Quantifying Patient-Initiated Upper Extremity Movement After Surgical Reconstruction for Adult Pan-Brachial Plexus...

Area of Science:

• Neuroscience
• Biomedical Engineering
• Rehabilitation Medicine

Background:

• Traumatic pan-brachial plexus injury (pBPI) poses challenges for assessing functional recovery.
• Traditional outcome measures may not reflect real-world arm function after pBPI.
• Objective quantification of arm use is crucial for evaluating treatment efficacy.

Purpose of the Study:

• To demonstrate the feasibility of using wearable motion sensors to quantify arm movement in adult pBPI patients post-surgery.
• To report the time and intensity of affected arm usage in real-world settings.
• To correlate sensor-derived movement data with clinical outcomes and return to work.

Main Methods:

• Twenty-nine adult patients with pBPI after surgical reconstruction were enrolled.
• Participants wore bilateral arm accelerometers for 7 days to collect vector time (VT) and vector magnitude (VM) data.
• Data were normalized to the uninjured arm to create VT and VM ratios for comparison.

Main Results:

• Mean VT ratio was 0.54 and mean VM ratio was 0.30 at a mean of 7.3 years post-surgery.
• Affected arm use was approximately 50% of the time and 30% of the intensity of the uninjured arm.
• VT and VM ratios significantly correlated with employment status and specific arm movements (elbow, forearm).

Conclusions:

• Wearable motion detection technology effectively captures spontaneous arm movements in pBPI patients.
• Surgical reconstruction enables significant functional recovery, with affected arm use correlating positively with return to work.
• These findings support the continued use of surgical reconstruction for traumatic pBPI.