Kinematic evaluation of the finger’s interphalangeal joints coupling mechanism—variability,flexion–extension differences,triggers, locking swanneck deformities,anthropometric correlations

The human finger contains tendon/ligament mechanisms essential for proper control. One mechanism couples the movements of the interphalangeal joints when the (unloaded) finger is flexed with active deep flexor. This study’s aim was to accurately determine in a large finger sample the kinematics and variability of the coupled interphalangeal joint motions, for potential clinical and finger model validation applications. The data could also be applied to humanoid robotic hands. Sixty-eight fingers were measured in seventeen hands in nine subjects. Fingers exhibited great joint mobility variability, with passive proximal interphalangeal hyperextension ranging from zero to almost fifty degrees. Increased measurement accuracy was obtained by using marker frames to amplify finger segment motions. Gravitational forces on the marker frames were not found to invalidate measurements. The recorded interphalangeal joint trajectories were highly consistent, demonstrating the underlying coupling mechanism. The increased accuracy and large sample size allowed for evaluation of detailed trajectory variability, systematic differences between flexion and extension trajectories, and three trigger types, distinct from flexor tendon triggers, involving initial flexion deficits in either proximal or distal interphalangeal joint. The experimental methods, data and analysis should advance insight into normal and pathological finger biomechanics (e.g., swanneck deformities), and could help improve clinical differential diagnostics of trigger finger causes. The marker frame measuring method may be useful to quantify interphalangeal joints trajectories in surgical/rehabilitative outcome studies. The data as a whole provide the most comprehensive collection of interphalangeal joint trajectories for clinical reference and model validation known to us to date.     

Finger joint impedance during tapping on a computer keyswitch

We studied the dynamic behavior of finger joints during the contact period of tapping on a computer keyswitch, to characterize and parameterize joint function with a lumped-parameter impedance model. We tested the hypothesis that the metacarpophalangeal (MCP) and interphalangeal (IP) joints act similarly in terms of kinematics, torque, and energy production when tapping. Fifteen human subjects tapped with the index finger of the right hand on a computer keyswitch mounted on a two-axis force sensor, which measured forces in the vertical and sagittal planes. Miniature fiber-optic goniometers mounted across the dorsal side of each joint measured joint kinematics. Joint torques were calculated from endpoint forces and joint kinematics using an inverse dynamic algorithm. For each joint, a linear spring and damper model was fitted to joint torque, position, and velocity during the contact period of each tap (22 per subject on average). The spring-damper model could account for over 90% of the variance in torque when loading and unloading portions of the contact were separated, with model parameters comparable to those previously measured during isometric loading of the finger. The finger joints functioned differently, as illustrated by energy production during the contact period. During the loading phase of contact the MCP joint flexed and produced energy, whereas the proximal and distal IP joints extended and absorbed energy. These results suggest that the MCP joint does work on the interphalangeal joints as well as on the keyswitch.     

A dynamic model for finger interphalangeal coordination

In this paper a dynamic model to investigate interphalangeal coordination in the human finger is proposed. Suitable models which describe the relationship between the tendon displacement and the joint angles have been chosen and incorporated into the skeletal dynamic model. A kinematic and kinetic model for interphalangeal coordination is suggested. Digital computer simulations are carried out to study interphalangeal (IP) flexion. Moreover, the effect of two different optimization methods is contrasted. The two optimization algorithms are employed to obtain a set of feasible values for the forces in the tendons or muscles of the finger.     

Finger joint coordination during tapping

We investigated finger joint coordination during tapping by characterizing joint kinematics and torques in terms of muscle activation patterns and energy profiles. Six subjects tapped with their index finger on a computer keyswitch as if they were typing on the middle row of a keyboard. Fingertip force, keyswitch position, kinematics of the metacarpophalangeal (MCP) and the proximal and distal interphalangeal (IP) joints, and intramuscular electromyography of intrinsic and extrinsic finger muscles were measured simultaneously. Finger joint torques were calculated based on a closed-form Newton–Euler inverse dynamic model of the finger. During the keystroke, the MCP joint flexed and the IP joints extended before and throughout the loading phase of the contact period, creating a closing reciprocal motion of the finger joints. As the finger lifted, the MCP joint extended and the interphalangeal (IP) joints flexed, creating an opening reciprocal motion. Intrinsic finger muscle and extrinsic flexor activities both began after the initiation of the downward finger movement. The intrinsic finger muscle activity preceded both the IP joint extension and the onset of extrinsic muscle activity. Only extrinsic extensor activity was present as the finger was lifted. While both potential energy and kinetic energy are present and large enough to overcome the work necessary to press the keyswitch, the motor control strategies utilize the muscle forces and joint torques to ensure a successful keystroke.     

Second toe wrap-around flap

The microsurgical second toe wrap-around technique is an ideal treatment option for reconstruction of the distal half of the finger with circumferential loss of skin and nail associated with an uninjured proximal interphalangeal joint and an intact insertion of the flexor digitorum superficialis tendon. Follow-up of 13 flaps in 10 patients from 1986 to 1989 demonstrates rapid and adequate functional recovery as well as satisfactory aesthetic appearance in all patients.     

Improvements in measuring shoulder joint kinematics

For many clinical applications it is necessary to non-invasively determine shoulder motion during dynamic movements, and in such cases skin markers are favoured. However, as skin markers may not accurately track the underlying bone motion the methods currently used must be refined. Furthermore, to determine the motion of the shoulder a model is required to relate the obtained marker trajectories to the shoulder kinematics. In Wu et al. (2005) the International Society of Biomechanics (ISB) proposed a shoulder model based on the position of bony landmarks. A limitation of the ISB recommendations is that the reference positions of the shoulder joints are not standardized. The aims of this research project were to develop a method to accurately determine shoulder kinematics using skin markers, and to investigate the effect of introduction of a standardized reference configuration. Fifteen subjects, free from shoulder pathology, performed arm elevations while skin marker trajectories were tracked. Shoulder kinematics were reconstructed using a chain model and extended Kalman filter. The results revealed significant differences between the kinematics obtained with and without introduction of the reference configuration. The curves of joint angle tended towards 0° for 0° of humerus elevation when the reference configuration was introduced. In conclusion, the shoulder kinematics obtained with introduction of the reference configuration were found to be easier to interpret than those obtained without introduction of the reference configuration.     

Temporal Control and Hand Movement Efficiency in Skilled Music Performance

Skilled piano performance requires considerable movement control to accomplish the high levels of timing and force precision common among professional musicians, who acquire piano technique over decades of practice. Finger movement efficiency in particular is an important factor when pianists perform at very fast tempi. We document the finger movement kinematics of highly skilled pianists as they performed a five-finger melody at very fast tempi. A three-dimensional motion-capture system tracked the movements of finger joints, the hand, and the forearm of twelve pianists who performed on a digital piano at successively faster tempi (7–16 tones/s) until they decided to stop. Joint angle trajectories computed for all adjacent finger phalanges, the hand, and the forearm (wrist angle) indicated that the metacarpophalangeal joint contributed most to the vertical fingertip motion while the proximal and distal interphalangeal joints moved slightly opposite to the movement goal (finger extension). An efficiency measure of the combined finger joint angles corresponded to the temporal accuracy and precision of the pianists’ performances: Pianists with more efficient keystroke movements showed higher precision in timing and force measures. Keystroke efficiency and individual joint contributions remained stable across tempo conditions. Individual differences among pianists supported the view that keystroke efficiency is required for successful fast performance.     

Finger joint force minimization in pianists using optimization techniques

A numerical optimization procedure was used to determine finger positions that minimize and maximize finger tendon and joint force objective functions during piano play. A biomechanical finger model for sagittal plane motion, based on finger anatomy, was used to investigate finger tendon tensions and joint reaction forces for finger positions used in playing the piano. For commonly used piano key strike positions, flexor and intrinsic muscle tendon tensions ranged from 0.7 to 3.2 times the fingertip key strike force, while resultant inter-joint compressive forces ranged from 2 to 7 times the magnitude of the fingertip force. In general, use of a curved finger position, with a large metacarpophalangeal joint flexion angle and a small proximal interphalangeal joint flexion angle, reduces flexor tendon tension and resultant finger joint force.     

Minimizing impairment in laborers with finger losses distal to the proximal interphalangeal joint by second toe transfer

Traditionally, toe-to-hand transfers have been reserved for thumb amputations or for use after severe mutilating injuries. The authors report their experience with the use of second toe-for-finger amputations with preserved or reconstructible proximal interphalangeal joints in manual workers. The aim of the procedure was to reduce impairment and to upgrade the hand from a functional and cosmetic standpoint. Fifteen second-toe wrap-around or variations were carried out on 11 adults (18 to 41 years old). Four patients with two or more finger amputations received two sequential second toes; four patients with two finger amputations received one toe; and each of three patients with single-digit amputation received a single toe. All but one amputation were performed less than 3 weeks after the accident. All toes survived. Range of motion at the native proximal interphalangeal joint was more than 90 percent in all patients but one; however, it was minimal at the transplanted joints. Patient satisfaction was high from a cosmetic and functional standpoint. Ten of 11 laborers resumed their previous activity. On the basis of this experience, a classification with aesthetic and functional implications is proposed to help in the decision-making process when dealing with multidigital injuries. It is concluded that second-toe transfer is an excellent choice for finger amputation distal to the proximal interphalangeal joint in laborers. Its prime indication is for amputations of two fingers where at least one toe should be transferred, as required, to achieve an "acceptable hand" (three-fingered hand). Early transfer allows salvage of critical structures from the damaged finger, such as joints, tendons, and bone, that otherwise would be lost. Early transplantation is highly recommended.     

Biomechanical Analysis of the Human Finger Extensor Mechanism during Isometric Pressing

This study investigated the effects of the finger extensor mechanism on the bone-to-bone contact forces at the interphalangeal and metacarpal joints and also on the forces in the intrinsic and extrinsic muscles during finger pressing. This was done with finger postures ranging from very flexed to fully extended. The role of the finger extensor mechanism was investigated by using two alternative finger models, one which omitted the extensor mechanism and another which included it. A six-camera three-dimensional motion analysis system was used to capture the finger posture during maximum voluntary isometric pressing. The fingertip loads were recorded simultaneously using a force plate system. Two three-dimensional biomechanical finger models, a minimal model without extensor mechanism and a full model with extensor mechanism (tendon network), were used to calculate the joint bone-to-bone contact forces and the extrinsic and intrinsic muscle forces. If the full model is assumed to be realistic, then the results suggest some useful biomechanical advantages provided by the tendon network of the extensor mechanism. It was found that the forces in the intrinsic muscles (interosseus group and lumbrical) are significantly reduced by 22% to 61% due to the action of the extensor mechanism, with the greatest reductions in more flexed postures. The bone-to-bone contact force at the MCP joint is reduced by 10% to 41%. This suggests that the extensor mechanism may help to reduce the risk of injury at the finger joints and also to moderate the forces in intrinsic muscles. These apparent biomechanical advantages may be a result of the extensor mechanism''s distinctive interconnected fibrous structure, through which the contraction of the intrinsic muscles as flexors of the MCP joint can generate extensions at the DIP and PIP joints.     

A method for reconstruction of the central slip of the extensor tendon of a finger.

Congenital absence of the proximal interphalangeal joint extensor mechanism was corrected by using the lateral band and attached intrinsics of an adjacent finger. This technique has worked well in 3 cases.     

The effect of finger extensor mechanism on the flexor force during isometric tasks.

The role of the intrinsic finger flexor muscles was investigated during finger flexion tasks. A suspension system was used to measure isometric finger forces when the point of force application varied along fingers in a distal-proximal direction. Two biomechanical models, with consideration of extensor mechanism Extensor Mechanism Model (EMM) and without consideration of extensor mechanism Flexor Model (FM), were used to calculate forces of extrinsic and intrinsic finger flexors. When the point of force application was at the distal phalanx, the extrinsic flexor muscles flexor digitorum profundus, FDP, and flexor digitorum superficialis, FDS, accounted for over 80% of the summed force of all flexors, and therefore were the major contributors to the joint flexion at the distal interphalangeal (DIP), proximal interphalangeal (PIP), and metacarpophalangeal (MCP) joints. When the point of force application was at the DIP joint, the FDS accounted for more than 70% of the total force of all flexors, and was the major contributor to the PIP and MCP joint flexion. When the force of application was at the PIP joint, the intrinsic muscle group was the major contributor for MCP flexion, accounting for more than 70% of the combined force of all flexors. The results suggest that the effects of the extensor mechanism on the flexors are relatively small when the location of force application is distal to the PIP joint. When the external force is applied proximally to the PIP joint, the extensor mechanism has large influence on force production of all flexors. The current study provides an experimental protocol and biomechanical models that allow estimation of the effects of extensor mechanism on both the extrinsic and intrinsic flexors in various loading conditions, as well as differentiating the contribution of the intrinsic and extrinsic finger flexors during isometric flexion.     

Estimation of the effective static moment arms of the tendons in the index finger extensor mechanism

A novel technique to estimate the contribution of finger extensor tendons to joint moment generation was proposed. Effective static moment arms (ESMAs), which represent the net effects of the tendon force on joint moments in static finger postures, were estimated for the 4 degrees of freedom (DOFs) in the index finger. Specifically, the ESMAs for the five tendons contributing to the finger extensor apparatus were estimated by directly correlating the applied tendon force to the measured resultant joint moments in cadaveric hand specimens. Repeated measures analysis of variance revealed that the finger posture, specifically interphalangeal joint angles, had significant effects on the measured ESMA values in 7 out of 20 conditions (four DOFs for each of the five muscles). Extensor digitorum communis and extensor indicis proprius tendons were found to have greater MCP ESMA values when IP joints are flexed, whereas abduction ESMAs of all muscles except extensor digitorum profundus were mainly affected by MCP flexion. The ESMAs were generally smaller than the moment arms estimated in previous studies that employed kinematic measurement techniques. Tendon force distribution within the extensor hood and dissipation into adjacent structures are believed to contribute to the joint moment reductions, which result in smaller ESMA values.     

Static and dynamic human flexor tendon–pulley interaction

The aim of the study was to investigate the influence of a preceding flexion or extension movement on the static interaction of human finger flexor tendons and pulleys concerning flexion torque being generated. Six human fresh frozen cadaver long fingers were mounted in an isokinetic movement device for the proximal interphalangeal (PIP) joint. During flexion and extension movement both flexor tendons were equally loaded with 40 N while the generated moment was depicted simultaneously at the fingertip. The movement was stopped at various positions of the proximal interphalangeal joint to record dynamic and static torque. The static torque was always greater after a preceding extension movement compared to a preceding flexion movement in the corresponding same position of the joint. This applied for the whole arc of movement of 0–105°. The difference between static extension and flexion torque was maximal 11% in average at about 83° of flexion. Static torque was always smaller than dynamic torque during extension movement and always greater than dynamic torque during flexion movement. The kind of preceding movement therefore showed an influence to the torque being generated in the proximal interphalangeal joint. The effect could be simulated on a mechanical finger device.     

Interpreting the autopodia of tetrapods: interphalangeal lines hinge on too many assumptions

Recently Peters proposed the concept of ‘interphalangeal lines’, defined as sub-parallel lines that could supposedly be drawn across the joints of the digits of all tetrapods. The lines were viewed as potential axes of rotation, and it was suggested that they could be used to determine the resting position of the digits, reconstruct missing digital elements of fossil tetrapods, and provide information on systematic relationships. Evidence was adduced from the skeletons of recent and fossil vertebrates and from footprints. However, detailed analysis shows that these claims are largely unfounded. Linear alignments of joints on neighbouring digits are not consistently present in tetrapods, especially across locomotor cycles. Even if present, interphalangeal (IP) lines would rarely be in an appropriate orientation to facilitate joint movements during locomotion. There is no reason to believe that IP lines would be homologous across different taxa, so they cannot be used to infer systematic relationships. Finally, the alleged support from the ichnological record is undermined by the uncertain relationship between the joint structure of the skeleton and the form of the print. We conclude that IP lines cannot be consistently constructed on tetrapod extremities, and would have minimal functional relevance or predictive power in any case.     

Extrinsic flexor muscles generate concurrent flexion of all three finger joints

The role of the forearm (extrinsic) finger flexor muscles in initiating rotation of the metacarpophalangeal (MCP) joint and in coordinating flexion at the MCP, the proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints remains a matter of some debate. To address the biomechanical feasibility of the extrinsic flexors performing these actions, a computer simulation of the index finger was created. The model consisted of a planar open-link chain comprised of three revolute joints and four links, driven by the change in length of the flexor muscles. Passive joint characteristics, included in the model, were obtained from system identification experiments involving the application of angular perturbations to the joint of interest. Simulation results reveal that in the absence of passive joint torque, shortening of the extrinsic flexors results in PIP flexion (80°), but DIP (8°) and MCP (7°) joint extension. The inclusion of normal physiological levels of passive joint torque, however, results in simultaneous flexion of all three joints (63° for DIP, 75° for PIP, and 43° for MCP). Applicability of the simulation results was confirmed by recording finger motion produced by electrical stimulation of the extrinsic flexor muscles for the index finger. These findings support the view that the extrinsic flexor muscles can initiate MCP flexion, and produce simultaneous motion at the MCP, PIP, and DIP joints.     

Inter-trial effects in priming of pop-out: Comparison of computational updating models

In visual search tasks, repeating features or the position of the target results in faster response times. Such inter-trial ‘priming’ effects occur not just for repetitions from the immediately preceding trial but also from trials further back. A paradigm known to produce particularly long-lasting inter-trial effects–of the target-defining feature, target position, and response (feature)–is the ‘priming of pop-out’ (PoP) paradigm, which typically uses sparse search displays and random swapping across trials of target- and distractor-defining features. However, the mechanisms underlying these inter-trial effects are still not well understood. To address this, we applied a modeling framework combining an evidence accumulation (EA) model with different computational updating rules of the model parameters (i.e., the drift rate and starting point of EA) for different aspects of stimulus history, to data from a (previously published) PoP study that had revealed significant inter-trial effects from several trials back for repetitions of the target color, the target position, and (response-critical) target feature. By performing a systematic model comparison, we aimed to determine which EA model parameter and which updating rule for that parameter best accounts for each inter-trial effect and the associated n-back temporal profile. We found that, in general, our modeling framework could accurately predict the n-back temporal profiles. Further, target color- and position-based inter-trial effects were best understood as arising from redistribution of a limited-capacity weight resource which determines the EA rate. In contrast, response-based inter-trial effects were best explained by a bias of the starting point towards the response associated with a previous target; this bias appeared largely tied to the position of the target. These findings elucidate how our cognitive system continually tracks, and updates an internal predictive model of, a number of separable stimulus and response parameters in order to optimize task performance.     

Mechanical advantages of the Neanderthal thumb in flexion: a test of an hypothesis

It has been proposed that the pollical phalangeal length proportions of the Neanderthals provided them with a greater mechanical advantage relative to recent humans for their pollical flexor muscles in power grips across the interphalangeal (IP) joint at the expense of the mechanical advantage of those pollical flexor muscles in precision grips at the finger tip. To test these related hypotheses, we compared the pollical load arm dimensions (phalanx lengths) to power arm dimensions (dorsopalmar articular heights) for the European and Near Eastern Neanderthals and for European and Amerindian samples of recent humans. It was found, initially, that the proximal articular height of the pollical distal phalanx is a poor predictor of the power arm at the IP articulation, even though the proximal articular height of the pollical proximal phalanx was an adequate indicator of the power arm size at the metacarpophalangeal (MCP) joint. In addition, differences in distal pollical ulnar deviation at the IP joint appeared to make little difference in the mechanical advantage comparisons. More importantly, the relative shortness of Neanderthal proximal pollical phalanges and the relative lengthening of their distal pollical phalanges was confirmed, and it was determined that, despite some minor differences in articular dimensions between Neanderthals and recent humans, these pollical phalangeal length contrasts translated into significant differences in mechanical advantages for the flexor muscles across the MCP and IP articulations.