scholarly journals Surface Electromyographic Biofeedback as a Rehabilitation Tool for Patients with Global Brachial Plexus Injury Receiving Bionic Reconstruction

10.3791/59839 ◽  
2019 ◽  
Author(s):  
Laura A. Hruby ◽  
Agnes Sturma ◽  
Oskar C. Aszmann
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Electromyographic Biofeedback ◽  
Bionic Reconstruction

Bionic reconstruction to restore hand function after brachial plexus injury: a case series of three patients

The Lancet ◽  
2015 ◽  
Vol 385 (9983) ◽  
pp. 2183-2189 ◽  
Author(s):  
Oskar C Aszmann ◽  
Aidan D Roche ◽  
Stefan Salminger ◽  
Tatjana Paternostro-Sluga ◽  
Malvina Herceg ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Hand Function ◽  
Case Series ◽  
Bionic Reconstruction

scholarly journals Prosthetic Embodiment and Body Image Changes in Patients Undergoing Bionic Reconstruction Following Brachial Plexus Injury

2021 ◽  
Vol 15 ◽  
Author(s):  
Agnes Sturma ◽  
Laura A. Hruby ◽  
Anna Boesendorfer ◽  
Anna Pittermann ◽  
Stefan Salminger ◽  
...  
Keyword(s):  
Body Image ◽  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Multiple Root ◽  
Body Part ◽  
The Body ◽  
Human Anatomy ◽  
Prosthetic Reconstruction ◽  
Patient Reported ◽  
Bionic Reconstruction

Brachial plexus injuries with multiple-root involvement lead to severe and long-lasting impairments in the functionality and appearance of the affected upper extremity. In cases, where biologic reconstruction of hand and arm function is not possible, bionic reconstruction may be considered as a viable clinical option. Bionic reconstruction, through a careful combination of surgical augmentation, amputation, and prosthetic substitution of the functionless hand, has been shown to achieve substantial improvements in function and quality of life. However, it is known that long-term distortions in the body image are present in patients with severe nerve injury as well as in prosthetic users regardless of the level of function. To date, the body image of patients who voluntarily opted for elective amputation and prosthetic reconstruction has not been investigated. Moreover, the degree of embodiment of the prosthesis in these patients is unknown. We have conducted a longitudinal study evaluating changes of body image using the patient-reported Body Image Questionnaire 20 (BIQ-20) and a structured questionnaire about prosthetic embodiment. Six patients have been included. At follow up 2.5–5 years after intervention, a majority of patients reported better BIQ-20 scores including a less negative body evaluation (5 out of 6 patients) and higher vital body dynamics (4 out of 6 patients). Moreover, patients described a strong to moderate prosthesis embodiment. Interestingly, whether patients reported performing bimanual tasks together with the prosthetic hand or not, did not influence their perception of the prosthesis as a body part. In general, this group of patients undergoing prosthetic substitution after brachial plexus injury shows noticeable inter-individual differences. This indicates that the replacement of human anatomy with technology is not a straight-forward process perceived in the same way by everyone opting for it.

scholarly journals Case Report: Bionic Reconstruction in an Adult With Obstetric Brachial Plexus Injury

2022 ◽  
Vol 2 ◽  
Author(s):  
Anna Boesendorfer ◽  
Agnes Sturma ◽  
Clemens Gstoettner ◽  
Anna Pittermann ◽  
Gregor Laengle ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Daily Living ◽  
Brachial Plexus Injury ◽  
Hand Function ◽  
Functional Improvement ◽  
Prosthetic Fitting ◽  
Obstetric Brachial Plexus ◽  
Bionic Reconstruction ◽  
Obstetric Brachial Plexus Injury

Introduction: Many adults who had a severe Narakas IV obstetric brachial plexus injury (OBPI) suffer from extensive impairments in daily living due to limited hand-arm function. The dramatic loss of axonal support at this very early age of development often render the entire extremity a biologic wasteland and reconstructive methods and therapies often fail to recover any functional hand use. In this scenario bionic reconstruction, including an elective amputation and a subsequent prosthetic fitting, may enable functional improvement in adults suffering from the consequences of such severe brachial plexus injuries. We here describe our experience in treating such patients and lay out the surgical rational and rehabilitation protocol exemplified in one patient.Case Presentation/Methods: A 27-year-old adult with a unilateral OBPI contacted our center. He presented with globally diminished function of the affected upper extremity with minimal hand activity, resulting in an inability to perform various tasks of daily living. No biological reconstructive efforts were available to restore meaningful hand function. An interdisciplinary evaluation, including a psychosocial assessment, was used to assess eligibility for bionic reconstruction. Before the amputation and after the prosthetic fitting functional assessments and self-reported questionnaires were performed.Results: One month after the amputation and de-rotation osteotomy of the humerus the patient was fitted with a myoelectric prosthesis. At the 1.5 year-follow-up assessment, the patient presented with a distinct improvement of function: the ARAT improved from 12 to 20 points, SHAP score improved from 8 to 29, and the DASH value improved from 50 to 11.7. The average wearing times of the prosthesis were 5 to 6 h per day (on 4–5 days a week).Discussion: The options for adults suffering from the consequences of severe OBPIs to improve function are limited. In selected patients in whom the neurological deficit is so severe that biologic hand function is unsatisfactory, an elective amputation and subsequent restoration of the hand with mechatronic means may be an option. The follow-up results indicate that this concept can indeed lead to solid hand function and independence in daily activities after amputation, subsequent prosthetic fitting, and rehabilitation.

RESTORATION OF HAND FUNCTION AFTER BRACHIAL PLEXUS INJURY

Hand Clinics ◽  
1995 ◽  
Vol 11 (4) ◽  
pp. 647-656
Author(s):  
Chantal Bonnard ◽  
Algimantas Narakas
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Hand Function

scholarly journals Role of MRI in the diagnosis of adult traumatic and obstetric brachial plexus injury compared to intraoperative findings

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Doria Mohammed Gad ◽  
Mostafa Thabet Hussein ◽  
Nagham Nabil Mahmoud Omar ◽  
Mohamed Mostafa Kotb ◽  
Mohamed Abdel-Tawab ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Tissue Characterization ◽  
Brachial Plexus Injury ◽  
Imaging Modality ◽  
Preoperative Evaluation ◽  
Diagnostic Modality ◽  
Non Invasive ◽  
Upper Limb Function ◽  
Obstetric Brachial Plexus ◽  
Sensitivity Specificity

Abstract Background Brachial plexus injury occurs following birth trauma or adult trauma as well, surgical repair is important to regain upper limb function, and preoperative evaluation with MRI is important and considered the accurate and safe imaging modality. Thirty-seven patients with clinically suspected obstetric (15 patients) or adult traumatic (22 patients) brachial plexus injury were included in our study; all of them underwent MRI examination including T1WI, T2WI, STIR, DWIBS, 3D STIR SPACE, and MR myelography sequences. Results In obstetric cases, MRI sensitivity, specificity, and accuracy for preganglionic injury were 63%, 89%, and 82%, respectively, while for postganglionic lesions, MRI sensitivity, specificity, and accuracy were 60%, 99%, and 95%, respectively. In adult cases, MRI sensitivity, specificity, and accuracy for preganglionic injury were 96%, 95%, and 95% respectively, while for postganglionic injury, MRI sensitivity, specificity, and accuracy were 60%, 100%, and 99%, respectively. Conclusion MRI represents a safe, non-invasive, diagnostic modality having the multiplanar capability and better soft tissue characterization.

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