Load and grip force coordination in static bimanual manipulation tasks in multiple sclerosis

The aim of the study was to reveal specific aspects of impaired hand function in mildly affected multiple sclerosis (MS) patients. Static manipulation tasks were tested in 13 mildly impaired (EDSS 1.5-4) MS patients and 13 age and gender matched controls. The tasks were based either on presumably visually (i.e., feedback) controlled tracing of depicted patterns of load force (LF; produced by symmetric bimanual tension and/or compression applied against an externally fixed device) or on predominantly feed-forward controlled amplitudes of sinusoidal patterns of LF. The task variables (based on accuracy of exerting the required LF pattern) suggested poor performance of MS subjects in feedback, but not in the feed-forward controlled tasks. The patients also revealed higher GF/LF ratio in all tasks. However, the coordination of GF and LF appeared to be comparable in the two groups. These results continue to support the chosen experimental paradigm and suggest that in mildly affected MS patients, sensorimotor deficits and overgripping precede the decoupling of grip and load forces observed in more severely affected patients.