Webber Christina M, Shin Alexander Y, Kaufman Kenton R
Mayo Clinic Graduate School of Biomedical Sciences, 200 First Street SW, Rochester, MN, USA; Mayo Clinic Department of Orthopedic Surgery, 200 First Street SW, Rochester, MN, USA.
Mayo Clinic Department of Orthopedic Surgery, 200 First Street SW, Rochester, MN, USA.
Clin Biomech (Bristol). 2019 Dec;70:209-216. doi: 10.1016/j.clinbiomech.2019.10.010. Epub 2019 Oct 19.
Injuries to the brachial plexus leave individuals with lasting effects in upper extremity motor function, even with successful surgical restoration of elbow flexion. Quantitatively describing independent patient function during activities of daily living utilizing motion analysis could aid in prioritization of secondary surgical targets, as well as serve as an outcome measure. This study explored the upper extremity kinematic profiles during activities of daily living in adults with brachial plexus injury.
Eight adult participants (4 subjects with brachial plexus injury, 4 healthy controls) completed activities of daily living during one motion capture setting. Trunk, shoulder, and elbow joint minima, maxima, and range of motion were calculated and compared between groups. Kinematic profiles over a motion cycle were compared between groups using statistical parametric mapping.
Subjects with brachial plexus injuries had significantly greater trunk range of motion during feeding and dressing tasks compared to control subjects. This compensatory trunk motion was accompanied by limited shoulder external rotation demonstrated using conventional descriptors and statistical parametric mapping.
Significant compensatory trunk motion is required to complete select activities of daily living in subjects with brachial plexus injury. Additionally, restoration of shoulder external rotation would be a beneficial secondary target of surgical restoration of motor function. These aspects should be considered in treatment planning, as they could impact patient outcomes. Combining conventional descriptors of patient motion (e.g. joint minima, maxima, and range of motion) with statistical parametric mapping can provide a rich description of patient compensations and limitations.
臂丛神经损伤会给个体的上肢运动功能带来持久影响，即便肘关节屈曲功能通过手术成功恢复。利用运动分析定量描述日常生活活动中的患者独立功能，有助于确定二次手术靶点的优先级，并可作为一项疗效指标。本研究探讨了臂丛神经损伤成人在日常生活活动中的上肢运动学特征。
八名成年参与者（4例臂丛神经损伤患者，4名健康对照者）在一次动作捕捉过程中完成日常生活活动。计算并比较两组之间的躯干、肩部和肘关节的最小值、最大值及运动范围。使用统计参数映射比较两组在一个运动周期内的运动学特征。
与对照者相比，臂丛神经损伤患者在进食和穿衣任务期间的躯干运动范围显著更大。这种代偿性躯干运动伴随着使用传统描述指标和统计参数映射所显示的肩部外旋受限。
臂丛神经损伤患者需要显著的代偿性躯干运动来完成特定的日常生活活动。此外，恢复肩部外旋功能将是运动功能手术修复的一个有益的二次靶点。在治疗规划中应考虑这些方面，因为它们可能会影响患者的治疗效果。将患者运动的传统描述指标（如关节最小值、最大值和运动范围）与统计参数映射相结合，可以对患者的代偿和限制进行丰富的描述。
