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Modulation of hand aperture during reaching in persons with incomplete cervical spinal cord injury

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Abstract

The intact neuromotor system prepares for object grasp by first opening the hand to an aperture that is scaled according to object size and then closing the hand around the object. After cervical spinal cord injury (SCI), hand function is significantly impaired, but the degree to which object-specific hand aperture scaling is affected remains unknown. Here, we hypothesized that persons with incomplete cervical SCI have a reduced maximum hand opening capacity but exhibit novel neuromuscular coordination strategies that permit object-specific hand aperture scaling during reaching. To test this hypothesis, we measured hand kinematics and surface electromyography from seven muscles of the hand and wrist during attempts at maximum hand opening as well as reaching for four balls of different diameters. Our results showed that persons with SCI exhibited significantly reduced maximum hand aperture compared to able-bodied (AB) controls. However, persons with SCI preserved the ability to scale peak hand aperture with ball size during reaching. Persons with SCI also used distinct muscle coordination patterns that included increased co-activity of flexors and extensors at the wrist and hand compared to AB controls. These results suggest that motor planning for aperture modulation is preserved even though execution is limited by constraints on hand opening capacity and altered muscle co-activity. Thus, persons with incomplete cervical SCI may benefit from rehabilitation aimed at increasing hand opening capacity and reducing flexor–extensor co-activity at the wrist and hand.

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Acknowledgments

This work was supported in part by NIH Grant K12 HD055931 and Craig H. Neilsen Foundation. The authors are very grateful to the participants. The authors would also like to thank Ian Cooke, Matthew Freeman, and Dennis Valerstain for their assistance with data collection.

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Authors and Affiliations

  1. Department of Rehabilitation Medicine, Emory University, 1441 Clifton Road, NE, Atlanta, GA, 30322, USA

    Victoria A. Stahl, Heather B. Hayes, Cathrin M. Buetefisch, Steven L. Wolf & Randy D. Trumbower

  2. Departments of Neurology and Rehabilitation Medicine, Emory University, 1441 Clifton Road, NE, Atlanta, GA, 30322, USA

    Cathrin M. Buetefisch

  3. VA Center of Excellence and Neurocognitive Rehabilitation, Atlanta, GA, USA

    Steven L. Wolf

  4. Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA

    Randy D. Trumbower

  5. The Shepherd Center, Atlanta, GA, USA

    Randy D. Trumbower

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  1. Victoria A. Stahl
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  2. Heather B. Hayes
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  3. Cathrin M. Buetefisch
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  4. Steven L. Wolf
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  5. Randy D. Trumbower
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Correspondence to Randy D. Trumbower.

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Victoria Stahl and Heather B Hayes have contributed equally to this work.

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Stahl, V.A., Hayes, H.B., Buetefisch, C.M. et al. Modulation of hand aperture during reaching in persons with incomplete cervical spinal cord injury. Exp Brain Res 233, 871–884 (2015). https://doi.org/10.1007/s00221-014-4163-y

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