Open Access Research

Effects of Carpal Tunnel Syndrome on adaptation of multi-digit forces to object mass distribution for whole-hand manipulation

Wei Zhang12, Jamie A Johnston3, Mark A Ross4, Brandon J Coakley4, Elizabeth A Gleason4, Amylou C Dueck4 and Marco Santello1*

Author Affiliations

1 School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, 85287, USA

2 Department of Physical Therapy, College of Staten Island, City University of New York, Staten Island, NY, 10314, USA

3 Faculty of Kinesiology and Hotchkiss Brain Institute, University of Calgary, Calgary, AB, T2N 1N4, Canada

4 Mayo Clinic Hospital, Phoenix, AZ, 85054, USA

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Journal of NeuroEngineering and Rehabilitation 2012, 9:83  doi:10.1186/1743-0003-9-83

Published: 21 November 2012

Abstract

Background

Carpal tunnel syndrome (CTS) is a compression neuropathy of the median nerve that results in sensorimotor deficits in the hand. Until recently, the effects of CTS on hand function have been studied using mostly two-digit grip tasks. The purpose of this study was to investigate the coordination of multi-digit forces as a function of object center of mass (CM) during whole-hand grasping.

Methods

Fourteen CTS patients and age- and gender-matched controls were instructed to grasp, lift, hold, and release a grip device with five digits for seven consecutive lifts while maintaining its vertical orientation. The object CM was changed by adding a mass at different locations at the base of the object. We measured forces and torques exerted by each digit and object kinematics and analyzed modulation of these variables to object CM at object lift onset and during object hold. Our task requires a modulation of digit forces at and after object lift onset to generate a compensatory moment to counteract the external moment caused by the added mass and to minimize object tilt.

Results

We found that CTS patients learned to generate a compensatory moment and minimized object roll to the same extent as controls. However, controls fully exploited the available degrees of freedom (DoF) in coordinating their multi-digit forces to generate a compensatory moment, i.e., digit normal forces, tangential forces, and the net center of pressure on the finger side of the device at object lift onset and during object hold. In contrast, patients modulated only one of these DoFs (the net center of pressure) to object CM by modulating individual normal forces at object lift onset. During object hold, however, CTS patients were able to modulate digit tangential force distribution to object CM.

Conclusions

Our findings suggest that, although CTS did not affect patients’ ability to perform our manipulation task, it interfered with the modulation of specific grasp control variables. This phenomenon might be indicative of a lower degree of flexibility of the sensorimotor system in CTS to adapt to grasp task conditions.

Keywords:
Sensorimotor memories; Grasping; Learning; Center of mass