Biomechanical analysis of upper limb movements in patients with lymphedema

The aim of the study was to develop a biomechanical analysis of upper limb movement from physiological parameters with the objective of identifying quantitative parameters capable of characterizing funtional limitations in upper limb movement associated with lymphedema. Lymphedema is a consequence of the removal of axillary lymph node during radical mastectomy in breast cancer patients. It manifests as swelling of the affected limb due to fluid retention and build-up of adipose tissue in the extracellular space, leading to functional limitations including reduced mobility of the glenohumeral joint, reduced motor abilities and quality of life. In this study, quantitative kinematic parameters were developed to characterize velocity, amplitude, and smoothness of upper limb movements during functional tasks. These parameters were derived from motion capture data collected from retroreflective markers attached to the arms of n=10 female subjects affected by upper limb lymphedema. The experimental protocol was conducted at the Bioengineering and Clinical Movement Analysis Laboratory of the University Hospital of Padua. The value of kinematic parameter obtained from patients with lymphedema were compared to those of n=10 healthy control subjects to identify whether parameters can highlight patients’ functional limitation. In addition, the value of the parameters obtained from patients with lymphedema before vs. after treatment were compared to evaluate the ability of the selected parameters to identify post-treatment improvements in limb function. The trajectories and spatial coordinates of the retroreflective markers placed on the upper limb were initially processed using the proprietary software provided with the motion capture system. The analysis was later carried out in the MATLAB environment, where temporal segmentation of the movements was performed, kinematic parameters were extracted, and the results were compared and interpreted. Motion analysis provides an objective assessment of motor function and joint limitations and allows the identification of quantitative parameters that have potential to characterize functional progress and evaluate the effectiveness of therapeutic treatments.