Characterization of the Stroke-Induced Changes in the Variability and Complexity of Handgrip Force

Introduction: The variability and complexity of handgrip forces in various modulations were investigated to identify post-stroke changes in force modulation, and extend our understanding of stroke-induced deficits. Methods: Eleven post-stroke subjects and ten age-matched controls performed voluntary grip force control tasks (power-grip tasks) at three contraction levels, and stationary dynamometer holding tasks (stationary holding tasks). Variability and complexity were described with root mean square jerk (RMS-jerk) and fuzzy approximate entropy (fApEn), respectively. Force magnitude, Fugl-Meyer upper extremity assessment and Wolf motor function test were also evaluated. Results: Comparing the affected side with the controls, fApEn was significantly decreased and RMS-jerk increased across the three levels in power-grip tasks, and fApEn was significantly decreased in stationary holding tasks. There were significant strong correlations between RMS-jerk and clinical scales in power-grip tasks. Discussion: Abnormal neuromuscular control, altered mechanical properties, and atrophic motoneurons could be the main causes of the differences in complexity and variability in post-stroke subjects.