Abstract

The human hand is a complex integrated system with motor and sensory components that provides individuals with high functionality and elegant behaviour. In direct connection with the brain, the hand is capable of performing countless actions ranging from fine digit manipulation to the handling of heavy objects. However the question of which movements mostly contribute to the manipulation skills of the hand, and thus should be included in prosthetic hands, is yet to be answered. Building from our previous work, and assuming that a hand with independent long fingers allowed performance comparable to a hand with coupled fingers, here we explored the actual contribution of independent fingers while performing activities of daily living using custom built orthoses. Our findings show that, when an opposable thumb is present, independent long fingers provide a measureable advantage in performing activities of daily living only when precision grasps are involved. In addition, the results suggest that the remarkable grasping skills of the human hand rely more on the independent abduction/adduction of the fingers than on their independent flexion/extension. These findings are of interest to the designers of artificial hands, including biomimetic prostheses and exoskeletons.

Highlights

  • The human hand is a complex integrated system with motor and sensory components that provides individuals with high functionality and elegant behaviour

  • The execution times of the Southampton Hand Assessment Procedure (SHAP) were used to calculate the global Index of Function (IOF) and six partial IOFs related to the six main grasp types involved in the test

  • In this work we sought to investigate the contribution of independent fingers during grasping by comparing the human hand performance with and without independent fingers, as measured by established standardized assessment procedures[5,15,19,20,21,22]

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Summary

Introduction

The human hand is a complex integrated system with motor and sensory components that provides individuals with high functionality and elegant behaviour. Individuals with transradial amputation are proficient at compensating for the missing DoFs in their hand prosthesis by changing the motions of their arms and body[6,7] These compensatory movements (CM) often put greater forces on the anatomy and may result in residual limb pain, secondary musculoskeletal complaints and overuse syndromes[8,9,10]. As a result of these efforts the new multi-grasp prostheses (like the i-Limb by Touch Bionics) offer up to five independent digits[13], albeit currently there are no clinically viable HMIs for controlling these digits independently[14] Puzzled by this paradox, in our recent study we questioned whether it is finger dexterity that is missing in current hand prostheses or instead if it is wrist dexterity the overlooked key for efficient grasping[5]. The biological wrist always contributes to the execution of a motor task involving the upper limb, it stands to reason www.nature.com/scientificreports/

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