Abstract: Accurate control of forces produced by the fingers is essential for performing object manipulation. This study examines the indices of finger interaction when accurate time profiles of force are produced in different directions, while using one of the fingers or all four fingers of the hand. We hypothesized that patterns of unintended force production among shear force components may involve features not observed in the earlier studies of vertical force production. In particular, we expected to see unintended forces generated by non-task fingers not in the
direction on the instructed force but in the opposite direction as well as substantial force production in directions orthogonal to the instructed direction. We also tested a hypothesis that multi-finger synergies, quantified using the framework of the uncontrolled manifold hypothesis, will help reduce across-trials variance of both total force magnitude and direction. Young, healthy subjects were required to produce accurate ramps of force in five different directions by
pressing on force sensors with the fingers of the right (dominant) hand. The index finger induced the smallest unintended forces in non-task fingers. The little finger showed the smallest unintended forces when it was a non-task finger. Task fingers showed substantial force production in directions orthogonal to the intended force direction. During four-finger tasks, individual force vectors typically pointed off the task direction, with these deviations nearly
perfectly matched to produce a resultant force in the task direction. Multi-finger synergy indices reflected strong co-variation in the space of finger modes (commands to fingers) that reduced variability of the total force magnitude and direction across trials. The synergy indices increased in magnitude over the first 30% of the trial time and then stayed at a nearly constant level. The synergy index for stabilization of total force magnitude was higher for shear force components as compared to the downward pressing force component. The results suggest complex interactions between enslaving and synergic force adjustments, possibly reflecting the experience with everyday prehensile tasks. For the first time, the data document multi-finger synergies stabilizing both shear force magnitude and force vector direction. These synergies may play a major role in
stabilizing the hand action during object manipulation.

Abstract: This study investigated temporal patterns of EMG activity during self-initiated falls with different optic flow information ('gaze directions'). Onsets of EMG during the flight phase were monitored from five experienced volunteers that completed 72 landings in three gaze directions (downward, mid-range and horizontal) and six heights of fall (10-130 cm). EMG recordings were obtained from the right gastrocnemius, tibialis anterior, biceps femoris and rectus femoris muscles, and used to determine the latency of onset (L(o)) and the perceived time to contact (T(c)). Impacts at touchdown were also monitored using as estimates the major peak of the vertical ground reaction forces (F(max)) normalized to body mass, time to peak (T(max)), peak impulse (I(norm)) normalized to momentum, and rate of change of force (dF(max)/dt). Results showed that L(o) was longer as heights of fall increased, but remained within a narrow time-window at >50 cm landings. No significant differences in L(o) were observed when gaze direction was changed. The relationship between T(c) and flight time followed a linear trend regardless of gaze direction. Gaze direction did not significantly affect the landing impacts. In conclusion, availability of optic flow during landing does not play a major role in triggering the preparatory muscle actions in self-initiated falls. Once a structured landing plan has been acquired, the relevant muscles respond relative to the start of the fall.

Abstract: BACKGROUND: Recovery of voluntary movement is a main rehabilitation goal. Efforts to identify effective upper limb (UL) interventions after stroke have been unsatisfactory. This study includes personalized impairment-based UL reaching training in virtual reality (VR) combined with non-invasive brain stimulation to enhance motor learning. The approach is guided by limiting reaching training to the angular zone in which active control is preserved (“active control zone”) after identification of a “spasticity zone”. Anodal transcranial direct current stimulation (a-tDCS) is used to facilitate activation of the affected hemisphere and enhance inter-hemispheric balance. The purpose of the study is to investigate the effectiveness of personalized reaching training, with and without a-tDCS, to increase the range of active elbow control and improve UL function. METHODS: This single-blind randomized controlled trial will take place at four academic rehabilitation centers in Canada, India and Israel. The intervention involves 10 days of personalized VR reaching training with both groups receiving the same intensity of treatment. Participants with sub-acute stroke aged 25 to 80 years with elbow spasticity will be randomized to one of three groups: personalized training (reaching within individually determined active control zones) with a-tDCS (group 1) or sham-tDCS (group 2), or non-personalized training (reaching regardless of active control zones) with a-tDCS (group 3). A baseline assessment will be performed at randomization and two follow-up assessments will occur at the end of the intervention and at 1 month post intervention. Main outcomes are elbow-flexor spatial threshold and ratio of spasticity zone to full elbow-extension range. Secondary outcomes include the Modified Ashworth Scale, Fugl-Meyer Assessment, Streamlined Wolf Motor Function Test and UL kinematics during a standardized reach-to-grasp task. DISCUSSION: This study will provide evidence on the effectiveness of personalized treatment on spasticity and UL motor ability and feasibility of using low-cost interventions in low-to-middle-income countries. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT02725853 . Initially registered on 12 January 2016.