Impairment of Multi-Finger Force Control in Adult Patients with Dyskinetic Cerebral Palsy

PURPOSE: This study aimed to investigate the impact of cerebral palsy (CP) on motor control strategies, with a focus on understanding the altered capability of multi-finger force control in adult patients with dyskinetic CP.METHODS: Eight adults with dyskinetic CP and ten age- and sex-matched healthy controls participated in this study. The participants performed three force production tasks using four fingers of the dominant hand under isometric conditions: maximum voluntary contraction (MVC) to assess maximum force production, a ramp task to evaluate finger interdependency (enslaving), and a pulse task to examine the ability to rapidly and precisely adjust force. The co-contraction index (CCI) of finger flexor and extensor was also determined during steady state and pulse force production.RESULTS: Patients with dyskinetic CP demonstrated significant impairments in finger force control compared to healthy controls. Specifically, the accuracy and consistency of force production were reduced in the CP group, and they exhibited a longer time to peak pulse force. The CP group also showed increased finger interdependency and elevated CCI during pulse force production, suggesting a greater reliance on co-contraction and less efficient motor control strategies.CONCLUSIONS: This study highlights the distinct motor control deficits in individuals with dyskinetic CP, particularly in tasks requiring rapid and precise finger force adjustment. These results have important implications for the functional rehabilitation of patients with CP. Therapies aimed at reducing excessive co-contraction and decreasing finger interdependency may be beneficial for improving muscle coordination and overall motor function.