Brachial Plexus Injury

Researchers are investigating the use of vagus nerve stimulation VNS combined with rehabilitation to improve arm movement after an ischemic stroke. This clinical trial compares active VNS paired with rehabilitation against a sham VNS with no electrical stimulation, also combined with rehabilitation, to assess their effects on upper extremity motor function in stroke patients. The study is conducted with a triple-blind, randomized, sham-controlled design and aims to evaluate both safety and efficacy.

Researchers are studying patients with subacute stroke to evaluate the additional effects of kinesio taping combined with conventional physical therapy on upper limb function, range of motion, and spasticity. This randomized control trial aims to determine whether adding kinesio taping provides significant improvements compared to physical therapy alone. The study is conducted in rehabilitation settings and includes adults aged 40 to 65 years with a history of diagnosed stroke and moderate spasticity. Participants are divided into two groups. The experimental group receives kinesio taping three times per week along with physical therapy exercises including passive and active range of motion ROM, PNF stretching, D1 flexion and extension movements, and resistance training with a medium resistance band from weeks 3 to 6. The control group receives the same physical therapy regimen but without kinesio taping. Treatments last 30 minutes on alternate days over six weeks. During the study, participants upper limb spasticity and function are assessed at baseline, week 3, and week 6 using the Modified Ashworth Scale and the Wolf Motor Function Test. Range of motion is measured with a goniometer for shoulder, elbow, and wrist joints. Data collection includes demographic information and questionnaires. The study monitors outcomes throughout the six-week treatment period to analyze differences between groups.

Researchers are comparing different nerve block techniques and patient-controlled analgesia to reduce tourniquet pain during forearm surgery. The trial focuses on the effectiveness of interscalene brachial plexus block ISBPB, intercostobrachial nerve ICBN block, and supraclavicular brachial plexus block SCBPB combined with fentanyl for pain control. This randomized study aims to better understand which method lowers the incidence and severity of pain caused by a tourniquet used during surgery. All participants will receive a supraclavicular block as their primary anesthetic using 20 to 30 mL of 0.5% bupivacaine under ultrasound guidance. The study groups differ by additional treatments one group receives an interscalene brachial plexus block with 10 mL of 0.125% bupivacaine around the nerve roots another group receives an intercostobrachial nerve block with 10 mL of 0.5% bupivacaine near the second and third intercostal space the third group uses patient-controlled analgesia with fentanyl. Midazolam may be given on request, and fentanyl is administered if pain occurs during surgery. Participants will be monitored for tourniquet pain incidence within two hours after surgery, along with hemodynamic changes, adverse reactions, and patient satisfaction up to 24 hours. Pain quality and location will be documented if pain arises during surgery. The study involves patients aged 18 to 70 undergoing forearm orthopedic or plastic surgery with specific anesthesia eligibility. Safety and effectiveness data collected during and after surgery will help determine the best pain management technique for this setting.

Researchers are investigating how individuals with limb weakness, limb paralysis, limb loss, or movement disorders move in various settings using different assistive devices and technologies. The study aims to understand how these devices impact human movement to improve technology and prepare for commercialization. Participants include both nondisabled individuals and those with disabilities who use assistive devices such as prostheses and orthoses. The study compares participants using their usual assistive devices or no device with those using investigational or commercially available devices, including prosthetic knees, ankles, feet, and ankle-foot orthoses. Activities are categorized into movement analysis in the laboratory and outside it, usability testing, and focus groups. Participants may complete different combinations of these activities, possibly more than once. During the study, participants will undergo various movement tests including walking speed, sit-to-stand timing, and the Timed Up and Go test, both with and without assistive devices. Assessments are collected at baseline and immediately after acclimating to the intervention. Participants perceptions are recorded, and safety during treadmill use is ensured. The studys involvement varies per individual and includes multiple assessments to evaluate assistive technology impact on mobility.

Researchers are comparing three types of nerve blocks used for managing pain after shoulder arthroscopic surgeries. The study focuses on anterior glenoid nerve block, pericapsular nerve group PENG block, and interscalene brachial plexus ISB block. These blocks help reduce postoperative pain, improve patient comfort, speed up rehabilitation, and potentially shorten hospital stays. ISB blocks are well known as the standard method, while the PENG block is a newer technique that may provide pain relief with fewer side effects and quicker movement recovery. Participants will be randomly assigned to receive one of the three nerve blocks the interscalene brachial plexus block, the anterior glenoid nerve block, or the pericapsular nerve group PENG block. All blocks are applied using ultrasound guidance during shoulder arthroscopic surgery. The study is double-blinded, meaning neither patients nor doctors know which block is given to ensure unbiased results. During the study, researchers will monitor the time until patients need their first rescue pain medication within 24 hours after surgery. They will also track total opioid use, pain levels, hospital stay duration, time to freely move the operated shoulder, and patient satisfaction. These measures help assess each blocks effectiveness and safety. The entire study includes follow-up up to one week after surgery to observe recovery progress and potential complications.

Researchers are studying pain management methods for patients undergoing shoulder surgery, a common orthopedic procedure often linked with moderate to severe pain after surgery. The study compares two nerve block techniques the standard interscalene brachial plexus block, which can cause breathing difficulties due to unintended nerve effects, and a newer diaphragm-sparing method combining suprascapular and axillary nerve blocks. The goal is to assess pain relief and preserve respiratory function during recovery. Participants will receive one of two ultrasound-guided nerve block procedures before surgery. One group will have an interscalene block with 10 mL of 0.5% bupivacaine injected near the C5 and C6 nerve roots. The other group will receive a combination of suprascapular and axillary nerve blocks, each with 5 mL of 0.5% bupivacaine injected around specific nerves near the shoulder. Both procedures are designed to provide pain relief while minimizing breathing complications. During the study, participants pain intensity at rest and movement will be measured up to 24 hours after surgery, along with total opioid consumption. Respiratory function will be monitored by measuring diaphragmatic movement and lung volumes before and after the nerve blocks and throughout the perioperative period. The study includes adult patients aged 18 to 65 scheduled for elective arthroscopic shoulder surgery, with assessments focused on pain control and breathing safety.

Researchers are investigating upper-extremity proprioception impairment in patients experiencing radicular neuropathic symptoms caused by cervical disc herniation. This study focuses on the specific subgroup of cervical radiculopathy, which has not been systematically examined before, aiming to better understand the relationship between proprioceptive deficits and clinical outcomes such as pain and functional status. The study compares patients aged 18 to 65 years with cervical radiculopathy to a healthy control group matched by age, sex, and body mass index. Proprioception is assessed using the PRO-Reach method, which measures multisensory spatial representation of the entire upper limb through multiplanar and multi-joint evaluations without the need for computerized or robotic devices. Participants undergo baseline assessments including the Upper Limb Proprioception Reaching Test PRO-Reach, pain rating scales Numeric Rating Scale and DN-4 Questionnaire, quality of life evaluation SHORT FORM-12, handgrip strength testing, and disability questionnaires Quick Disabilities of the Arm, Shoulder and Hand Questionnaire. These measures help researchers evaluate sensory-motor function and its impact. The study involves healthy volunteers and patients, with data collection focused on initial measurements before any treatments, and participation is expected to last during the baseline assessment period.

This research aims to assess Associative Peripheral Stimulation APS, a non-invasive therapy combining electrical muscle stimulation with voluntary movement, for helping people recover upper limb function during the acute phase after a stroke. The focus is on reducing motor impairment in patients who have recently experienced ischemic or hemorrhagic stroke and are showing weakness or paralysis in their upper extremity. Participants are randomly assigned to one of two groups one receiving APS paired with rehabilitative exercises, and a control group receiving random peripheral stimulation paired with similar exercises. The study is conducted under triple masking to ensure unbiased results and compares outcomes over a 5-week and 3-month period. Throughout the study, participants undergo assessments including measurements of upper limb range of motion and the Fugl-Meyer Assessment for upper extremity function. Additional evaluations such as the Action Research Arm Test are also used. The study tracks progress at 5 weeks and 3 months to monitor motor recovery and function improvement, aiming to provide insight into APSs potential role in stroke rehabilitation.

Researchers are studying an experimental therapy to help people recover arm movement after a stroke. This therapy combines functional electrical stimulation with a P-300 based Brain-Computer Interface system BCI-FES to assist arm rehabilitation. The study compares two groups one receives only conventional physical therapy, and the other receives both conventional therapy and BCI-FES. The goal is to improve motor recovery and independence in patients with moderate to severe upper limb weakness due to stroke. Both groups will undergo 20 sessions of conventional physical therapy over 4 weeks, with five sessions each week. The experimental group will also receive 20 sessions of BCI-FES therapy during the same period. The BCI system detects the patients intended hand movements and assists with movements such as hand opening, grasping, pinching, pronation, and supination. These movements are practiced alongside daily tasks using objects like bottles and spoons. The therapy aims to stimulate brain pathways involved in movement to support recovery. Participants will be evaluated before and after the 4-week treatment using tests that measure arm motor function, spasticity, independence, and depression. Brain imaging with MRI and EEG will assess changes in brain structure and activity. Safety and comfort during sessions will be monitored, including fatigue and skin irritation. The total involvement lasts about one month, with close follow-up during therapy and assessments of progress and brain changes.

Chronic pain affects many adults and is often resistant to existing treatments. This research explores a novel approach using closed-loop deep brain stimulation DBS that targets multiple brain regions involved in different pain dimensions. The goal is to develop personalized DBS technology that adapts to each patients pain signals, potentially offering more lasting relief for treatment-resistant chronic pain. Participants begin with an inpatient trial where temporary electrodes are placed bilaterally in brain areas linked to pain perception. This stage helps identify personalized pain biomarkers and optimal stimulation settings. A subgroup showing potential benefit will then receive permanent implants targeting up to three brain regions for long-term monitoring and stimulation. The study compares active closed-loop DBS against inactive stimulation in a randomized, blinded crossover design using devices such as the Medtronic Summit RCS or Percept RC. Throughout the trial, participants undergo brain recordings and stimulation sessions monitored over weeks and months. Researchers assess pain, mood, and functional outcomes using clinical scores and sensory testing. Safety and adverse events are tracked for two years. The study aims to validate neural signals predicting pain fluctuations and test the feasibility and effectiveness of personalized closed-loop DBS for chronic pain management.