Accuracy and Reliability of Video-Based Range-of-Motion Assessments in Postreconstruction Brachial Plexus Patients

Area of Science:

• Orthopedics
• Rehabilitation Medicine
• Medical Imaging

Background:

• Patients with brachial plexus injuries (BPI) often experience limited limb motion post-surgery.
• Current active range of motion (AROM) assessments rely on in-person methods prone to interobserver variability.
• Standardized video recording offers a potential solution for objective AROM measurement.

Purpose of the Study:

• To evaluate the reliability of video-based AROM assessments in BPI patients.
• To compare the inter-rater reliability (IRR) of visual estimation versus digital goniometry using video recordings.
• To establish video-based AROM as a dependable tool for BPI patient evaluation.

Main Methods:

• Eight BPI surgeons assessed AROM from standardized videos of 8 postreconstruction BPI patients.
• Motions assessed included elbow flexion (EF), shoulder flexion (FF), and shoulder abduction (ABD).
• Surgeons performed both visual estimations and digital goniometry (ImageJ) for AROM, with results compared to in-person measurements and analyzed for IRR.

Main Results:

• Digital goniometry showed higher correlation with in-person measurements for EF (r=0.92) and ABD (r=0.85) compared to visual assessment.
• High IRR was observed for all motions: EF (visual: 0.80, digital: 0.96), FF (visual: 0.95, digital: 0.99), and ABD (visual: 0.91, digital: 0.96).
• Digital goniometry demonstrated slightly superior IRR compared to visual estimates across all assessed movements.

Conclusions:

• Video-based AROM assessments are highly reliable among surgeons for evaluating EF, FF, and ABD in BPI patients.
• Digital goniometry using video recordings offers a reliable and potentially more accurate method than visual estimation.
• This approach can facilitate remote assessments, reduce patient travel, and minimize reporting bias in clinical research.