Balance Impairments after Brachial Plexus Injury as Assessed through Clinical and Posturographic Evaluation

Abstract

Objective: To investigate whether a sensorimotor deficit of the upper limb following a brachial plexus injury (BPI) affects the upright balance.Design: Eleven patients with a unilateral BPI and 11 healthy subjects were recruited. The balance assessment included the Berg Balance Scale (BBS), the number of feet touches on the ground while performing a 60 s single-leg stance and posturographic assessment (eyes open and feet placed hip-width apart during a single 60 s trial). The body weight distribution (BWD) between the legs was estimated from the center of pressure (COP) lateral position. The COP variability was quantified in the anterior-posterior and lateral directions.Results: BPI patients presented lower BBS scores (p = 0.048) and a higher frequency of feet touches during the single-leg stance (p = 0.042) compared with those of the healthy subjects. An asymmetric BWD toward the side opposite the affected arm was shown by 73% of BPI patients. Finally, higher COP variability was observed in BPI patients compared with healthy subjects for anterior-posterior (p = 0.020), but not for lateral direction (p = 0.818).Conclusions: This study demonstrates that upper limb sensorimotor deficits following BPI affect body balance, serving as a warning for the clinical community about the need to prevent and treat the secondary outcomes of this condition.

Reduced functional connectivity within the primary motor cortex of patients with brachial plexus injury

“…Thus, by strongly disrupting upper limb motor synergies ( Schieber, 2001 ), denervation due to BPA would affect long-range connections and strongly reduce functional connectivity within M1. Accordingly, we recently showed that brachial plexus injured patients show altered postural control ( Souza et al, 2015 ).…”

Plasticity in the Brain after a Traumatic Brachial Plexus Injury in Adults

“…Interestingly, these modifications also encompassed the M1 trunk/ lower limb representation, suggesting that TBPI might imply in a bodily extended motor dysfunction. Accordingly, it was also found that TBPI affects body balance [57]. Souza et al [57] showed that TBPI patients oscillate more in the sagittal plane as compared to a control group while standing barefoot on a force platform for 60s.…”

“…Accordingly, it was also found that TBPI affects body balance [57]. Souza et al [57] showed that TBPI patients oscillate more in the sagittal plane as compared to a control group while standing barefoot on a force platform for 60s.…”

“…Moreover, Souza et al [57] showed that motor impairment after TBPI is not restricted to the upper limb segment, since the clinical balance assessment and posturographic analysis in a TBPI group indicate that these individuals do exhibit balance impairments. This study indicated that rehabilitation after TBPI should not be directed only to the upper limb, but also to prevent and treat the secondary outcomes of this condition.…”

The Homuncular Jigsaw: Investigations of Phantom Limb and Body Awareness Following Brachial Plexus Block or Avulsion

“…Additionally, changes in functional brain organization after brachial-plexus injury could extend beyond the sensorimotor primary cortex [47]. Some features of the disorder, such as body-balance alterations, indicate the possibility of much larger neurological effects [48]. Moreover, it is possible to suppose that the effects of neurological trauma could have more connection than previously thought to many body-representation disorders that are typically considered to be of only psychiatric relevance [49].…”