在日常生活中扮演重要角色的精細抓握動作，依賴手指靈巧地協調來抓握物品或操作工具。過去研究探討手指施力的控制機制，發現手部感覺損傷將會影響抓握力量的協調控制，如腕隧道症候群患者。但過去實驗設計未考量自然抓握型態與功能性動作，因而難以完全地應用於現實生活或臨床中。此外，除針對感覺神經異常之相關研究外，未見探討手指肌腱損傷是否對施力協同產生影響之研究。因此，本研究目的在於(1)檢視各指於功能性抓握任務中，其施力連續波形之重複性；(2)探討扳機指對於五指抓握施力之影響；(3)比較腕隧道患者與控制組在五指抓握施力時之控制特徵。
本研究發現手指施力的重複性取決於施力的方向和執行的任務。雖然動作表現的一致性常被認為是控制能力的表徵，但抓握時呈現的中高度之手指施力重複性可能是因為手指力量的控制包含許多自由度。手指施力除了由數條肌肉收縮貢獻外，亦需與其他指進行協調，因此可因應不同的精細任務而調整施力。如此高度發展的手部精細功能，即便是單指罹患扳機指之患者，其抓握施力協調亦受到影響。這異常的施力模式可能與患指在抓握功能所扮演的角色有關。而腕隧道症候群患者在執行精細抓握時，藉由增加手指施力且提高施力變異程度來代償感覺障礙的影響。患者以過度施力的抓握方式可能導致日後累積性的手指肌腱傷害。因手指施力的低相關且難以因應任務需求而調整施力，患者可能難以執行進階的精細任務。

The precision grasp, requiring the subtle force coordination among digits, plays a critical role in the daily activity. The cylindrical grasps have drawn much attention to investigate the force control during five-digit grasping. Besides, the capacity of force control has been shown to be disturbed by the impaired sensory, such as in the patients with carpal tunnel syndrome (CTS). In addition to CTS, the trigger digit (TD) may also impact the control of digit force. However, the previous findings may not be generalized exactly to the reality due to ignoring the natural configuration and functional tasks. To realize the applied force with regards to the functional performance, the dynamic analysis should be conducted rather than the static observations or a representative mean variable. Therefore, the purposes of this study were to (1) examine the continuous waveform repeatability of digit force during the functional five-digit grasping; (2) investigate the alteration in applied forces during grasping tasks with five digits in patients with TD and the controls; (3) compare the control characteristics of digit forces during five-digit grasping by patients with CTS and control group.
We found that the waveform repeatability of digit force was related to the force direction and the task. Although the performance consistence was considered as the control capacity, the fair to good repeatability of force waveform may be due to the high flexibility in the force control of each digit. Since the applied force of each digit was contributed by several muscles and coordinated with other digits, it can be controlled subtly to compensate for various task demands. As for the TD patients with only one digit affected, the force coordination of five digits was altered. The abnormal patterns in TD patients may be associated with the role of the affected digit during functional grasping. The CTS patients with sensory impairment adopted compensatory strategies by augmenting the digits forces associated with predominant force variability, which may lead to the cumulative overloading injuries. The decreased force correlation with less adjustment to the changes of task in CTS may retard the performance of an advanced precise task.

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