Abstract
Background: Traumatic brachial plexus injury (TBPI) typically causes sensory, motor and autonomic deficits of the affected upper limb. Recent studies have suggested that a unilateral TBPI can also affect the cortical representations associated to the uninjured limb.Objective: To investigate the kinematic features of the uninjured upper limb in participants with TBPI.Methods: Eleven participants with unilateral TBPI and twelve healthy controls matched in gender, age and anthropometric characteristics were recruited. Kinematic parameters collected from the index finger marker were measured while participants performed a free-endpoint whole-body reaching task and a cup-to-mouth task with the uninjured upper limb in a standing position.Results: For the whole-body reaching task, lower time to peak velocity (p = 0.01), lower peak of velocity (p = 0.003), greater movement duration (p = 0.04) and shorter trajectory length (p = 0.01) were observed in the TBPI group compared to the control group. For the cup-to-mouth task, only a lower time to peak velocity was found for the TBPI group compared to the control group (p = 0.02). Interestingly, no differences between groups were observed for the finger endpoint height parameter in either of the tasks. Taken together, these results suggest that TBPI leads to a higher cost for motor planning when it comes to movements of the uninjured limb as compared to healthy participants. This cost is even higher in a task with a greater postural balance challenge.Conclusion: This study expands the current knowledge on bilateral sensorimotor alterations after unilateral TBPI and should guide rehabilitation after a peripheral injury.
Highlights
The brachial plexus comprises a dense network of spinal nerves originating from vertebrae C5 to T1
Whereas lower to Peak Velocity (TPV) values were found in the Traumatic brachial plexus injury (TBPI) group compared to the control group for both tasks, lower peak velocity (PV) values, greater Movement Duration (MD) and shorter Trajectory Length (TL) were found in the TBPI group only for the reaching task
A reduced TPV of the uninjured limb was found in the TBPI group compared to the control group
Summary
The brachial plexus comprises a dense network of spinal nerves originating from vertebrae C5 to T1. Traumatic brachial plexus injury (TBPI) is more commonly found in young adults involved in motorcycle accidents (Faglioni et al, 2014), and typically causes sensory, motor and autonomic deficits of the affected upper limb (Resnick, 1995). In a similar way, Nazarahari et al (2020) found increased trunk motion when the injured shoulder was performing flexion/extension and abduction/adduction as compared with the uninjured side. These results point toward plastic modifications of the motor plan after a TBPI in respect of upper limb movements, presenting a potential challenge to postural balance. Traumatic brachial plexus injury (TBPI) typically causes sensory, motor and autonomic deficits of the affected upper limb. Recent studies have suggested that a unilateral TBPI can affect the cortical representations associated to the uninjured limb
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