Surface EMG-driven home exercise program for postoperative rehabilitation after peripheral nerve injuries

Brachial plexus and other peripheral nerve injuries often lead to severe functional impairments, with impacts on one's independence and quality of life. Nerve reconstruction surgeries offer the best chance for restoring motor function, however, return of muscle strength occurs slowly over the course of 1-2 years. Rehabilitation and hand/physical therapy is critical for recovery, but many patients lose motivation and engagement over this long period of time. We previously developed a wearable surface electromyography (EMG) device, which detects electrical signals from underlying muscle activation to provide biofeedback of muscle function, and integrated this with a mobile app-based game. In this project, we propose a two-center, randomized, interventional pilot study to examine the use of surface EMG-driven therapeutic gaming in individuals with brachial plexus and upper extremity peripheral nerve injuries who have undergone nerve reconstruction surgery. We seek to describe differences between receiving standard-of-care hand therapy versus the addition of surface EMG- driven therapeutic gaming, as measured by 1) improvements in muscle strength and 2) changes in patient reported outcome measures over a six-month period. The results of our study will generate the necessary preliminary data and provide critical insights to inform the design of a multicenter randomized controlled trial assessing the efficacy of this adjunctive intervention for postoperative rehabilitation, as well as greatly improve our understanding of the patient experience in the postoperative recovery period with the use of patient reported outcomes in addition to standard clinical tests of muscle strength. Project Number: 1R03HD120500-01 | Fiscal Year: 2026 | NIH Institute/Center: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) | Principal Investigator: Yusha Liu | Institution: UNIVERSITY OF WASHINGTON, SEATTLE, WA | Award Amount: $324,875 | Activity Code: R03 | Study Section: Special Emphasis Panel[ZRG1 MSOS-M (52)] View on NIH RePORTER: https://reporter.nih.gov/project-details/11285975