movement under the no-cue condition is initiated before building sufficient motor planning, especially in the direction requiring large temporal costs. It is likely that humans achieve their intended movements by allocating the temporal costs required before and after movement initiation according to the difficulty of motor control which varies with the direction and distance.

DDP-FedFV: A Dual-Decoupling Personalized Federated Learning Framework for Finger Vein Recognition.

Finger vein recognition methods, as emerging biometric technologies, have attracted increasing attention in identity verification due to their high accuracy and live detection capabilities. However, as privacy protection awareness increases, traditional centralized finger vein recognition algorithms face privacy and security issues. Federated learning, a distributed training method that protects data privacy without sharing data across endpoints, is gradually being promoted and applied. Nevertheless, its performance is severely limited by heterogeneity among datasets. To address these issues, this paper proposes a dual-decoupling personalized federated learning framework for finger vein recognition (DDP-FedFV). The DDP-FedFV method combines generalization and personalization. In the first stage, the DDP-FedFV method implements a dual-decoupling mechanism involving model and feature decoupling to optimize feature representations and enhance the generalizability of the global model. In the second stage, the DDP-FedFV method implements a personalized weight aggregation method, federated personalization weight ratio reduction (FedPWRR), to optimize the parameter aggregation process based on data distribution information, thereby enhancing the personalization of the client models. To evaluate the performance of the DDP-FedFV method, theoretical analyses and experiments were conducted based on six public finger vein datasets. The experimental results indicate that the proposed algorithm outperforms centralized training models without increasing communication costs or privacy leakage risks.

Exploring the bias: how skin color influences oxygen saturation readings via Monte Carlo simulations.

Significance: Our goal is to understand the root cause of reported oxygen saturation ( SpO 2 ) overestimation in heavily pigmented skin types to devise solutions toward enabling equity in pulse oximeter designs. Aim: We aim to gain theoretical insights into the effect of skin tone on SpO 2 - R curves using a three-dimensional, four-layer tissue model representing a finger. Approach: A finger tissue model, comprising the epidermis, dermis, two arteries, and a bone, was developed using a Monte Carlo-based approach in the MCmatlab software. Two skin tones-light and dark-were simulated by adjusting the absorption and scattering properties within the epidermal layer. Following this, SpO 2 - R curves were generated in various tissue configurations, including transmission and reflection modes using red and infrared wavelengths. In addition, the influence of source-detector (SD) separation distances on both light and dark skin tissue models was studied. Results: In transmission mode, SpO 2 - R curves did not deviate with changes in skin tones because both pulsatile and non-pulsatile terms experienced equal attenuation at red and infrared wavelengths. However, in reflection mode, measurable variations in SpO 2 - R curves were evident. This was due to differential attenuation of the red components, which resulted in a lower perfusion index at the red wavelength in darker skin. As the SD separation increased, the effect of skin tone on SpO 2 - R curves in reflection mode became less pronounced, with the largest SD separation exhibiting effects similar to those observed in transmission mode. Conclusions: Monte Carlo simulations have demonstrated that different light pathlengths within the tissue contribute to the overestimation of SpO 2 in people with darker skin in reflection mode pulse oximetry. Increasing the SD separation may mitigate the effect of skin tone on SpO 2 readings. These trends were not observed in transmission mode; however, further planned research using more complex models of the tissue is essential.

Somatotopically Evoked Tactile Sensation via Transcutaneous Electrical Nerve Stimulation Improves Prosthetic Sensorimotor Performance.

Sensory feedback provides critical interactive information for the effective use of hand prostheses. Non-invasive neural interfaces allow convenient access to the sensory system, but they communicate a limited amount of sensory information. This study examined a novel approach that leverages a direct and natural sensory afferent pathway, and enables an evoked tactile sensation (ETS) of multiple digits in the projected finger map (PFM) of participants with forearm amputation non-invasively. A bidirectional prosthetic interface was constructed by integrating the non-invasive ETS-based feedback system into a commercial prosthetic hand. The pressure information of five fingers was encoded linearly by the pulse width modulation range of the buzz sensation. We showed that simultaneous perception of multiple digits allowed participants with forearm amputation to identify object length and compliance by using information about contact patterns and force intensity. The ETS enhanced the grasp-and-transport performance of participants with and without prior experience of prosthetic use. The functional test of transport-and-identification further revealed improved execution in classifying object size and compliance using ETS-based feedback. Results demonstrated that the ETS is capable of communicating somatotopically compatible information to participants efficiently, and improves sensory discrimination and closed-loop prosthetic control. This non-invasive sensory interface may establish a viable way to restore sensory ability for prosthetic users who experience the phenomenon of PFM.

Two aspects of feed-forward control of action stability: effects of action speed and unexpected events.

We explored two types of anticipatory synergy adjustments (ASA) during accurate four-finger total force production task. The first type is a change in the index of force-stabilizing synergy during a steady state when a person is expecting a signal to produce a quick force change, which is seen even when the signal does not come (steady-state ASA). The other type is the drop in in the synergy index prior to a planned force change starting at a known time (transient ASA). The subjects performed a task of steady force production at 10% of maximal voluntary contraction (MVC) followed by a ramp to 20% MVC over 1 s, 3 s, and as a step function (0 s). In another task, in 50% of the trials during the steady-state phase, an unexpected signal could come requiring a quick force pulse to 20% MVC (0-surprise). Inter-trial variance in the finger force space was used to quantify the index of force-stabilizing synergy within the uncontrolled manifold hypothesis. We observed significantly lower synergy index values during the steady state in the 0-ramp trials compared to the 1-ramp and 3-ramp trials. There was also larger transient ASA during the 0-ramp trials. In the 0-surprise condition, the synergy index was significantly higher compared to the 0-ramp condition whereas the transient ASA was significantly larger. The finding of transient ASA scaling is of importance for clinical studies, which commonly involve populations with slower actions, which can by itself be associated with smaller ASAs. The participants varied the sharing pattern of total force across the fingers more in the task with "surprises". This was coupled to more attention to precision of performance, i.e., inter-trial deviations from the target as reflected in smaller variance affecting total force, possibly reflecting higher concentration on the task, which the participants perceived as more challenging compared to a similar task without surprise targets.

Effect of time delay on performance and timing control in dyadic rhythm coordination using finger tapping.

In musical ensembles, people synchronise with each other despite the presence of time delays such as those related to sound transmission. However, the ways in which time delays in synchronisation are overcome remain unclear. This study aimed to investigate the basic characteristics and mechanism of synchronisation with time delays using a dyadic synchronisation-continuation finger-tapping task with time delays ranging from 0 to 240 ms. The results reveal that synchronisation performance improved under time delays of 40-160 ms compared with in the other conditions. This tolerance to the time delay could have been because such a delay allowed both participants in each pair to tap before receiving the stimuli from their partner, as seen in synchronisation with a constant-tempo metronome. In addition, the dependency of the timing control on the partner's previous inter-tap interval decreased at a time delay of 80 ms, relating to the fact that the acceleration and deceleration of the tapping tempo reduced under certain time delays, while the synchronisation performance improved. Uncertainty in the timing of the partner's stimulus could induce greater anticipatory responses, making it possible to tolerate longer time delays in dyadic finger-tapping tasks.

Flexible Arc-Shaped Micro-Fiber Bragg Grating Array Three-Dimensional Tactile Sensor for Fingertip Signals Detection and Human Pulse Monitoring.

A flexible arc-shaped micro-Fiber Bragg Grating (mFBG) array three-dimensional tactile sensor for fingertip signal detection and human pulse monitoring is presented. It is based on a three mFBGs array which is embedded in an arc-shaped poly (dimethylsiloxane) (PDMS) elastomer, which can effectively discriminate the normal force, left force, and right force by monitoring the reflected intensity variation of the three mFBGs. Different from the traditional FBG sensors, this sensor measures force by detecting changes in light intensity, effectively avoiding the wavelength cross-sensitivity impact of temperature variations on the sensor performance. This design strategy simplifies the sensor structure, reduces the system complexity and signal interrogation cost, and enhances reliability and practicality. Through systematic experiments, we successfully validated the sensor's superior performance, achieving a minimum detection force of 0.01 N and providing robust data support for practical applications. In addition, the sensor has been used to monitor human pulse accurately. The successful fabrication and experimental validation of this sensor lay a foundation for its widespread application in fields such as robot perception and human vital signal detection.

Boundaries of task-specificity: bimanual finger dexterity is reduced in musician's dystonia.

Task-specific dystonia leads to loss of sensorimotor control for a particular motor skill. Although focal in nature, it is hugely disabling and can terminate professional careers in musicians. Biomarkers for underlying mechanism and severity are much needed. In this study, we designed a keyboard device that measured the forces generated at all fingertips during individual finger presses. By reliably quantifying overflow to other fingers in the instructed (enslaving) and contralateral hand (mirroring) we explored whether this task could differentiate between musicians with and without dystonia. 20 right-handed professional musicians (11 with dystonia) generated isometric flexion forces with the instructed finger to match 25%, 50% or 75% of maximal voluntary contraction for that finger. Enslaving was estimated as a linear slope of the forces applied across all instructed/uninstructed finger combinations. Musicians with dystonia had a small but robust loss of finger dexterity. There was increased enslaving and mirroring, primarily during use of the symptomatic hand (enslaving p = 0.003; mirroring p = 0.016), and to a lesser extent with the asymptomatic hand (enslaving p = 0.052; mirroring p = 0.062). Increased enslaving and mirroring were seen across all combinations of finger pairs. In addition, enslaving was exaggerated across symptomatic fingers when more than one finger was clinically affected. Task-specific dystonia therefore appears to express along a gradient, most severe in the affected skill with subtle and general motor control dysfunction in the background. Recognition of this provides a more nuanced understanding of the sensorimotor control deficits at play and can inform therapeutic options for this highly disabling disorder.

Use of computational modeling to examine fingertip force production in children with hemiplegic cerebral palsy.

Most children with hemiplegic cerebral palsy (HCP), one of the most prevalent subtypes of cerebral palsy, struggle with grasping and manipulating objects. This impairment may arise from a diminished capacity to properly direct forces created with the finger pad due to aberrant force application. Children with HCP were asked to create maximal force with the index finger pad in the palmar (normal) direction with both the paretic and non-paretic hands. The resulting forces and finger postures were then applied to a computational musculoskeletal model of the hand to estimate the corresponding muscle activation patterns. Subjects tended to create greater shear force relative to normal force with the paretic hand (p < 0.05). The resultant force was directed 33.6°±10.8° away from the instructed palmar direction in the paretic hand, but only 8.0°±7.3° in the non-paretic hand. Additionally, participants created greater palmar force with the non-paretic hand than with the paretic hand (p < 0.05). These differences in force production are likely due to differences in muscle activation pattern, as our computational models showed differences in which muscles are active and their relative activations when recreating the measured force vectors for the two hands (p < 0.01). The models predicted reduced activation in the extrinsic and greater reductions in activation in the intrinsic finger muscles, potentially due to reduced voluntary activation or muscle atrophy. As the large shear forces could lead to objects slipping from grasp, muscle activation patterns may provide an important target for therapeutic treatment in children with HCP.