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P
N
i1
e
2
i
N
v
u
u
u
t
;
whose mean over a grouping is
RMSE
M
X
M
i1
RMSE
i
and the CV of force, that is,
CV
P
N
i1
f
c
f
c
2
i
=N
s
f
c
;
whose mean over a grouping is
CV
M
X
M
i1
CV
i
:
In these expressions N is the number of samplings within
the trial segment with the summation running overall
sampling instances in the interval being evaluated and
M is the number of trials or trial segments over which
the variable mean is taken.
Instrumentation and procedures
This study used the Manual Force Quantification System
(MFQS) (Fig. 1a and b), controlled by LabVIEW software
(LabVIEW 6.1; National Instruments, Austin, Texas,
USA), which quantifies low-level isometric force control
during a precision pinch task of the thumb and index
finger (Spirduso et al., 2005a). Spirduso et al. (2005a) can
also be referenced for instrumentation, procedures, and
data acquisition.
After a demonstration, the participants provided three
maximum pinch forces for a duration of 6 s each with a
1-min rest between them. The participants performed 10
force-matching (Fig. 2) trials at 5% MVIC for a test time
duration scaled to their MVIC, between 12 and 18 s.
These were the last 10 trials of a battery of three tests:
tracing (20 trials), tracking (20 trials) and force-matching
(10 trials). The protocol was similar to that described
by Spirduso et al. (2005b), and the details and outcomes
of these other results (tracing and tracking) are presented
in separate studies. No static force-matching elements
were included in the 40 prior task trials, thus the
participants gained no specific force-matching practice
by performing the prior tasks. Five of the 100 participants
used their left hand as their preferred hand (Fig. 2).
Analysis
Statistical analyses included descriptive statistics. A mod-
ified z-score method of finding outliers (Shiffler, 1988) was
used. Trial data that were above an absolute value of 2.85
(maximum z-score for an N of 10) were removed from the
data analysis but saved for reference. Means and SDs were
recalculated based on the remaining trials.
A simple analysis of variance (ANOVA) was used to analyze
MVIC, and two-way MANOVA (decade and gender) with
Bonferroni correction was carried out to analyze RMSE and
CV in force-matching. Main effects and interactions were
tested. Post-hoc, pair-wise comparisons were carried out for
decades in MVIC, RMSE, and CV. Levenes test of
MVIC pinch and force-matching Herring-Marler et al. 161
Copyright Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
homogeneity, Pearsons product-moment correlation, and
regression analyses were performed.
Results
Maximum voluntary isometric contraction force
The main effect for decades MVIC was significant
[F(4,90) =4.857, P<0.001, Z
2
P
=0.178] for precision
pinch peak force (Fig. 3). Post-hoc, pair-wise comparisons
revealed that the maximum isometric pinch forces
of the participants in their 70s were significantly lower
than those of participants in their 40s (P<0.01),
50s (P<0.005), and 60s (P<0.01). Although the 30s
had higher MVIC values than the 70s, the difference
between the groups was not statistically significant
(P=0.09).
The main effect for gender was significant with a large
effect size for maximal pinch force [F(1,90) =81.09,
P<0.001, Z
2
P
=0.474]. The MVIC of women was 29.9%
less than that of men overall (Table 1). Gender did not
interact with decade in MVIC.
Force-matching
The force-matching test also resulted in age-related
effects for force variability and accuracy. The mean
within-participant force variability for each decade,
produced by averaging all the individual CV values of
the groups participants CV, revealed a main effect for
decade [F(4,90) =7.318, P<0.001, Z
2
P
=0.240]. Post-
hoc tests revealed that participants in their 70s were
more variable than participants in their 30s, 40s, 50s, and
60s (46, 48, 39, and 35% difference, respectively,
P<0.01; Fig. 4a). A main effect for accuracy (RMSE)
was found [F(4,90) =4.773, P<0.005, Z
2
P
=0.175].
Participants in their 70s produced significantly more
error than the participants in their 30s and 40s (43 and
36% at P<0.01, respectively). Additionally, participants
in their 70s approached significance in error differences
from participants in their 50s (30% more error, P=0.06);
whereas those in their 60s were not different from those
in their 70s (23% more error, P=0.33; Fig. 4b).
No gender effects were found for force variability.
However, there were gender effects for accuracy
[F(1,90) =17.389, P<0.001, Z
2
P
=0.162]. Men per-
formed with higher error at RMSE=0.073 N, whereas
the equivalent value for women was 32% lower
(RMSE=0.50 N). No interactions were found.
Correlation and homogeneity
Pearsons product-moment correlation with sexes com-
bined (N=100) between MVIC and accuracy (RMSE)
was r =0.293, P<0.01; whereas, for CV and RMSE it was
r =0.783, P<0.001. MVIC and CV were not significantly
correlated with each other.
Fig. 1
(a) Manual Force Quantification System (MFQS) and (b) force transducers. The MFQS includes a force-matching template displayed on a computer
screen, a platform, and a console (a) that supports the adjustable force transducers (b) and arm and wrist supports. Matching task is displayed on
computer monitor.
Fig. 2
Start
Stop
Target line
Visual cue lines
Analyzed data
Initial cursor position
Force-matching task. The participants dot cursor is red until his or her
combined thumb and finger force reaches his or her 5% maximum
voluntary isometric contraction (MVIC) force level, which is the start point
on the horizontal line. Time, not the participant, moves the cursor across
the target line. The participant simply attempts to match a constant 5%
MVIC force level denoted by the target line for the time configured for
each participant, which is a time relative to his or her own MVIC.
162 International Journal of Rehabilitation Research 2014, Vol 37 No 2
Copyright Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Levenes test for homogeneity of variance was applied
to determine how homogeneous each decades CV and
RMSE were CV (P<0.009) and RMSE (P<0.002). SDs
within each decade group tended to increase as the
decades increased with the greatest diversity (SD) being
in the 7079-year group (Table 2).
Regression
A regression analysis was performed to determine the
impact of MVIC, decade, and gender on force-variability
characteristics (CV and RMSE). The model revealed a
significant overall effect [F(3,99) =11.296, P<0.001,
R=0.511] for CV and [F(3,99) =12.631, P<0.001,
R=0.532] for RMSE.
MVIC, decade, and gender were all strong predictors of
CV (P<0.05, b = 0.292; P<0.01, b =0.422; and
P<0.001, b = 0.317, respectively). A 4.7% of variance
in CV was uniquely accounted for by MVIC (part
correlation = 0.217), 17% by decade (part correlation =
0.413), and 5.7% by gender (part correlation = 0.239).
Decade was a strong predictor (P<0.001, b =0.391) of
RMSE, whereas gender was a moderate predictor
(P<0.05, b= 0.229). Fifteen percent of RMSE var-
iance was uniquely accounted for by decade (part
correlation =0.383) and 3.0% by gender (part correla-
tion =0.172). MVIC was not a significant predictor of
RMSE [Part correlation (otherwise known as semipartial
correlations), as opposed to partial correlation, takes into
account other variables contributions and eliminates those
contributions from the influence of the variable of interest.].
Discussion
Maximum voluntary isometric pinch force
The results suggest that fine motor pinch strength
declines with age. Declines were slightly less than
previously reported for gross motor strength after 5070
years, 15% per decade (Grabiner and Enoka, 1995) or
11.5% per year (Spirduso et al., 2005b) with a 7%
decrease from the 50s to the 60s and 13% from the 60s to
the 70s. Furthermore, the strength differences between
the 70s and the 30s were similar (19% decrease; women
27%, men 13%) to losses previously recorded in various
fine motor strength studies involving older adults ranging
from 60 to 75 years and younger adults from 20 to 35 years
old, with 26% (Ranganathan et al., 2001), 30% (Oliveira
et al., 2008), 26.6% (De Serres and Fang, 2004), and 14%
(Sperling, 1980) strength losses.
Pinch-force strength did not decline linearly across the
decade groups, as has been seen with isometric grip
strength, which involves multiple larger muscle
masses. Rantanen et al. (1998) reported a clear linear
decline significantly different in every age group in a
sample of 3680 men ranging in age from 45 to 92 years in
grip strength, a manual isometric test requiring full force
from both intrinsic and extrinsic muscles controlling the
thumb and digits. Puh (2010) also found significant
differences in isometric grip and three different pinch
forces in four different age categories ranging from 2034
to 6579 years; however, these were not linear. Puhs
second age group (3549 years) and this studys second
age group (4049 years) showed higher strength levels
than the respective younger age groups.
While our 4069-year-olds were statistically stronger than
the 70-year-olds, 30-year-olds had higher MVIC values
Fig. 3
MVIC
M
V
I
C
(
N
)
120
100
80
60
40
20
0
30s 40s 50s 60s 70s
Men Women
Maximum voluntary isometric contraction (MVIC) force across decades.
The 7079-year-olds were weaker than people in their 60s, 50s, and
40s (P<0.01), but, interestingly, not weaker than the 30s. Values are
the decade group meansSD.
Table 1 Maximal voluntary isometric contraction by decade and gender
MSD
Fourth decade
(3039 years)
Fifth decade
(4049 years)
Sixth decade
(5059 years)
Seventh decade
(6069 years)
Eighth decade
(7079 years)
Average across
decades
MVIC force (N) 63.214 66.019 69.516 67.016 54.016 64.317
Men MVIC (N) 73.507 78.317 78.815 80.110 63.313 74.814
Women MVIC (N) 52.811 55.012 59.210 53.908 44.713 53.112
MVIC, maximum voluntary isometric contraction.
MVIC pinch and force-matching Herring-Marler et al. 163
Copyright Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
than those in their 70s, but not so much so that it
resulted in significant differences. Upon closer examina-
tion, the 30-year-olds contained a wide distribution of
MVIC values with two substantially low MVICs, which
contributed toward the insignificant differences (P=
0.09) between the 30- and 70-year-olds.
Gender effects on maximumvoluntary isometric contraction
The significant gender main effect indicated that
womens pinch-force averages were lower than mens
throughout the decades. Averaged over five decades, men
were 29% stronger than women. An analysis of within-
gender age differences revealed that men in their 70s
were able to produce 87% of their MVIC compared with
men in their 30s, whereas women in their 70s produced
only 75% compared with women in their 30s.
The decade gender interaction was not significant. The
observation of lower MVIC for women is consistent
with previous findings. This could be explained by the
findings that women have less muscle mass than men
(Puh, 2010), demonstrate smaller twitch forces (Doherty
and Brown, 1997), have a longer half-relaxation time, and
have a higher proportion of type I fibers (Hunter, 2009).
Force variability and accuracy
The ability of participants to sustain a steady force at a
target level was compromised with aging. Adults in their
70s exhibited higher force variability than those in all
other decades. The results were similar for accuracy;
however, the difference in the 60s and 70s approached
significance (P=0.06). Group mean step differences
between decades for force variability (CV) were as
follows: fifthfourth decade =0.000, sixthfifth decade =
0.001, seventhsixth decade =0.001, and eighth
seventh decade =0.008 (Fig. 4a). Group mean step
differences in force error (RMSE) were 0.006, 0.005,
0.005, and 0.019 N, respectively (Fig. 4b). Therefore, the
age differences for force-matching were also nonlinear.
Accuracy, but not force variability, was weakly and
positively correlated with fine motor strength, which
suggests that the stronger the participant was the less
accurate his or her force-matching performance was (as
measured by RMSE). CV and RMSE were positively
correlated with each other. Finally, the older the age
group was the greater were the differences in MVIC,
accuracy, and force variability among members of that
decade.
Fig. 4
0.04
0.035
0.16
0.14
0.12
0.1
0.08
(a) (b)
0.06
0.04
0.02
0
CV
C
V
RMSE
R
M
S
E
0.03
0.02
0.015
0.01
0.005
0
30s 40s 50s 60s 70s 30s 40s 50s 60s 70s
0.025
Men Women
Force-matching. (a) Force variability [coefficient of variability (CV)] across decades, (b) accuracy [root mean square error (RMSE)] across decades.
Arrows, significant difference; double hash intercepts, near differences. The 7079-year-olds were significantly different from the 30s, 40s, 50s, and
60s (P<0.001) for CV but the 70s were not different from the 50s (P=0.06) or 60s (P=0.32) for RMSE. Values are decade group meansSD.
Table 2 Force variability (coefficient of variation) and accuracy (root mean square error) by decade and gender
MSD
Fourth decade
(3039 years)
Fifth decade
(4049 years)
Sixth decade
(5059 years)
Seventh decade
(6069 years)
Eighth decade
(7079 years)
Average across
decades
Force variability (CV) 0.0130.004 0.0130.005 0.0140.005 0.0150.006 0.0230.010 0.0160.006
Men (CV) 0.0130.004 0.0120.003 0.0150.007 0.0160.007 0.0250.007 0.0160.006
Women (CV) 0.0120.004 0.0130.006 0.0120.003 0.0140.006 0.0230.012 0.0130.005
Accuracy (RMSE) 0.0480.015 0.0540.025 0.0590.034 0.0650.028 0.0840.042 0.0620.032
Men (RMSE) 0.0550.015 0.0560.017 0.0740.042 0.0750.022 0.1070.042 0.0730.034
Women (RMSE) 0.0410.012 0.0520.032 0.0450.015 0.0540.030 0.0600.028 0.0500.024
CV, coefficient of variability; RMSE, root mean square error.
164 International Journal of Rehabilitation Research 2014, Vol 37 No 2
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Several factors have been proposed as explanations for
greater force variability and lower accuracy in the force
control of older adults: lower levels of maximum strength,
enhanced neural noise, and tactile and proprioceptive
effects.
Low force levels
It is well documented that controlling very low levels (5%
MVIC) of force is more difficult than controlling higher
levels (Slifkin and Newell, 1999; Varadhan et al., 2010).
Also, in older participants who have significantly lower
MVICs, the requirement of extremely low force levels
(5% MVIC) could account for the greater difficulty that
older adults have in the force-matching task. Producing
5% of a very low MVIC could possibly be more
challenging than producing 5% of a moderate MVIC
(Sosnoff and Newell, 2006).
Enhanced neural noise
Neuronal noise is a term commonly used to describe the
continuous and frequent random synaptic inputs within
complex neural networks that affect individual neurons,
creating a noisy synaptic input state for any given
neuron. The noisier the neural state is the higher the
signal (motor command) has to be to be detected.
Neuronal and synaptic noise has been shown to increase
with age, resulting in lower signal-to-noise ratios, which
in turn results in older adults greater error fluctuations
during voluntary force production (Jones et al.,
2002; Smits-Engelsman et al., 2003; Christou and Tracy,
2006; John et al., 2009). Pasco et al. (2011) suggested that
age-related changes in the integration of synaptic input
reduce the ability of older adults to modulate discharge
characteristics of motor units at low sustained isometric
force levels (5% MVC) of the biceps brachii.
Tactile and proprioceptive mechanisms
A third factor that may explain age differences in
variability and accuracy is the contribution of tactile and
proprioceptive mechanisms. Neurologists and physical
therapists often use weighted spoons, wrist or ankle cuffs,
or vests to assist their patients in producing steadier and
smoother movements and hence prevent food and drink
spills. Weighting enhances sensory information from
receptors for increased proprioception (muscle spindles
and Golgi tendon organs), thus assisting patients by
providing more feedback about their location in space
and allowing them to better feel the force they are
producing. In addition, pressure (force) is sensed through
pacinian corpuscles, which enhances the development of
motor memory for the task at hand (Fix, 2002). A similar
phenomenon could be occurring with the force-matching
task. Researchers suggest that 5% MVIC of a weaker
person could result in a more unloaded condition,
feasibly offering significantly reduced initial sensory feed-
forward proprioception information as well as providing
less proprioception and kinesthesia for the participant
(Robles-De-La-Torre and Hayward, 2001).
Gender effects on force variability and accuracy
Gender differences were not significant in force variability
(CV), but they were significant in accuracy as measured by
RMSE. Just as Shinohara et al. (2003b) found men to be
more variable, this study showed similar results: men
produced greater error, RMSE=0.073N, than women,
RMSE=0.050 N. The differences in mens and womens
body sizes have been attributed to more effective gross
motor performance in men (Thomas et al., 1991), but fine
motor tasks require different sensorimotor attributes than
strength and power. Women have been shown to perform
better in tasks requiring sensory discrimination (Noble,
1978). Women also have a greater number of type 1 fibers;
therefore, they would activate more motor units at lower
force levels than men and, hence, would be better able to
modify fine motor forces.
Conclusion
As expected, 7079-year-olds were weaker than 4069-
year-olds, and women were weaker than men. Unique
findings of this study were that (a) no differences were
found in strength, steadiness, or force variability among
the decades, up to the seventh decade (r69 years of
age); (b) 7079-year-olds were weaker, less steady, and
less accurate in force-matching than their younger
counterparts; (c) although Hackel (1992) found women
more variable and Shim et al. (2004) reported no gender
difference, the results of this study were in agreement
with those of Shinohara et al. (2003b) that men performed
low-level force-matching with greater error than women;
(d) strength was not correlated with steadiness but was
weakly correlated with accuracy, and steadiness and
accuracy were strongly correlated; and (e) decade and
gender were moderate and strong predictors of accuracy
and steadiness, respectively.
Clinical applications
Fine motor strength declines are significant and can cause
severe limitations in daily activities as adults age. Society
has been educated and trained to address age-related gross-
muscle motor losses with research, rehabilitation, and
training, but it is clear that fine motor deficits can be
seriously debilitating as well and should receive more
attention. The results suggest that additional research
should address the benefits of training programs designed
to increase finger strength and dexterity. Accordingly, these
programs should be initiated no later than a persons sixth
decade (age 5059 years), especially in women.
The increase in SD in MVIC, force variability, and accuracy
within decade groups as age progresses suggest that as
people age they become more diversified within their age
groups. This implies that some people retain function as
they grow old, and some do not. An important goal of aging
MVIC pinch and force-matching Herring-Marler et al. 165
Copyright Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
research is to determine how to increase the number of
individuals who maintain function in their later years.
Limitations
A potential limitation for this study is a possible order
effect of task administration that could have produced
cognitive and physical fatigue. Force-matching was the
last of three tasks the participants performed within the
test session and was the easiest, but all tasks required
high levels of attention and information processing. Each
test session was B3045 min long and could have
produced some cognitive fatigue. However, given that
the matching task included only 10 trials and required
only 5% MVIC and that the overall duration over which
the slowest participants were actively contracting isome-
trically during the entire protocol was no more than
B4 min, it is unlikely that physical fatigue, even in the
older groups, compromised the results.
Acknowledgements
The authors acknowledge and express extended appre-
ciation for the excellent help of Diana Hunter for
consultation on design and written representation,
Michael Mahometa from the Division of Statistics and
Scientific Computation at The University of Texas at
Austin for statistical consultation, and Tess Roach for
editing services.
Conflicts of interest
There are no conflicts of interest.
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