Referent control of anticipatory grip force during reaching in stroke: an experimental and modeling study

  • Silvi Frenkel-Toledo
  • Juri Yamanaka
  • Jason Friedman
  • Anatol G. Feldman
  • Mindy F. LevinEmail author
Research Article


To evaluate normal and impaired control of anticipatory grip force (GF) modulation, we compared GF production during horizontal arm movements in healthy and post-stroke subjects, and, based on a physiologically feasible dynamic model, determined referent control variables underlying the GF–arm motion coordination in each group. 63% of 13 healthy and 48% of 13 stroke subjects produced low sustained initial force (< 10 N) and increased GF prior to arm movement. Movement-related GF increases were higher during fast compared to self-paced arm extension movements only in the healthy group. Differences in the patterns of anticipatory GF increases before the arm movement onset between groups occurred during fast extension arm movement only. In the stroke group, longer delays between the onset of GF change and elbow motion were related to clinical upper limb deficits. Simulations showed that GFs could emerge from the difference between the actual and the referent hand aperture (Ra) specified by the CNS. Similarly, arm movement could result from changes in the referent elbow position (Re) and could be affected by the co-activation (C) command. A subgroup of stroke subjects, who increased GF before arm movement, could specify different patterns of the referent variables while reproducing the healthy typical pattern of GF–arm coordination. Stroke subjects, who increased GF after arm movement onset, also used different referent strategies than controls. Thus, altered anticipatory GF behavior in stroke subjects may be explained by deficits in referent control.


Anticipatory grip force Stroke Referent control 



The research was partially funded by a grant from CHRP-CIHR-NSERC (Canada) to AGF and MFL, and support from the Eldee Foundation and the Bloomfield family of Montreal, Canada, granted through Tel Aviv University (SFT). Thanks to Ruth Dannenbaum and Valeri Goussev for help with data collection and analysis and to the participants who volunteered for the study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Physiotherapy Department, School of Health SciencesAriel UniversityArielIsrael
  2. 2.Department of Physical Therapy, Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  3. 3.Department of Neurology and NeurosurgeryMcGill UniversityMontrealCanada
  4. 4.Center for Interdisciplinary Research in Rehabilitation (CRIR)MontrealCanada
  5. 5.Department of NeuroscienceUniversité de MontréalMontrealCanada
  6. 6.School of Physical and Occupational Therapy, Faculty of MedicineMcGill UniversityMontrealCanada

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