RESUMO
We analyze hand dexterity in Parkinson's disease patients (PD) and control subjects using a natural manual transport task (moving an object from one place to another). Eight PD patients and 10 control subjects carried out the task repeatedly at maximum speed both in off and on medicated status. The movement parameters and the grip and load forces were recorded. Using the force and velocity signals, 10 subsequent phases of the transport movement were defined and their durations were measured. The difference between the control group and the test group in off and on was established statistically using non-parametric methods. There was slowed reaching and a striking disturbance of establishing the precision grip in PD. The transport capabilities were impaired differentially. Although acceleration and reaching sufficient height of the lift were disturbed in PD subjects, transport of the object toward the target position was almost normal. A partial disturbance was observed when cancelling the grip. Dopaminergic medication improved only specific hand skills, especially establishment of the precision grip and one of the four transport phases. A long movement path was more sensitive for movement disturbance in Parkinson's disease than a short one.
Assuntos
Mãos/fisiopatologia , Doença de Parkinson/fisiopatologia , Desempenho Psicomotor/fisiologia , Idoso , Antiparkinsonianos/farmacologia , Antiparkinsonianos/uso terapêutico , Processamento Eletrônico de Dados , Feminino , Lateralidade Funcional/fisiologia , Força da Mão/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/tratamento farmacológico , Desempenho Psicomotor/efeitos dos fármacos , Fatores de TempoRESUMO
During transport of an object using the precision grip with thumb and index finger, a modulation of the grip force is needed in response to the forces evoked by the movement. We measured the grip force (GF) and the load force (LF) in 10 healthy participants moving a 640-g object forward and upward. The task was repeated with various speeds. There were considerable changes with speed of the LF trajectory but not of the GF trajectory. A loss of synergy between GF and LF appeared in fast lifts. This is in contrast to the close coupling between load force and grip force repeatedly demonstrated during simple lifts. We suggest that (a) speed should be considered as an input parameter for movement planning, and (b) regulation of GF and of LF are independent under certain conditions. We discuss whether the grip-load force synergy should be considered a special case rather than a more general principle
