Francisco J. Valero-Cuevas

LARGE INDEX-FINGERTIP FORCES ARE PRODUCED BY SUBJECT-INDEPENDENT PATTERNS OF MUSCLE EXCITATION

Are fingertip forces produced by subject-independent patterns of muscle excitation? If so, understanding the mechanical basis underlying these muscle coordination strategies would greatly assist surgeons in evaluating options for restoring grasping. With the finger in neutral ad- abduction and flexed 45 degrees at the MCP and PIP, and 10 degrees at DIP joints, eight subjects attempted to produce maximal voluntary forces in four orthogonal directions perpendicular to the distal phalanx (palmar, dorsal, lateral and medial) and in one direction collinear with it (distal). Forces were directed within 4.7 +/- 2.2 degrees (mean +/- S.D.) of target and their magnitudes clustered into three distinct levels (p < 0.05; post hoc pairwise RMANOVA). Palmar (27.9 +/- 4.1 N), distal (24.3 +/- 8.3 N) and medial (22.9 +/- 7.8 N) forces were highest, lateral (14.7 +/- 4.8 N) was intermediate, and dorsal (7.5 +/- 1.5 N) was lowest. Normalized fine-wire EMGs from all seven muscles revealed distinct muscle excitation groups for palmar, dorsal and distal forces (p < 0.05; post hoc pairwise RMANOVA). Palmar force used flexors, extensors and dorsal interosseous; dorsal force used all muscles; distal force used all muscles except for extensors; medial and lateral forces used all muscles including significant co-excitation of interossei. The excitation strategies predicted to achieve maximal force by a 3-D computer model (four pinjoints, inextensible tendons, extensor mechanism and isometric force models for all seven muscles) reproduced the observed use of extensors and absence of palmar interosseous to produce palmar force (to regulate net joint flexion torques), the absence of extensors for distal force, and the use of intrinsics (strong MCP flexors) for dorsal force. The model could not predict the interossei co-excitation seen for medial and lateral forces, which may be a strategy to prevent MCP joint damage. The model predicts distal force to be most sensitive to dorsal interosseous strength, and palmar and distal forces to be very sensitive to MCP and PIP flexor moment arms, and dorsal force to be sensitive to the moment arm of and the tension allocation to the PIP extensor tendon of the extensor mechanism.

DEFINITION AND CLASSIFICATION OF HYPERKINETIC MOVEMENTS IN CHILDHOOD

Hyperkinetic movements are unwanted or excess movements that are frequently seen in children with neurologic disorders. They are an important clinical finding with significant implications for diagnosis and treatment. However, the lack of agreement on standard terminology and definitions interferes with clinical treatment and research. We describe definitions of dystonia, chorea, athetosis, myoclonus, tremor, tics, and stereotypies that arose from a consensus meeting in June 2008 of specialists from different clinical and basic science fields. Dystonia is a movement disorder in which involuntary sustained or intermittent muscle contractions cause twisting and repetitive movements, abnormal postures, or both. Chorea is an ongoing random‐appearing sequence of one or more discrete involuntary movements or movement fragments. Athetosis is a slow, continuous, involuntary writhing movement that prevents maintenance of a stable posture. Myoclonus is a sequence of repeated, often nonrhythmic, brief shock‐like jerks due to sudden involuntary contraction or relaxation of one or more muscles. Tremor is a rhythmic back‐and‐forth or oscillating involuntary movement about a joint axis. Tics are repeated, individually recognizable, intermittent movements or movement fragments that are almost always briefly suppressible and are usually associated with awareness of an urge to perform the movement. Stereotypies are repetitive, simple movements that can be voluntarily suppressed. We provide recommended techniques for clinical examination and suggestions for differentiating between the different types of hyperkinetic movements, noting that there may be overlap between conditions. These definitions and the diagnostic recommendations are intended to be reliable and useful for clinical practice, communication between clinicians and researchers, and for the design of quantitative tests that will guide and assess the outcome of future clinical trials.

Design and control of tensegrity robots for locomotion

The static properties of tensegrity structures have been widely appreciated in civil engineering as the basis of extremely lightweight yet strong mechanical structures. However, the dynamic properties and their potential utility in the design of robots have been relatively unexplored. This paper introduces robots based on tensegrity structures, which demonstrate that the dynamics of such structures can be utilized for locomotion. Two tensegrity robots are presented: TR3, based on a triangular tensegrity prism with three struts, and TR4, based on a quadrilateral tensegrity prism with four struts. For each of these robots, simulation models are designed, and automatic design of controllers for forward locomotion are performed in simulation using evolutionary algorithms. The evolved controllers are shown to be able to produce static and dynamic gaits in both robots. A real-world tensegrity robot is then developed based on one of the simulation models as a proof of concept. The results demonstrate that tensegrity structures can provide the basis for lightweight, strong, and fault-tolerant robots with a potential for a variety of locomotor gaits

Structured variability of muscle activations supports the minimal intervention principle of motor control

Numerous observations of structured motor variability indicate that the sensorimotor system preferentially controls task-relevant parameters while allowing task-irrelevant ones to fluctuate. Optimality models show that controlling a redundant musculo-skeletal system in this manner meets task demands while minimizing control effort. Although this line of inquiry has been very productive, the data are mostly behavioral with no direct physiological evidence on the level of muscle or neural activity. Furthermore, biomechanical coupling, signal-dependent noise, and alternative causes of trial-to-trial variability confound behavioral studies. Here we address those confounds and present evidence that the nervous system preferentially controls task-relevant parameters on the muscle level. We asked subjects to produce vertical fingertip force vectors of prescribed constant or time-varying magnitudes while maintaining a constant finger posture. We recorded intramuscular electromyograms (EMGs) simultaneously from all seven index finger muscles during this task. The experiment design and selective fine-wire muscle recordings allowed us to account for a median of 91% of the variance of fingertip forces given the EMG signals. By analyzing muscle coordination in the seven-dimensional EMG signal space, we find that variance-per-dimension is consistently smaller in the task-relevant subspace than in the task-irrelevant subspace. This first direct physiological evidence on the muscle level for preferential control of task-relevant parameters strongly suggest the use of a neural control strategy compatible with the principle of minimal intervention. Additionally, variance is nonnegligible in all seven dimensions, which is at odds with the view that muscle activation patterns are composed from a small number of synergies.

Challenges and new approaches to proving the existence of muscle synergies of neural origin.

Muscle coordination studies repeatedly show low-dimensionality of muscle activations for a wide variety of motor tasks. The basis vectors of this low-dimensional subspace, termed muscle synergies, are hypothesized to reflect neurally-established functional muscle groupings that simplify body control. However, the muscle synergy hypothesis has been notoriously difficult to prove or falsify. We use cadaveric experiments and computational models to perform a crucial thought experiment and develop an alternative explanation of how muscle synergies could be observed without the nervous system having controlled muscles in groups. We first show that the biomechanics of the limb constrains musculotendon length changes to a low-dimensional subspace across all possible movement directions. We then show that a modest assumption—that each muscle is independently instructed to resist length change—leads to the result that electromyographic (EMG) synergies will arise without the need to conclude that they are a product of neural coupling among muscles. Finally, we show that there are dimensionality-reducing constraints in the isometric production of force in a variety of directions, but that these constraints are more easily controlled for, suggesting new experimental directions. These counter-examples to current thinking clearly show how experimenters could adequately control for the constraints described here when designing experiments to test for muscle synergies—but, to the best of our knowledge, this has not yet been done.

The Potential of Virtual Reality and Gaming to Assist Successful Aging with Disability

Using the advances in computing power, software and hardware technologies, virtual reality (VR), and gaming applications have the potential to address clinical challenges for a range of disabilities. VR-based games can potentially provide the ability to assess and augment cognitive and motor rehabilitation under a range of stimulus conditions that are not easily controllable and quantifiable in the real world. This article discusses an approach for maximizing function and participation for those aging with and into a disability by combining task-specific training with advances in VR and gaming technologies to enable positive behavioral modifications for independence in the home and community. There is potential for the use of VR and game applications for rehabilitating, maintaining, and enhancing those processes that are affected by aging with and into disability, particularly the need to attain a balance in the interplay between sensorimotor function and cognitive demands and to reap the benefits of task-specific training and regular physical activity and exercise.

Reported anatomical variability naturally leads to multimodal distributions of Denavit-Hartenberg parameters for the human thumb

A realistic biomechanical thumb model would elucidate the functional consequences of orthopedic and neurological diseases and their treatments. We investigated whether a single parametric kinematic model can represent all thumbs, or whether different kinematic model structures are needed to represent different thumbs. We used Monte Carlo simulations to convert the anatomical variability in the kinematic model parameters into distributions of Denavit-Hartenberg parameters amenable for robotics-based models. Upon convergence (3550 simulations, where mean and coefficient of variance changed <1% for the last 20+% simulations) the distributions of Denavit-Hartenberg parameters appeared multimodal, in contrast to the reported unimodal distributions of the anatomy-based parameters. Cluster analysis and one-way analysis of variance confirmed four types of kinematic models (p<0.0001) differentiated primarily by the biomechanically relevant order of MCP joint axes (in 65.2% of models, the flexion-extension axis was distal to the adduction-abduction axis); and secondarily by a detail specifying the direction of a common normal between successive axes of rotation. Importantly, this stochastic analysis of anatomical variability redefines the debate on whether a single generic biomechanical model can represent the entire population, or if subject-specific models are necessary. We suggest a practical third alternative: that anatomical and functional variability can be captured by a finite set of model-types.

The strength-dexterity test as a measure of dynamic pinch performance.

We have developed a method to quantify the dynamic interaction between fingertip force magnitude (strength) and directional control (dexterity) during pinch with a novel strength-dexterity (S-D) test based on the principle of buckling of compression springs. The test consists of asking participants to use key and opposition pinch to attempt to fully compress springs, in random order, with a wide range of combinations of strength and dexterity requirements. The minimum force required to fully compress the spring and the propensity of the spring to buckle define the strength and dexterity requirements, respectively. The S-D score for each pinch style was the sum of the strength values of all springs successfully compressed fully. We tested 3 participant groups: 18 unimpaired young adults (40yr), and 14 adults diagnosed with carpo-metacarpal osteoarthritis (CMC OA) (>or = 36yr). We investigated the repeatability of the S-D test with 74 springs by testing 14 young adults twice on different days. The per-spring repeatability across subjects was >or = 94%. A minimum performance score for young adults was found as they all could compress a subset of 39 springs. Using this subset of springs, we compared the ability of the S-D score vs. maximal pinch force values to distinguish unimpaired hands from those with CMC OA of the thumb. The score for this 39-spring S-D test distinguished between CMC OA and asymptomatic older adults, whereas pinch meter readings did not (p<0.05). We conclude that the S-D test is repeatable and applicable to clinical research. We propose including the S-D test in studies aiming to quantify impairment and compare treatment outcomes in orthopaedic and neurological afflictions that degrade dynamic manipulation.

Quantification of fingertip force reduction in the forefinger following simulated paralysis of extensor and intrinsic muscles

Objective estimates of fingertip force reduction following peripheral nerve injuries would assist clinicians in setting realistic expectations for rehabilitating strength of grasp. We quantified the reduction in fingertip force that can be biomechanically attributed to paralysis of the groups of muscles associated with low radial and ulnar palsies. We mounted 11 fresh cadaveric hands (5 right, 6 left) on a frame, placed their forefingers in a functional posture (neutral abduction, 45 degrees of flexion at the metacarpophalangeal and proximal interphalangeal joints, and 10 degrees at the distal interphalangeal joint) and pinned the distal phalanx to a six-axis dynamometer. We pulled on individual tendons with tensions up to 25% of maximal isometric force of their associated muscle and measured fingertip force and torque output. Based on these measurements, we predicted the optimal combination of tendon tensions that maximized palmar force (analogous to tip pinch force, directed perpendicularly from the midpoint of the distal phalanx, in the plane of finger flexion-extension) for three cases: non-paretic (all muscles of forefinger available), low radial palsy (extrinsic extensor muscles unavailable) and low ulnar palsy (intrinsic muscles unavailable). We then applied these combinations of tension to the cadaveric tendons and measured fingertip output. Measured palmar forces were within 2% and 5 degrees of the predicted magnitude and direction, respectively, suggesting tendon tensions superimpose linearly in spite of the complexity of the extensor mechanism. Maximal palmar forces for ulnar and radial palsies were 43 and 85% of non-paretic magnitude, respectively (p<0.05). Thus, the reduction in tip pinch strength seen clinically in low radial palsy may be partly due to loss of the biomechanical contribution of forefinger extrinsic extensor muscles to palmar force. Fingertip forces in low ulnar palsy were 9 degrees further from the desired palmar direction than the non-paretic or low radial palsy cases (p<0.05).

Morphological communication: exploiting coupled dynamics in a complex mechanical structure to achieve locomotion

Traditional engineering approaches strive to avoid, or actively suppress, nonlinear dynamic coupling among components. Biological systems, in contrast, are often rife with these dynamics. Could there be, in some cases, a benefit to high degrees of dynamical coupling? Here we present a distributed robotic control scheme inspired by the biological phenomenon of tensegrity-based mechanotransduction. This emergence of morphology-as-information-conduit or ‘morphological communication’, enabled by time-sensitive spiking neural networks, presents a new paradigm for the decentralized control of large, coupled, modular systems. These results significantly bolster, both in magnitude and in form, the idea of morphological computation in robotic control. Furthermore, they lend further credence to ideas of embodied anatomical computation in biological systems, on scales ranging from cellular structures up to the tendinous networks of the human hand.