Synchronous muscular co-ordination and 3-dimensional motion analysis in treatment of patients with obstetric plexus-lesion

Lesions of the n. plexus brachialis are one of the major causes for functional impairments in upper extremity movement. They are often caused by a birth trauma, when the whole nerve or parts of it are torn, or even eradicated off their root in the spinal channel. This ensues in improper, insufficient or no nerval supply of the affected muscles, depending on the progress of reinnervation. One very important factor for a successful treatment of plexus lesions is the correct diagnosis of the cause for the impairment. Up to date there is a lack of objective methods for the identification of the dysfunction’s cause. The decision for a specific treatment is still based on subjective data as obtained in clinical examination and by visual assessment. This can result in an erroneous diagnosis and thus in an incorrect medication, for example an unnecessary operation. Furthermore, if not doctored adequately, the lesion may lead to an irreversible dysfunction in posture. At the Helmholtz-Institute, a procedure based on a synchronised analysis of the 3-dimensional upper extremity movement and the muscular co-ordination pattern detected by bipolar surface EMG has been developed, which allows the objective and quantitative assessment of the impairments cause. Depending on the source of the dysfunction, different medications like nerve transplantation, paralysing injections in affected muscles and/or gymnastics are used in treatment.