Blackbox Automated Gait Analysis As A Tool For Assessing Functional Outcomes In Peripheral Nerve Injury

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Background Accurate assessment of motor recovery after peripheral nerve injury (PNI) in murine models is essential for evaluating surgical interventions and predicting translational outcomes. Current functional assays include the Basso, Beattie, Bresnahan (BBB) locomotor scale, a 21-point ordinal rating of gait mechanics by an observer, and the Sciatic Functional Index (SFI), which calculates a composite score based on manual measurements such as toe spread, intermediate toe spread, and paw length. While widely used, both methods are subject to observer bias and limited sensitivity to subtle changes in recovery. BlackBox, an automated gait analysis platform, provides objective, high-resolution metrics including total distance traveled, step length, gait width, toe spread, rearing, and jumping. This pilot study focused on toe spread as a key preliminary measure, as it is an established component of the SFI and a key correlate of sciatic nerve motor recovery. Accurate and objective assessment of functional recovery in murine models is vital for predicting reinnervation potential and informing surgical strategies in peripheral nerve injury, where delays or incomplete repair can severely limit functional recovery. Methods IACUC approval was obtained to create an animal model common peroneal (CP) transection injury (n=9) followed by a delayed nerve transfer (n=6) nine days later. Hindpaw gait was recorded twice weekly for five minutes per session using the BlackBox interface, which provides automated video and weight-sensing analysis of locomotor parameters. Toe-spread values were compared between injured and uninjured hindpaws within each group, between surgical groups, and longitudinally across postoperative weeks. Results CP transection produced a consistent decrease in right hindpaw toe spread compared to the contralateral side (p 0.001), validating the injury model. In the nerve transfer group, distinct temporal changes in toe spread were observed compared with transection-only animals, with significant differences emerging between weeks 2 and 3 post-surgery (p 0.001). Direct comparisons between the injured hindpaws of nerve transfer and transection only groups did not demonstrate significant recovery differences at this time. These findings indicate that BlackBox toe-spread analysis is sensitive to both injury induced deficits and temporal trends associated with attempted reinnervation. Conclusion This preliminary study demonstrates the feasibility of BlackBox automated gait analysis as an objective tool for quantifying functional recovery after peripheral nerve injury and repair. Compared with BBB and SFI, BlackBox provides high-resolution, unbiased metrics that may reduce variability and enhance reproducibility. Future work will incorporate additional BlackBox parameters including weight bearing and gait cycle dynamics and correlate them with BBB and SFI scores to define standardized outcome measures. Ongoing studies will also refine interpretation of nerve transfer outcomes in CP models, recognizing that murine anatomy complicates complete denervation of muscles such as the tibialis anterior. Establishing reliable, automated metrics of recovery in preclinical models will directly inform translational strategies and improve the evaluation of interventions designed to restore function in patients with peripheral nerve injuries. Word count: 470/500 *Source: https://ps-rc.org/meeting/Program/2026/OS57.cgi*

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