Selective deficits of grip force control during object manipulation in patients with reduced sensibility of the grasping digits.

Persons with impaired manual sensibility frequently report problems to use the hand in manipulative tasks, such as using tools or buttoning a shirt. At least two control processes determine grip forces during voluntary object manipulation. Anticipatory force control specifies the motor commands on the basis of predictions about physical object properties and the consequences of our own actions. Feedback sensory information from the grasping digits, representing mechanical events at the skin-object interface, automatically modifies grip force according to the actual loading requirements and updates sensorimotor memories to support anticipatory grip force control. We investigated grip force control in nine patients with moderately impaired tactile sensibility of the grasping digits and in nine sex- and age-matched healthy controls lifting and holding an instrumented object. In healthy controls grip force was adequately scaled to the weight of the object to be lifted. The grip force was programmed to smoothly change in parallel with load force over the entire lifting movement. In particular, the grip force level was regulated in an economical way to be always slightly higher than the minimum required to prevent the object slipping. The temporal coupling between the grip and load force profiles achieved a high precision with the maximum grip and load forces coinciding closely in time. For the temporal regulation of the grip force profile patients with impaired tactile sensibility maintained the close co-ordination between proximal arm muscles, responsible for the lifting movement and the fingers stabilising the grasp. Maximum grip force coincided with maximum acceleration of the lifting movement. However, patients employed greater maximum grip forces and greater grip forces to hold the object unsupported when compared with controls. Our results give further evidence to the suggestion that during manipulation of objects with known physical properties the anticipatory temporal regulation of the grip force profile is centrally processed and less under sensory feedback control. In contrast, sensory afferent information from the grasping fingers plays a dominant role for the efficient scaling of the grip force level according to actual loading requirements.