Patients with brachial plexus injuries (BPI) have limited upper extremity function as a result of a traumatic episode damaging the nerves exiting the spinal cord that provide sensory and motor function to the arm. Current clinical outcome measures may not adequately describe a patient’s independent function during daily life after injury and subsequent treatment. Utilizing both established and emerging quantitative and qualitative methodologies, this dissertation produced a detailed description of independent daily function of individuals with BPI.

Activity monitoring in the free-living environment provided a measure of the asymmetrical upper extremity usage following a BPI. A difference in asymmetry index between BPI severities was discerned using an asymmetry index. Immobilizing the elbow and wrist in unimpaired individuals forced increased reliance upon the contralateral limb, quantified by increased asymmetry indices. Utilizing immobilization, it was demonstrated that regardless of the location on a rigid segment, activity monitors record the same accelerations, indicating that the arm primarily undergoes translation during daily activity.

Activities of daily living (ADLs) were difficult to accomplish for patients with BPI. Subjects were only able to complete feeding and dressing tasks in a controlled setting. Compensatory trunk motion and limited shoulder external rotation existed in subjects with BPI during laboratory testing using motion capture techniques, as demonstrated by conventional kinematic descriptors and an emerging analysis—Statistical Parametric Mapping (SPM).

To complete the description of daily independent function, a subset of patients with BPI who rely on the use of a myoelectric elbow orthosis (MEO) to assist with elbow flexion were consulted through a focus group and phone interviews. The use of an MEO was beneficial in a rehabilitation setting, but had limited utility in daily life. A streamlined device that provided shoulder and elbow support is desired by participants.

Activity monitoring, motion capture, and qualitative analysis of function in patients with a BPI has established a multidimensional framework that can serve as a baseline for future studies evaluating promising clinical treatments for BPI. Combining these methodologies with current clinical outcome measures offers the opportunity to identify areas of strength and potential targets for improvement in existing treatment paradigms.