Grip force behavior during object manipulation in neurological disorders: toward an objective evaluation of manual performance deficits.

The control of prehensile finger forces is an essential feature of skilled manual performance. The basic aspects of healthy grip force behavior have been well documented. In healthy subjects, grip force is precisely adjusted to the mechanical object properties. Grip force is always slightly higher than the minimum necessary to prevent the object from slipping. When we move a hand-held object, grip force is modulated in parallel with movements-induced load fluctuations without an obvious delay. The absence of a temporal delay between grip and load force profiles suggests that the central nervous system is able to predict the load variations before the intended manipulation and consequently regulates grip force in anticipation. Feedback from the grasping fingertips is used to adjust the level of applied fingertip force efficiently to the actual loading requirements. Pathologic grip force control affects the efficiency of produced force and the precision of the temporal coupling between grip and load force profiles. Here, we review the characteristics of pathologic grip force behavior in various neurological disorders. Detailed examination of grip force control is simple and well suited for the objective evaluation of impaired motor function of the hand and its rehabilitation. (c) 2004 Movement Disorder Society.