Upper Limb Multifactorial Movement Analysis in Brachial Plexus Birth Injury

Abstract

Multifactorial motion analysis was first established for gait and then developed in the upper extremity. Recordings of infrared light reflecting sensitive passive markers in space, combined with surface eletromyographic recordings and/or transmitted forces, allow eclectic study of muscular coordination in the upper limb. Brachial plexus birth injury is responsible for various patterns of muscle weakness, imbalance, and/or simultaneous activation, soft tissue contractures, and bone-joint deformities, leading to individual motion patterns and adaptations, which we studied by means of motion analysis tools. We describe the technical development and examination setup to evaluate motion impairment and present first clinical results.

Motion analysis is a reliable objective assessment tool allowing precise pre- and postoperative multimodal evaluation of upper limb function.

Level of evidence: II.

Keywords

motion analysis - upper limb - brachial plexus birth injury - medial rotation contracture

• References

• 1 Bahm J. Obstetric brachial plexus palsy—clinics, pathophysiology and surgical treatment [in German]. Handchir Mikrochir Plast Chir 2003; 35 (2) 83-97
• 2 Bahm J. Secondary procedures in obstetric brachial plexus lesions [in German]. Handchir Mikrochir Plast Chir 2004; 36 (1) 37-46
• 3 Bahm J, Becker M, Disselhorst-Klug C , et al. Surgical strategy in obstetric brachial plexus palsy: the Aachen experience. Semin Plast Surg 2004; 18: 285-299
• 4 Borschel GH, Clarke HM. Obstetrical brachial plexus palsy. Plast Reconstr Surg 2009; 124 (1, Suppl): 144e-155e
• 5 Malessy MJA, Pondaag W. Nerve repair/reconstruction strategies for neonatal brachial plexus palsies. In: Chung KC, Yang LJS, McGillicuddy JE, eds. Practical Management of Pediatric and Adult Brachial Plexus Palsies. London: Elsevier; 2012: 86-102
• 6 Disselhorst-Klug C, Bahm J, Ramaekers V, Trachterna A, Rau G. Non-invasive approach of motor unit recording during muscle contractions in humans. Eur J Appl Physiol 2000; 83 (2–3) 144-150
• 7 Bahm J, Meinecke L, Brandenbusch V, Rau G, Disselhorst-Klug C. High spatial resolution electromyography and video-assisted movement analysis in children with obstetric brachial plexus palsy. Hand Clin 2003; 19 (3) 393-399
• 8 Rau G, Disselhorst-Klug C, Schmidt R. Movement biomechanics goes upwards: from the leg to the arm. J Biomech 2000; 33 (10) 1207-1216
• 9 Williams S, Schmidt R, Disselhorst-Klug C, Rau G. An upper body model for the kinematical analysis of the joint chain of the human arm. J Biomech 2006; 39 (13) 2419-2429
• 10 Zatsiorsky VM. Kinetics of Human Motion. Champaign, IL: US Human Kinetics; 2002
• 11 Denavit J, Hartenberg RS. A kinematic notation for lower-pair mechanisms based on matrices. Trans ASME. J Appl Mech 1955; 23: 215-221
• 12 van Oosterhout E. Using a robot in upper extremity movement analysis in children. Stagebericht faculteit der gezondheidswetenschappen, bewegingswetenschappen Universiteit Maastricht; Februari 2004
• 13 Popovic N, Williams S, Schmitz-Rode T, Rau G, Disselhorst-Klug C. Robot-based methodology for a kinematic and kinetic analysis of unconstrained, but reproducible upper extremity movement. J Biomech 2009; 42 (10) 1570-1573
• 14 Popovic N. Modellbasierte Erfassung der dreidimensionalen Kinetik der Bewegung der oberen Extremitäten [dissertation]. Aachen: RWTH Aachen Elektrotechnische Fakultät; 2010
• 15 Kleiber T, Popovic N, Bahm J, Disselhorst-Klug C. A modeling approach to compute modification of net joint forces caused by coping movements in obstetric brachial plexus palsy. J Brachial Plex Peripher Nerve Inj 2013; 8 (1) 10
• 16 Disselhorst-Klug C, Bahm J. An Update on Kinematic Evaluation of the Upper Extremity. Seminar of the Department of Orthopaedics and Traumatology, Erasme University Hospital, Brussels; 2009