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.     

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.     

Motor control theories improve biomechanical model of the hand for finger pressing tasks

BackgroundBiomechanical models are a useful tool to estimate tendon tensions. Unfortunately, in previous fingers' models, each finger acts independently from the others. This is contradictory with hand motor control theories which show that fingers are functionally linked in order to balance the wrist/forearm joint with minimal tendon tensions. (i.e. principle of minimization of the secondary moments). We propose to adapt a hand biomechanical model according to this principle by including the wrist joint. We will determine whether the finger tendon tensions changed with the wrist joint added to the model.MethodsTwo models have been tested: one considering fingers independently (model A) and one with the fingers mechanically linked by the inclusion of the wrist balance (model B). A single set of data, additional results from the literature and in-vivo values have been used to compare the results.ResultsModel A corroborates previous results in the literature. Contrast results were obtained with model B, especially for the Ring and Little fingers. Different tendon tensions were obtained, particularly, in finger extensor muscles critical to balance the wrist.DiscussionWe discuss the biomechanical results in accordance with the hand/finger motor control theories. It appears that the wrist joint balance is critical for finger tendon tension estimation. When including the wrist joint into finger models, the tendon tension estimations agree well with the minimization of secondary moments and the force deficit.     

The biomechanical model of the long finger extensor mechanism and its parametric identification

The extensor mechanism of the finger is a structure transmitting the forces from several muscles to the finger joints. Force transmission in the extensor mechanism is usually modeled by equations with constant coefficients which are determined experimentally only for finger extension posture. However, the coefficient values change with finger flexion because of the extensor mechanism deformation. This induces inaccurate results for any other finger postures. We proposed a biomechanical model of the extensor mechanism represented as elastic strings. The model includes the main tendons and ligaments. The parametric identification of the model in extension posture was performed to match the distribution of the forces among the tendons to experimental data. The parametrized model was used to simulate three degrees of flexion. Furthermore, the ability of the model to reproduce how the force distribution in simulated extensor mechanism changes according to the muscle forces was also demonstrated. The proposed model could be used to simulate the extensor mechanism for any physiological finger posture for which the coefficients involved in the equations are unknown.     

New approaches in the study of the neuroplasticity process in patients with central nervous system lesions

Methods that, on the one hand, can ensure patient’s mobility and, on the other hand, activate afferent inputs are the main in the rehabilitation treatment. Recent studies have shown that plasticity is the structural basis of recovery after central nervous system lesions. Reorganization of cortical areas, increase in the efficiency of the functioning of preserved structures; and active use of alternative ascending pathways, e.g., intensification of afferent input, constitute the anatomical basis of plasticity. However, sensory correction methods, without accounting of functional condition of patients, may lead to the formation of pathological symptoms: spasticity, hyperreflexia, etc. So, the main aim is to study adequate management of the neuroplasticity process. This problem cannot be solved without modern methods of neuroimaging and brain mapping. The new approach for the study of cortical mechanisms of neuroplasticity, responsible for locomotion, was developed in the present study. This approach is an integrated use of functional magnetic resonance imaging (fMRI) and navigation transcranial magnetic stimulation (nTMS). It has been shown that vast fMRI activation area in the first and second sensorimotor areas emerges with a passive sensorimotor paradigm usage that imitates backing load during walking. The Korvit mechanical stimulator of backing zones of footsteps is used to create this paradigm. The nTMS examination used after fMRI helps to localize motor representation of muscles which control locomotion more accurately. We assume that the new approach can be used for studying the neuroplasticity process and assessing neuroplasticity changes when taking rehabilitation measures to restore and correct the walking process.     

A light weight compliant hand mechanism with high degrees of freedom

This paper presents the design and prototyping of an inherently compliant lightweight hand mechanism. The hand mechanism itself has 15 degrees of freedom and five fingers. Although the degrees of freedom in each finger are coupled, reducing the number of independent degrees of freedom to 5, the 15 degrees of freedom of the hand could potentially be individually actuated. Each joint consists of a novel flexing mechanism that is based on the loading of a compression spring in the axial and transverse direction via a cable and conduit system. Currently, a bench top version of the prototype is being developed; the three joints of each finger are coupled together to simplify the control system. The current control scheme under investigation simulates a control scheme where myoelectric signals in the wrist flexor and extensor muscles are converted in to x and y coordinates on a control scheme chart. Static load-deformation analysis of finger segments is studied based on a 3-dimensional model without taking the stiffener into account, and the experiment validates the simulation.     

Studies on the tendinous compartments of the extensor muscles on the back of the human hand and their tendon sheaths. I

In 47 dissected right and left hands of adults of both sexes, kept in a moist condition, significant practical-clinical investigations of the transitional zone between forearm and hand were undertaken. In particular it was sought to determine the characteristic sizes of the extensor retinaculum, the osteofibrous tunnels, the insertion tendons of the hand and finger extensor muscles, and their tendon sheaths. Together with the palmar carpal ligament, the 2 to 3 cm wide extensor retinaculum annularly surrounds the whole circumference of the carpus. It extends obliquely from radial-proximal to ulnar-distal and conducts the extensor tendons over the carpal articulations. According to recent studies, it is divided into a superficial and a deep fibrous layer. From the undermost surface, vertical and oblique septa run to the plane of the forearm and carpal bones. They separate the fibrous portion of the 6 tendinous compartments of the dorsum manus. In 8.5% of cases, an accessory and completely independent tunnel of the extensor pollicis brevis muscle exists in the material investigated, and in 2.2% of cases, there is an additional tunnel for the extensor carpi radialis muscle. Hence, one occasionally finds 8 separate osteofibrous gliding compartments for the extensor muscles in the dorsal hand region. The longest tunnel belongs, as a rule, to the extensor digiti minimi muscle, whilst the widest pertains to the extensor digitorum muscle. Within the tunnel and also proximal and distal to it, the extensor tendons are surrounded by synovial sheaths. Because of its wide encroachment on the dorsum of the hand, the insertion tendon of the extensor digiti minimi muscle possesses the longest tendon sheath, measuring 68.8 mm. The next longest sheath, that of the extensor pollicis longus muscle, which measures 56.2 mm, begins further proximal to the gap of the radiocarpal articulation. In 12.8% of cases, there are divided sheaths of the abductor pollicis longus and of the extensor pollicis brevis muscle. The tendon sheath of both extensor carpi radiales muscles is frequently divided into 2 compartments which, in 2/3 of cases, communicate. The compartment of the extensor carpi radialis brevis muscle, in 91.5% of cases, shares a window-like opening with the roof of the synovial vagina of the extensor pollicis longus muscle. The tendon sheath of the long extensor muscles of the fingers originates 5 mm proximal to the forearm border of the extensor retinaculum and has a communal recess. The IVth tendon sheath opens distally and splays out in a glove-like manner to some distal recesses.(ABSTRACT TRUNCATED AT 400 WORDS)     

Coordinated force production in multi-finger tasks: finger interaction and neural network modeling

During maximal voluntary contraction (MVC) with several fingers, the following three phenomena are observed: (1) the total force produced by all the involved fingers is shared among the fingers in a specific manner (sharing); (2) the force produced by a given finger in a multi-finger task is smaller than the force generated by this finger in a single-finger task (force deficit); (3) the fingers that are not required to produce any force by instruction are involuntary activated (enslaving). We studied involuntary force production by individual fingers (enslaving effects, EE) during tasks when (an)other finger(s) of the hand generated maximal voluntary pressing force in isometric conditions. The subjects (n = 10) were instructed to press as hard as possible on the force sensors with one, two, three and four fingers acting in parallel in all possible combinations. The EE were (A) large, the slave fingers always producing a force ranging from 10.9% to 54.7% of the maximal force produced by the finger in the single-finger task; (B) nearly symmetrical; (C) larger for the neighboring fingers; and (D) non-additive. In most cases, the EE from two or three fingers were smaller than the EE from at least one finger (this phenomenon was coined occlusion). The occlusion cannot be explained only by anatomical musculo-tendinous connections. Therefore, neural factors contribute substantially to the EE. A neural network model that accounts for all the three effects has been developed. The model consists of three layers: the input layer that models a central neural drive; the hidden layer modeling transformation of the central drive into an input signal to the muscles serving several fingers simultaneously (multi-digit muscles); and the output layer representing finger force output. The output of the hidden layer is set inversely proportional to the number of fingers involved. In addition, direct connections between the input and output layers represent signals to the hand muscles serving individual fingers (uni-digit muscles). The network was validated using three different training sets. Single digit muscles contributed from 25% to 50% of the total finger force. The master matrix and the enslaving matrix were computed; they characterize the ability of a given finger to enslave other fingers and its ability to be enslaved. Overall, the neural network modeling suggests that no direct correspondence exists between neural command to an individual finger and finger force. To produce a desired finger force, a command sent to an intended finger should be scaled in accordance with the commands sent to the other fingers. Received: 17 October 1997 / Accepted in revised form: 12 May 1998     

A musculoskeletal model of the hand and wrist: model definition and evaluation

Abstract

To improve our understanding on the neuromechanics of finger movements, a comprehensive musculoskeletal model is needed. The aim of this study was to build a musculoskeletal model of the hand and wrist, based on one consistent data set of the relevant anatomical parameters. We built and tested a model including the hand and wrist segments, as well as the muscles of the forearm and hand in OpenSim. In total, the model comprises 19 segments (with the carpal bones modeled as one segment) with 23 degrees of freedom and 43 muscles. All required anatomical input data, including bone masses and inertias, joint axis positions and orientations as well as muscle morphological parameters (i.e. PCSA, mass, optimal fiber length and tendon length) were obtained from one cadaver of which the data set was recently published. Model validity was investigated by first comparing computed muscle moment arms at the index finger metacarpophalangeal (MCP) joint and wrist joint to published reference values. Secondly, the muscle forces during pinching were computed using static optimization and compared to previously measured intraoperative reference values. Computed and measured moment arms of muscles at both index MCP and wrist showed high correlation coefficients (r?=?0.88 averaged across all muscles) and modest root mean square deviation (RMSD?=?23% averaged across all muscles). Computed extrinsic flexor forces of the index finger during index pinch task were within one standard deviation of previously measured in-vivo tendon forces. These results provide an indication of model validity for use in estimating muscle forces during static tasks.     

Resistance training enhances the stability of sensorimotor coordination

Strategies for the control of human movement are constrained by the neuroanatomical characteristics of the motor system. In particular, there is evidence that the capacity of muscles for producing force has a strong influence on the stability of coordination in certain movement tasks. In the present experiment, our aim was to determine whether physiological adaptations that cause relatively long-lasting changes in the ability of muscles to produce force can influence the stability of coordination in a systematic manner. We assessed the effects of resistance training on the performance of a difficult coordination task that required participants to synchronize or syncopate movements of their index finger with an auditory metronome. Our results revealed that training that increased isometric finger strength also enhanced the stability of movement coordination. These changes were accompanied by alterations in muscle recruitment patterns. In particular, the trained muscles were recruited in a more consistent fashion following the programme of resistance training. These results indicate that resistance training produces functional adaptations of the neuroanatomical constraints that underlie the control of voluntary movement.     

Comparative anatomical analyses of the forearm muscles of Cebus libidinosus (Rylands et al. 2000): manipulatory behavior and tool use

The present study describes the flexor and extensor muscles in Cebus libidinosus' forearm and compares them with those from humans, chimpanzees and baboons. The data is presented in quantitative anatomical indices for similarity. The capuchin forearm muscles showed important similarities with chimpanzees and humans, particularly those that act on thumb motion and allow certain degree of independence from other hand structures, even though their configuration does not enable a true opposable thumb. The characteristics of Cebus' forearm muscles corroborate the evolutionary convergence towards an adaptive behavior (tool use) between Cebus genus and apes.     

Age effects on force produced by intrinsic and extrinsic hand muscles and finger interaction during MVC tasks.

Finger-pressing forces are produced by activation of the intrinsic hand muscles, which are finger specific, and the extrinsic muscles that connect to multiple fingers. We tested a hypothesis of greater weakening of intrinsic hand muscles with age and quantified associated indexes of finger interaction such as enslaving (force production by unintended fingers) and force deficit (loss of finger force in multifinger tasks compared with single-finger tasks). Twelve young (23-35 yr old) and 12 elderly (70-95 yr old) men and women performed single-finger and four-finger maximal pressing tasks, in which force was applied at the proximal phalanges (PP, the intrinsic muscles are major focal force generators) and at the distal phalanges (DP, the extrinsic muscles are focal force generators). The decline in the peak force with age was greater at PP (30%) than at DP (19%). Larger indexes of finger interaction were observed at PP (enslaving = 17.2 +/- 9.4%, force deficit = 36.1 +/- 11.1%) than at DP (enslaving = 14.9 +/- 8.8%, force deficit = 27.7 +/- 10.8%) across ages and genders. We conclude that intrinsic hand muscles show disproportionate weakening with age. The greater indexes of finger interaction in PP tests with greater involvement of intrinsic hand muscles suggest that the finger interactions are predominantly of a central origin across ages and genders.     

Anatomical variations of the extensor tendons to the fingers over the dorsum of the hand: a study of 50 hands and a review of the literature

The extensor tendons to the fingers were studied in dissections of 50 fresh cadaveric hands, and the divisions of the tendons, as well as the communications (juncturae), were analyzed. The pattern of distribution most frequently observed was as follows. The extensor digitorum communis provided one tendon to the index finger, one to the middle finger, two to the ring finger, and none to the little finger. The extensor indicis exhibited one tendon, whereas the extensor digiti minimi exhibited two tendons. The extensor indicis tendon was always observed to lack a junctura tendinum. The extensor indicis was absent in both hands of one cadaver. A tendon slip from the extensor digiti minimi to the ring finger was observed in one hand. All surgeons must bear in mind the existence of these variations when performing common tendon transfers.     

An open-source model and solution method to predict co-contraction in the finger

A novel open-source biomechanical model of the index finger with an electromyography (EMG)-constrained static optimization solution method are developed with the goal of improving co-contraction estimates and providing means to assess tendon tension distribution through the finger. The Intrinsic model has four degrees of freedom and seven muscles (with a 14 component extensor mechanism). A novel plugin developed for the OpenSim modelling software applied the EMG-constrained static optimization solution method. Ten participants performed static pressing in three finger postures and five dynamic free motion tasks. Index finger 3D kinematics, force (5, 15, 30 N), and EMG (4 extrinsic muscles and first dorsal interosseous) were used in the analysis. The Intrinsic model predicted co-contraction increased by 29% during static pressing over the existing model. Further, tendon tension distribution patterns and forces, known to be essential to produce finger action, were determined by the model across all postures. The Intrinsic model and custom solution method improved co-contraction estimates to facilitate force propagation through the finger. These tools improve our interpretation of loads in the finger to develop better rehabilitation and workplace injury risk reduction strategies.     

Work-Related Pain in Extrinsic Finger Extensor Musculature of Instrumentalists Is Associated with Intracellular pH Compartmentation during Exercise

Background

Although non-specific pain in the upper limb muscles of workers engaged in mild repetitive tasks is a common occupational health problem, much is unknown about the associated structural and biochemical changes. In this study, we compared the muscle energy metabolism of the extrinsic finger extensor musculature in instrumentalists suffering from work-related pain with that of healthy control instrumentalists using non-invasive phosphorus magnetic resonance spectroscopy (³¹P-MRS). We hypothesize that the affected muscles will show alterations related with an impaired energy metabolism.

Methodology/Principal Findings

We studied 19 volunteer instrumentalists (11 subjects with work-related pain affecting the extrinsic finger extensor musculature and 8 healthy controls). We used ³¹P-MRS to find deviations from the expected metabolic response to exercise in phosphocreatine (PCr), inorganic phosphate (Pi), Pi/PCr ratio and intracellular pH kinetics. We observed a reduced finger extensor exercise tolerance in instrumentalists with myalgia, an intracellular pH compartmentation in the form of neutral and acid compartments, as detected by Pi peak splitting in ³¹P-MRS spectra, predominantly in myalgic muscles, and a strong association of this pattern with the condition.

Conclusions/Significance

Work-related pain in the finger extrinsic extensor muscles is associated with intracellular pH compartmentation during exercise, non-invasively detectable by ³¹P-MRS and consistent with the simultaneous energy production by oxidative metabolism and glycolysis. We speculate that a deficit in energy production by oxidative pathways may exist in the affected muscles. Two possible explanations for this would be the partial and/or local reduction of blood supply and the reduction of the muscle oxidative capacity itself.     

Sarcomere length organization as a design for cooperative function amongst all lumbar spine muscles

The functional design of spine muscles in part dictates their role in moving, loading, and stabilizing the lumbar spine. There have been numerous studies that have examined the isolated properties of these individual muscles. Understanding how these muscles interact and work together, necessary for the prediction of muscle function, spine loading, and stability, is lacking. The objective of this study was to measure sarcomere lengths of lumbar muscles in a neutral cadaveric position and predict the sarcomere operating ranges of these muscles throughout full ranges of spine movements. Sarcomere lengths of seven lumbar muscles in each of seven cadaveric donors were measured using laser diffraction. Using published anatomical coordinate data, superior muscle attachment sites were rotated about each intervertebral joint and the total change in muscle length was used to predict sarcomere length operating ranges. The extensor muscles had short sarcomere lengths in a neutral spine posture and there were no statistically significant differences between extensor muscles. The quadratus lumborum was the only muscle with sarcomere lengths that were optimal for force production in a neutral spine position, and the psoas muscles had the longest lengths in this position. During modeled flexion the extensor, quadratus lumborum, and intertransversarii muscles lengthened so that all muscles operated in the approximate same location on the descending limb of the force-length relationship. The intrinsic properties of lumbar muscles are designed to complement each other. The extensor muscles are all designed to produce maximum force in a mid-flexed posture, and all muscles are designed to operate at similar locations of the force-length relationship at full spine flexion.     

Development of a finite element musculoskeletal model with the ability to predict contractions of three-dimensional muscles

Representation of realistic muscle geometries is needed for systematic biomechanical simulation of musculoskeletal systems. Most of the previous musculoskeletal models are based on multibody dynamics simulation with muscles simplified as one-dimensional (1D) line-segments without accounting for the large muscle attachment areas, spatial fibre alignment within muscles and contact and wrapping between muscles and surrounding tissues. In previous musculoskeletal models with three-dimensional (3D) muscles, contractions of muscles were among the inputs rather than calculated, which hampers the predictive capability of these models. To address these issues, a finite element musculoskeletal model with the ability to predict contractions of 3D muscles was developed. Muscles with realistic 3D geometry, spatial muscle fibre alignment and muscle-muscle and muscle-bone interactions were accounted for. Active contractile stresses of the 3D muscles were determined through an efficient optimization approach based on the measured kinematics of the lower extremity and ground force during gait. This model also provided stresses and strains of muscles and contact mechanics of the muscle-muscle and muscle-bone interactions. The total contact force of the knee predicted by the model corresponded well to the in vivo measurement. Contact and wrapping between muscles and surrounding tissues were evident, demonstrating the need to consider 3D contact models of muscles. This modelling framework serves as the methodological basis for developing musculoskeletal modelling systems in finite element method incorporating 3D deformable contact models of muscles, joints, ligaments and bones.     

Cortical control of grasp in non-human primates

The skilled use of the hand for grasping and manipulation of objects is a fundamental feature of the primate motor system. Grasping movements involve transforming the visual information about an object into a motor command appropriate for the coordinated activation of hand and finger muscles. The cerebral cortex and its descending projections to the spinal cord are known to play a crucial role for the control of grasp. Recent studies in non-human primates have provided some striking new insights into the respective contribution of the parietal and frontal motor cortical areas to the control of grasp. Also, new approaches allowed investigating the coupling of grasp-related activity in different cortical areas for the control of the descending motor command.     

Classification of finger movements by using the ultra-wide band radar

The coding system of finger movements depends on the differences in the characteristics of the muscles that are responsible for these movements. The ability of ultra-wide band (UWB) radar for use as a tool for identifying the movements of each finger is presented. This will facilitate the ability of the UWB radar in designing a coding system for the movement of fingers of each hand.     

Classification of finger movements by using the ultra-wide band radar

The coding system of finger movements depends on the differences in the characteristics of the muscles that are responsible for these movements. The ability of ultra-wide band (UWB) radar for use as a tool for identifying the movements of each finger is presented. This will facilitate the ability of the UWB radar in designing a coding system for the movement of fingers of each hand.