Assessment of recovery after peripheral nerve and brachial plexus injury has traditionally relied on manual muscle testing (MMT) and Medical Research Council (MRC) grading. While these measures remain essential for evaluating motor reinnervation and guiding surgical decision-making, they incompletely capture functional recovery, patient experience, and limb use in daily life. We examine limitations of conventional outcome measures and propose an integrated, multidimensional approach to recovery assessment. Evidence is synthesized across key outcome domains, including clinical motor and sensory examination, performance-based functional testing, patient-reported outcome measures, motion and kinematic analysis, wearable sensors, and smartphone-based assessment. Strength and sensory testing characterize impairment but may overestimate recovery by failing to detect compensatory movement patterns, impaired coordination, or restricted limb use. Functional performance tests assess task completion but provide limited insight into movement quality. Kinematic analysis and sensor-based technologies enable evaluation of coordination, compensation, and longitudinal recovery trajectories beyond clinic visits. When integrated with patient-reported outcomes, these tools offer a more comprehensive understanding of functional recovery. Recovery after peripheral nerve injury is inherently multidimensional and cannot be adequately described by any single assessment modality. An integrated outcomes framework combining clinical examination, functional testing, patient-reported outcomes, and objective kinematic and sensor-based measures provides a more accurate assessment of recovery and may improve clinical decision-making, rehabilitation planning, and comparability across peripheral nerve studies.
Blum et al. (2026) studied this question.