Three-Dimensional Upper Limb Movement Analysis in Children and Adolescents With Brachial Plexus Birth Injury: A
Laura Le Roy1, Anke van Bladel2, Sophie De Mits2
1Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.
Insights
Three-dimensional upper limb movement analysis (3D-ULMA) offers objective data for brachial plexus birth injury (BPBI) in children. This method aids in assessing movement strategies and therapy effectiveness, complementing existing clinical scales.
Area of Science:
- Biomedical Engineering
- Pediatric Orthopedics
- Rehabilitation Science
Background:
- Brachial plexus birth injury (BPBI) significantly impacts pediatric upper limb function.
- Objective assessment of movement is crucial for effective management of BPBI.
Approach:
- Systematic review of MEDLINE, Embase, and Web of Science up to April 2022.
- Inclusion of 21 observational studies (609 participants, 493 BPBI cases).
- Assessment of study quality using established risk of bias tools.
Key Points:
- Varied kinematic devices and protocols were identified for 3D-ULMA.
- The modified Mallet positions were frequently utilized in 3D-ULMA for BPBI.
- 3D-ULMA provides objective, quantified data on movement strategies.
Conclusions:
- 3D-ULMA is a valuable tool for clinicians managing pediatric BPBI.
- This analysis complements traditional clinical scales and aids in evaluating therapeutic interventions.
- Findings inform future research and clinical practice for 3D-ULMA in BPBI.
Background:
To synthesize the current evidence on clinical use of three-dimensional upper limb movement analysis (3D-ULMA) in children and adolescents with brachial plexus birth injury (BPBI).
Methods:
MEDLINE, Embase, and Web of Science were searched for relevant studies up to April 2022. An automatic e-mail alert was installed to ensure no eligible article was missed. Articles evaluating 3D-ULMA in children and adolescents with BPBI were included. Covidence web-based platform was used for blind screening of eligible articles. Twenty-one observational studies with a final sample size of 609, encompassing 493 BPBI cases, met the inclusion criteria. Data were extracted using a custom form to support standardized extraction conforming to the Cochrane Checklist of items. Risk of bias was assessed using the Newcastle-Ottawa Scale, the Strengthening the Reporting of Observational Studies in Epidemiology checklist, and a specifically established quality assessment form for kinematic analysis studies.
Results:
Study setups differed, including six different types of kinematic devices. Twelve studies used the (modified) Mallet positions for their 3D-ULMA. Throughout the studies, 3D-ULMA was used for various purposes. The Newcastle-Ottawa Scale scored 16 articles with five stars or more, indicating fair to moderate quality.
Conclusions:
This systematic review summarizes the different 3D-ULMA kinematic devices, test protocols, and their clinical use for BPBI. The use of 3D-ULMA provides valuable, objective, and quantified data to clinicians with regard to movement strategies; it complements existing clinical scales and can be implemented to evaluate effectiveness of therapy interventions. Implications for future research and clinical practice are discussed.
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