Can we predict the prevalence of upper limb dysfunction based on movement quality parameters?

May 3, 2023

Half of the breast cancer survivors complains about upper limb dysfunctions 6 months after their last radiotherapy treatment. These persistent upper limb dysfunctions interfere with their ability to perform tasks of daily living and decreases their quality of life. Therefore upper limb movement recovery after breast cancer is important. The analysis of human movement allows to quantify altered movement patterns and can be used to evaluate musculoskeletal conditions and function. Wearable inertial sensor can calculate features beyond established kinematic parameters derived from traditional movement analysis, and this may provide insights into the quality of movement. Only by the use of one sensor placed on the upper limb, small changes in movement pattern can be detected and perhaps musculoskeletal conditions in their pre-manifesting condition. This has been used before in gait analysis or habitual lower limb tasks. This small tool is portable, not restricted to a lab setting and can be used for repetitive daily live activities. The possibilities for clinical applications is tremendous.

In an exploratory study we analysed the following movement quality measures in a repeated upper limb task in breast cancer survivors:

  1. Local dynamic stability. This outcome describes how well one can cope with small perturbations during a repeated movement.
  2. Movement predictability. This outcome indicates how accurate the performed movement can be predicted, by measuring the similarity and the (ir)regularity of parameters during a repeated assessment.
  3. Movement smoothness. Movement smoothness measures the rate of change of acceleration over time. If there is a constant acceleration (i.e., a smooth movement), this score will be zero. If there is an unsmooth movement, a high value of change of acceleration is presented.
  4. Movement symmetry. This outcome defines the regularity of repeating the same movement in a certain time delay. If a perfect symmetry is presented, this will be indicated with a coefficient equal to one.
  5. Movement variability. This indicates the variability of the movement pattern during a repeated movement.

This is the first time these movement quality parameters were calculated on upper limb movement in breast cancer survivors. We found no significant differences in upper limb movement quality before and one month after surgery for a cyclic, weighted reaching task. However fair positive correlations were presented with upper limb pain severity, indicating that women who experience more pain have a more unstable, smoother and symmetrical movement pattern. These results should be interpreted with caution as these measures were done in a limited sample of 30 breast cancer survivors. However, these results could be a first suggestion that breast cancer survivors make subtle pattern changes during their treatment trajectory and that there could be a correlation with pain or upper limb dysfunctions or perhaps, these pattern changes are even a subtle behavioral feature of avoidance beliefs.  So, with more research in this topic, this can be an excellent manner to quantitatively describe movement quality of the upper limb and detect early-stage upper limb dysfunctions in breast cancer survivors.

Blog post written by: Nieke Vets



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