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Dorich JM, Whiting J, Plano Clark VL, Ittenbach RF, Cornwall R. The dynamic and diverse experience of adults with brachial plexus birth injury: a collective case study. Int J Qual Stud Health Well-being 2024; 19:2408810. [PMID: 39365894 DOI: 10.1080/17482631.2024.2408810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 09/21/2024] [Indexed: 10/06/2024] Open
Abstract
PURPOSE To explore brachial plexus birth injury (BPBI)-affected adults' health-related quality of life (HRQoL) experiences informed by the theoretical framework of the International Classification of Functioning, Disability, and Health. METHODS This study applied a qualitative collective case study design. Twelve participants who participated in a prior survey study were recruited using maximum variation sampling. One-on-one semi-structured interviews focused on gaining in-depth understanding of participants' experiences with HRQoL. Interviews were recorded verbatim and thematically analysed. RESULTS We identified two themes. First, the theme biopsychosocial dimensions of the experience comprised the ways BPBI affects physical and emotional health and how BPBI is intertwined with affected individuals' identities, activities/participation, and social environments. Second, the theme lifelong and variable experience encompassed how BPBI is a chronic condition that changes over time and varies among affected individuals. The cross-case analysis derived a conceptual model of BPBI HRQoL to describe the BPBI experience through the lifespan. In this model, multiple dimensions of BPBI HRQoL expand through the lifespan while BPBI-specific health resources' availability contract. CONCLUSIONS By providing insight into the many ways that BPBI affects and is affected by an individual's functioning and personal, social, and healthcare environmental factors, these findings underscore lifelong individualized care for BPBI-affected persons is needed.
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Affiliation(s)
- Jenny M Dorich
- Departments of Orthopaedic Surgery and Allied Health Sciences, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
| | | | - Vicki L Plano Clark
- Research Methods, School of Education, University of Cincinnati, Cincinnati, OH, USA
| | | | - Roger Cornwall
- Departments of Orthopaedic Surgery and Developmental Biology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, USA
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Manske MCB, Wilson MD, Wise BL, Melnikow J, Hedriana HL, James MA, Tancredi DJ. Maternal Epidemiology of Brachial Plexus Birth Injuries in California: 1996 to 2012. Am J Perinatol 2024; 41:e2106-e2114. [PMID: 37216973 DOI: 10.1055/a-2097-1358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE This study aimed to evaluate the incidence of brachial plexus birth injury (BPBI) and its associations with maternal demographic factors. Additionally, we sought to determine whether longitudinal changes in BPBI incidence differed by maternal demographics. STUDY DESIGN We conducted a retrospective cohort study of over 8 million maternal-infant pairs using California's Office of Statewide Health Planning and Development Linked Birth Files from 1991 to 2012. Descriptive statistics were used to determine BPBI incidence and the prevalence of maternal demographic factors (race, ethnicity, age). Multivariable logistic regression was used to determine associations of year, maternal race, ethnicity, and age with BPBI. Excess population-level risk associated with these characteristics was determined by calculating population attributable fractions. RESULTS The incidence of BPBI between 1991 and 2012 was 1.28 per 1,000 live births, with peak incidence of 1.84 per 1,000 in 1998 and low of 0.9 per 1,000 in 2008. Incidence varied by demographic group, with infants of Black (1.78 per 1,000) and Hispanic (1.34 per 1,000) mothers having higher incidences compared with White (1.25 per 1,000), Asian (0.8 per 1,000), Native American (1.29 per 1,000), other race (1.35 per 1,000), and non-Hispanic (1.15 per 1,000) mothers. After controlling for delivery method, macrosomia, shoulder dystocia, and year, infants of Black (adjusted odds ratio [AOR] = 1.88, 95% confidence interval [CI] = 1.70, 2.08), Hispanic (AOR = 1.25, 95% CI = 1.18, 1.32), and advanced-age mothers (AOR = 1.16, 95% CI = 1.09, 1.25) were at increased risk. Disparities in risk experienced by Black, Hispanic, and advanced-age mothers contributed to a 5, 10, and 2% excess risk at the population level, respectively. Longitudinal trends in incidence did not vary among demographic groups. Population-level changes in maternal demographics did not explain changes in incidence over time. CONCLUSION Although BPBI incidence has decreased in California, demographic disparities exist. Infants of Black, Hispanic, and advanced-age mothers are at increased BPBI risk compared with White, non-Hispanic, and younger mothers. KEY POINTS · The incidence of BPBI has decreased over time.. · Demographic disparities in BPBI incidence and risk exist.. · Infants of Black, Hispanic, and advanced age mothers are at greatest risk of BPBI..
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Affiliation(s)
- Mary Claire B Manske
- Department of Orthopaedic Surgery, University of California Davis, Sacramento, California
- Department of Orthopaedic Surgery, Shriners Hospitals for Children Northern California, Sacramento, California
| | - Machelle D Wilson
- Department of Public Health Sciences, Division of Biostatistics, Clinical and Translational Science Center, University of California Davis, Sacramento, California
| | - Barton L Wise
- Department of Internal Medicine, University of California Davis, Sacramento, California
| | - Joy Melnikow
- Department of Family and Community Medicine, University of California Davis, Sacramento, California
| | - Herman L Hedriana
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine University of California Davis, Sacramento, California
| | - Michelle A James
- Department of Orthopaedic Surgery, University of California Davis, Sacramento, California
- Department of Orthopaedic Surgery, Shriners Hospitals for Children Northern California, Sacramento, California
| | - Daniel J Tancredi
- Department of Pediatrics, University of California Davis, Sacramento, California
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Dorich JM, Whiting J, Plano Clark VL, Ittenbach RF, Cornwall R. Impact of brachial plexus birth injury on health-related quality of life in adulthood: a mixed methods survey study. Disabil Rehabil 2024; 46:2042-2055. [PMID: 37199089 DOI: 10.1080/09638288.2023.2212917] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 05/07/2023] [Indexed: 05/19/2023]
Abstract
PURPOSE To describe the scope and nature of health concerns, functional impairments, and quality of life issues among adults with brachial plexus birth injury (BPBI). METHODS A mixed methods study was conducted by surveying two social media networks of adults with BPBI using a combination of closed-ended and open-ended questions regarding the role of BPBI on ones' health, function, and quality of life. Closed-ended responses were compared across ages and genders. Open-ended responses were qualitatively analyzed to expand upon the close-ended responses. RESULTS Surveys were completed by 183 respondents (83% female, age range 20-87 years). BPBI was reported to impact hand and arm use in 80% of participants (including affected and unaffected limbs and bimanual tasks), overall health in 60% (predominantly pain), activity participation in 79% (predominantly activities of daily living and leisure), life roles in 76% (predominantly occupation and parenting), and overall quality of life in 73% (predominantly self-esteem, relationships, and appearance). Significantly more females than males reported other medical conditions and an impact on hand and arm use and life roles. No other responses varied by age or gender. CONCLUSIONS BPBI affects many facets of health related quality of life in adulthood with variability among affected individuals.
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Affiliation(s)
- Jenny M Dorich
- Cincinnati Children's Hospital Medical Center, Departments of Orthopaedic Surgery and Allied Health Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Jordyn Whiting
- Vice-President/Board of Directors, United Brachial Plexus Network, Reading, MA, USA
| | - Vicki L Plano Clark
- School of Education - Research Methods, University of Cincinnati, Cincinnati, OH, USA
| | - Richard F Ittenbach
- Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
| | - Roger Cornwall
- Cincinnati Children's Hospital Medical Center, Departments of Orthopaedic Surgery and Developmental Biology, University of Cincinnati, Cincinnati, OH, USA
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Ho ES, Ferdosi DV, Pourtousi A, Davidge KM, Anthony SJ. Mental health risk and protective factors associated with brachial plexus birth injuries: a scoping review. Disabil Rehabil 2024; 46:21-30. [PMID: 36562352 DOI: 10.1080/09638288.2022.2156628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/03/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE The purpose of this scoping review is to synthesize the current evidence on the risk and protective factors associated with mental health in children with brachial plexus birth injury (BPBI) and associated interventions. MATERIALS AND METHODS MEDLINE, EMBASE, and Cochrane databases were searched for reports on mental health in children with BPBI between 10 and 18 years. Risk and protective factors were charted using the VicHealth review and the Person-Environment-Occupation model. RESULTS Of 732 records found, 133 full text reports were reviewed and 16 reports were included. Multiple mental health risks associated with BPBI were identified, while protective factors were largely unexplored. Person-related risks were most common including negative coping strategies (n = 8, 50%) and pain (n = 6, 38%). Most frequently reported environment and occupation risk factors were social difficulties (n = 9, 56%) and challenges with upper limb function and daily activities (n = 6, 38%). Good self-determination and/or self-concept (n = 5, 30%) was the most common protective factor. CONCLUSIONS Research using a strengths-based approach is needed to elucidate protective factors and further understanding of the intersection of person and socio-cultural risk factors of mental health in children with BPBI.
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Affiliation(s)
- Emily S Ho
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- Division of Plastic and Reconstructive Surgery, Department of Surgery, The Hospital for Sick Children, Toronto, Canada
| | - Diba Vahidi Ferdosi
- Division of Plastic and Reconstructive Surgery, Department of Surgery, The Hospital for Sick Children, Toronto, Canada
| | - Ava Pourtousi
- Division of Plastic and Reconstructive Surgery, Department of Surgery, The Hospital for Sick Children, Toronto, Canada
| | - Kristen M Davidge
- Division of Plastic and Reconstructive Surgery, Department of Surgery, The Hospital for Sick Children, Toronto, Canada
- Department of Surgery, University of Toronto, Toronto, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Canada
| | - Samantha J Anthony
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
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Tanrıverdi M, Hoşbay Z, Aydın A. Quality of upper extremity skills and disability inventory via manual ability classification in children with neonatal brachial plexus palsy. Disabil Rehabil 2024; 46:407-413. [PMID: 36582135 DOI: 10.1080/09638288.2022.2163311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 12/22/2022] [Indexed: 12/31/2022]
Abstract
PURPOSE The aim of study was to investigate the relationship between upper extremity skill quality and disability inventory according to manual ability classification system in children with neonatal brachial plexus palsy (NBPP). MATERIALS AND METHODS Children with NBPP were included between the ages of 4-7.5 years. Children were classified in Manual Ability Classification System (MACS). Upper extremity skill quality was evaluated with Quality of Upper Extremity Skills Test (QUEST), disability status was assessed with Pediatric Evaluation of Disability Inventory (PEDI). RESULTS Total of 63 children (girls:31/boys:32), and mean age was 6.32 ± 1.73 years. 37 (58.73%) of children were at MACS Level-2. According to MACS classification, significant differences were noted in PEDI scores (p = 0.001), dissociated movements (p = 0.016) and grasp (p = 0.002) domains of QUEST. However, no significant differences between QUEST total scores (p = 0.079). PEDI (ROC; AuC = 0.762) and QUEST total score (ROC; AuC = 0.714) were sensitive to difference between groups across MACS in children with NBPP. CONCLUSION The PEDI and QUEST are sensitive in distinguishing the disability of children with NBPP at different MACS levels. Assessment of children with NBPP is not limited to functionality, disability, and quality of movement, it is multidimensional. Outcomes measures studies of movement's quality in children with NBPP are needed.
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Affiliation(s)
- Müberra Tanrıverdi
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bezmialem Vakıf University, İstanbul, Turkey
| | - Zeynep Hoşbay
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Biruni University, İstanbul, Turkey
| | - Atakan Aydın
- Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of İstanbul Medicine, İstanbul University, İstanbul, Turkey
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Manske MC, Wilson MD, Wise BL, James MA, Melnikow J, Hedriana HL, Tancredi DJ. Association of Parity and Previous Birth Outcome With Brachial Plexus Birth Injury Risk. Obstet Gynecol 2023; 142:1217-1225. [PMID: 37797333 PMCID: PMC10592124 DOI: 10.1097/aog.0000000000005394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/20/2023] [Indexed: 10/07/2023]
Abstract
OBJECTIVE To evaluate the association of maternal delivery history with a brachial plexus birth injury risk in subsequent deliveries and to estimate the effect of subsequent delivery method on brachial plexus birth injury risk. METHODS We conducted a retrospective cohort study of all live-birth deliveries occurring in California-licensed hospitals from 1996 to 2012. The primary outcome was recurrent brachial plexus birth injury in a subsequent pregnancy. The exposure was delivery history (parity, shoulder dystocia in a previous delivery, or previously delivering a neonate with brachial plexus birth injury). Multiple logistic regression was used to model adjusted associations of delivery history with brachial plexus birth injury in a subsequent pregnancy. The adjusted risk and adjusted risk difference for brachial plexus birth injury between vaginal and cesarean deliveries in subsequent pregnancies were determined, stratified by delivery history, and the number of cesarean deliveries needed to prevent one brachial plexus birth injury was determined. RESULTS Of 6,286,324 neonates delivered by 4,104,825 individuals, 7,762 (0.12%) were diagnosed with a brachial plexus birth injury. Higher parity was associated with a 5.7% decrease in brachial plexus birth injury risk with each subsequent delivery (adjusted odds ratio [aOR] 0.94, 95% CI 0.92-0.97). Shoulder dystocia or brachial plexus birth injury in a previous delivery was associated with fivefold (0.58% vs 0.11%, aOR 5.39, 95% CI 4.10-7.08) and 17-fold (1.58% vs 0.11%, aOR 17.22, 95% CI 13.31-22.27) increases in brachial plexus birth injury risk, respectively. Among individuals with a history of delivering a neonate with a brachial plexus birth injury, cesarean delivery was associated with a 73.0% decrease in brachial plexus birth injury risk (0.60% vs 2.21%, aOR 0.27, 95% CI 0.13-0.55) compared with an 87.9% decrease in brachial plexus birth injury risk (0.02% vs 0.15%, aOR 0.12, 95% CI 0.10-0.15) in individuals without this history. Among individuals with a history of brachial plexus birth injury, 48.1 cesarean deliveries are needed to prevent one brachial plexus birth injury. CONCLUSIONS Parity, previous shoulder dystocia, and previously delivering a neonate with brachial plexus birth injury are associated with future brachial plexus birth injury risk. These factors are identifiable prenatally and can inform discussions with pregnant individuals regarding brachial plexus birth injury risk and planned mode of delivery.
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Affiliation(s)
- M. Claire Manske
- Assistant Professor, Department of Orthopaedic Surgery, University of California Davis, Sacramento, California, United States
- Department of Orthopaedic Surgery, Shriners Hospitals for Children Northern California, Sacramento, California, United States
| | - Machelle D. Wilson
- Principal Biostatistician, Clinical and Translational Science Center, Department of Public Health Sciences, Division of Biostatistics, University of California Davis, Sacramento, California, United States
| | - Barton L. Wise
- Professor, Department of Internal Medicine, University of California Davis, Sacramento, California, United States
| | - Michelle A. James
- Assistant Professor, Department of Orthopaedic Surgery, University of California Davis, Sacramento, California, United States
- Department of Orthopaedic Surgery, Shriners Hospitals for Children Northern California, Sacramento, California, United States
| | - Joy Melnikow
- Professor Emeritus, Department of Family and Community Medicine, University of California Davis, Sacramento, California, United States
| | - Herman L. Hedriana
- Professor and Chief, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of California Davis, Sacramento, California, United States
| | - Daniel J. Tancredi
- Professor in Residence, Department of Pediatrics, University of California Davis, Sacramento, California, United States
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Purther H, Nitert-Brown C, Vahidi Ferdosi D, Ho ES. Intersection of physical and mental health of youth with brachial plexus birth injuries: A qualitative study. HAND THERAPY 2023; 28:103-110. [PMID: 37904902 PMCID: PMC10581534 DOI: 10.1177/17589983231168034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 03/21/2023] [Indexed: 11/01/2023]
Abstract
Introduction Youth with brachial plexus birth injuries (BPBI) have an increased risk of mental health issues such as depression, anxiety, and diminished self-confidence. Despite this evidence, current standards of care focus on physical interventions. Evaluation of psychological and emotional concerns is rarely prioritized in clinical settings. Therefore, mental health needs are unmet and poorly understood. Methods An interpretivist qualitative approach was used to understand the perspectives of youth with BPBI and their caregivers on the barriers and facilitators of addressing mental health concerns, to inform practice guidelines, and promote meaningful participation within this population. Results A purposeful sample of nine youth with BPBI between 10 to 20 years and eight caregivers participated in in-depth interviews. The interviews were semi-structured and an average of 60 min (35-85 min) long. Three themes emerged from these data: (i) physical disability identity and mental health; (ii) pursuit of "normal" body image; and (iii) paradox of advocacy. Findings illuminated the intersection of physical and mental health in these youth and provides actionable practice recommendations. Areas of need were identified including mental health support around the challenges of advocacy, body image, surgery, and preparation for the 'aging out' process for youth and their families. Conclusions The well-being of youth with BPBI is a result of the intersection between their physical and mental health. Further research on optimizing mental health resources within physical health settings is needed to better support the holistic needs of these youth and their families.
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Affiliation(s)
- Halle Purther
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Cora Nitert-Brown
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Diba Vahidi Ferdosi
- Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, Toronto, ON, Canada
| | - Emily S Ho
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
- Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, Toronto, ON, Canada
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de Matos MA, Souto DO, Soares BA, de Oliveira VC, Leite HR, Camargos ACR. Effectiveness of Physical Therapy Interventions in Children with Brachial Plexus Birth Injury: A Systematic Review. Dev Neurorehabil 2023; 26:52-62. [PMID: 35848401 DOI: 10.1080/17518423.2022.2099995] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
AIM To systematically review the effectiveness of physical therapy interventions in infants, children and adolescents with brachial plexus birth injury (BPBI). METHODS Systematic review of randomized controlled trials including patients under 18 years old with BPBI was conducted on Medline, Cochrane, Embase, Amed and Pedro databases. Methodological quality was assessed by the PEDro score and quality of evidence by the GRADE system. The primary outcomes measured were range of motion, muscle strength and bone mineral density. RESULTS Seven studies were included, two in infant and 5 in children, of 932 title and abstracts screened. The interventions, characteristics of the participants and outcomes were diverse. The largest effect was found when other intervention was combined with conventional physical therapy in the primary outcomes, with low quality of evidence. CONCLUSION Physical therapy interventions alone or in combination with other treatment modalities are effective in improving short-term disabilities in children with BPBI.
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Affiliation(s)
- Mariana Aguiar de Matos
- Physical Therapy Department, Faculdade Sete Lagoas (FACSETE), Sete Lagoas, Minas Gerais, Brasil
| | - Deisiane Oliveira Souto
- Physical Therapy Department, Faculdade de Santa Luzia (UNIESP S.A), Santa Luzia, Minas Gerais, Brasil.,Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Bruno Alvarenga Soares
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Vinícius Cunha de Oliveira
- Graduate Program in Rehabilitation and Functional Performance, Faculty of Biological and Health Science Universidade Federal Dos Vales Do Jequitinhonha E Mucuri, Diamantina, Minas Gerais, Brazil
| | - Hércules Ribeiro Leite
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Cristina Resende Camargos
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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van der Laan TM, Postema SG, van der Sluis CK, Reneman MF. Functional capacity of individuals with brachial plexus injury. Work 2023; 76:1019-1030. [PMID: 37248939 PMCID: PMC10657678 DOI: 10.3233/wor-220414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 03/14/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND To enable (pain free) functioning, individuals with brachial plexus injury (BPI) may require a higher functional capacity compared to two-handed individuals, because the load on unaffected structures is greater. OBJECTIVE This study compared the functional capacity of individuals with BPI and healthy controls and explored differences in the functional capacity of BPI-affected individuals with respect to: those with and without hand function; affected and unaffected sides; with and without musculoskeletal complaints (MSCs). METHODS Six functional capacity tests adjusted for one-handed function were performed by 23 BPI-affected individuals and 20 healthy controls. Hand function was assessed through physical examination and the Dutch Musculoskeletal Questionnaire was used to assess MSCs. RESULTS Individuals with BPI scored lower for the two-handed tests, compared with the controls (p≤0.01, effect size (r) ≤-0.41 for both tests). However, both groups performed similar in the one-handed tests. On average individuals with BPI met the physical demands to perform sedentary to light physical work. Among BPI-affected individuals, two-handed overhead lifting capacity was higher in those with hand function than in those without hand function (p = 0.02; r = 0.33). Functional capacity tended to be lower for the unaffected side than for the affected side (4 tests; p≤0.05, r≤-0.36). Test results of BPI-affected Individuals with and without MSCs were similar. CONCLUSION Individuals with BPI demonstrated lower two-handed functional capacity than healthy controls. Effect sizes were medium. Capacity of their unaffected side was similar to the dominant side of controls. No association was found between MSCs and functional capacity.
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Affiliation(s)
- Tallie M.J. van der Laan
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sietke G. Postema
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Corry K. van der Sluis
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Michiel F. Reneman
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Prevalence of perinatal factors in infants with brachial plexus birth injuries and their association with injury severity. J Perinatol 2022; 43:578-583. [PMID: 36585508 DOI: 10.1038/s41372-022-01594-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To determine the prevalence of perinatal factors associated with brachial plexus birth injury (BPBI) in affected infants and their relationship with BPBI severity. STUDY DESIGN Retrospective study of BPBI infants prospectively enrolled in a multicenter registry. The prevalence of perinatal factors was calculated. Infants were stratified by injury severity and groups were compared to determine the association of severity and perinatal factors. RESULTS Seven-hundred-ninety-six BPBI infants had a mean 4.2 ± 1.6 perinatal factors. Nearly all (795/796) reported at least one factor, including shoulder dystocia(96%), no clavicle fracture (91%), difficult delivery(84%), parity >1(61%) and birthweight >4000 g(55%). Ten-percent (74/778) had Horner's syndrome and 28%(222/796) underwent nerve surgery. Birth asphyxia and NICU admission were significantly associated with injury severity. CONCLUSIONS NICU admission and asphyxia were associated with BPBI severity. An improved understanding of the relationship between perinatal factors and BPBI severity may be used to guide early referral to BPBI providers and support prevention efforts.
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van Leeuwen LM, Tamminga SJ, Ravinskaya M, de Wind A, Hahn EA, Terwee CB, Beckerman H, Boezeman EJ, Hoving JL, Huysmans MA, Nieuwenhuijsen K, de Boer AGEM, van der Beek AJ. Proposal to extend the PROMIS® item bank v2.0 'Ability to Participate in Social Roles and Activities': item generation and content validity. Qual Life Res 2020; 29:2851-2861. [PMID: 32488684 PMCID: PMC7561593 DOI: 10.1007/s11136-020-02540-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Previous research indicated that the Patient-Reported Outcomes Measurement Information System (PROMIS®) item bank v2.0 'Ability to Participate in Social Roles and Activities' may miss subdomains of social participation. The purpose of this study was to generate items for these missing subdomains and to evaluate their content validity. METHODS A three-step approach was followed: (1) Item generation for 16 International Classification of Functioning Disability and Health subdomains currently not covered by the item bank; (2) Evaluation of content validity of generated items through expert review (n = 20) and think-aloud interviews with a purposeful sample of people with and without (chronic) health conditions (n = 10), to assess item comprehensibility, relevance, and comprehensiveness; and 3) Item revision based on the results of step 2, in a consensus procedure. RESULTS First, 48 items were generated. Second, overall, content experts indicated that the generated items were relevant. Furthermore, based on experts' responses, items were simplified and 'participation in social media' was identified as an important additional subdomain of social participation. Additionally, 'participating in various social roles simultaneously' was identified as a missing item. Based on the responses of the interviewed adults items were simplified. Third, in total 17 items, covering 17 subdomains, were proposed to be added to the original item bank. DISCUSSION The relevance, comprehensibility and comprehensiveness of the 17 proposed items were supported. Whether the proposed extension of the item bank leads to better psychometric properties of the item bank should be tested in a large-scale field study.
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Affiliation(s)
- Lisette M van Leeuwen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology-Head and Neck Surgery, Ear & Hearing, Amsterdam Public Health Research Institute, De Boelelaan, 1081 BT, Amsterdam, Netherlands.
| | - Sietske J Tamminga
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef, Amsterdam, Netherlands
| | - Margarita Ravinskaya
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef, Amsterdam, Netherlands
| | - Astrid de Wind
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef, Amsterdam, Netherlands
| | - Elisabeth A Hahn
- Northwestern University Feinberg School of Medicine, Department of Medical Social Sciences, Chicago, IL, USA
| | - Caroline B Terwee
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, De Boelelaan, Amsterdam, Netherlands
| | - Heleen Beckerman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Public Health Research Institute, De Boelelaan, Amsterdam, Netherlands
| | - Edwin J Boezeman
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef, Amsterdam, Netherlands
| | - Jan L Hoving
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef, Amsterdam, Netherlands
| | - Maaike A Huysmans
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, De Boelelaan, Amsterdam, Netherlands
| | - Karen Nieuwenhuijsen
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef, Amsterdam, Netherlands
| | - Angela G E M de Boer
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef, Amsterdam, Netherlands
| | - Allard J van der Beek
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, De Boelelaan, Amsterdam, Netherlands
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Tamminga SJ, van Vree FM, Volker G, Roorda LD, Terwee CB, Goossens PH, Vliet Vlieland TPM. Changes in the ability to participate in and satisfaction with social roles and activities in patients in outpatient rehabilitation. J Patient Rep Outcomes 2020; 4:73. [PMID: 32870463 PMCID: PMC7462938 DOI: 10.1186/s41687-020-00236-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 08/13/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND One of the main aims of rehabilitation is to improve participation. Patient-Reported Outcomes Measurement Information System (PROMIS®) item banks 'Ability to Participate in Social roles and Activities, (PROMIS-APS) and 'Satisfaction with Social Roles and Activities' (PROMIS-SPS) are promising options to measure participation, but the literature on PROMIS measures of (satisfaction with) participation across diagnoses in rehabilitation is limited. Therefore, the objective of this study was to describe levels of and changes in participation, as assessed with the PROMIS-APS and the PROMIS-SPS short forms, of patients in outpatient rehabilitation. METHODS This study had quantitative, observational design with assessments at admission and discharge. Consecutive patients treated between April and August 2018 receiving outpatient multidisciplinary rehabilitation were the population of this study. The following diagnosis categories were included: brain injury (e.g. stroke), spinal cord and nerve injury, neuromuscular disorder (e.g. lateral sclerosis), amputation, musculoskeletal condition (e.g. osteoarthritis) or heart or lung disease (e.g. myocardial infarction, chronic obstructive pulmonary disease). The main patient-reported outcomes (PRO) of this study were the short form of the PROMIS-APS (8 items, Dutch general population reference score 50.6 [SD 9.5]), and PROMIS-SPS (8 items, Dutch general population reference score 47.5 [SD 8.3]. RESULTS Of the 1279 patients invited, 777 (61%) completed the online forms at admission. Of those, 329 patients were invited at discharge, with 209 (64%) completing the forms. The mean (SD) T-scores of the PROMIS-APS and PROMIS-SPS were lower at admission (42.7 [SD 7.4]; (41.4 [SD 7.7]) and discharge (43.6 [SD 7.2]; (43.7 [SD 7.8]) than the Dutch general population. The change scores of the PROMIS-APS and PROMIS-SPS were 1.2 (95% CI 0.4-1.9; p = 0.004; effect size 0.16), and 2.4 (95% CI 1.6-3.2; p < 0.0001; effect size 0.31), respectively. In all diagnostic subgroups with > 30 paired measurements statistically significant improvements of PROMIS-APS, PROMIS-SPS or both were seen. CONCLUSIONS Patients undergoing outpatient rehabilitation had, both at admission and discharge, considerably lower PROMIS-APS and PROMIS-SPS T-scores short forms than the general Dutch population, and showed small T-score improvements at discharge.
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Affiliation(s)
- Sietske J Tamminga
- Basalt Rehabilitation, Leiden/The Hague, the Netherlands.
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands.
| | | | - Gerard Volker
- Basalt Rehabilitation, Leiden/The Hague, the Netherlands
| | - Leo D Roorda
- Amsterdam Rehabilitation Research Center, Amsterdam, the Netherlands
| | - Caroline B Terwee
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | | | - Thea P M Vliet Vlieland
- Basalt Rehabilitation, Leiden/The Hague, the Netherlands
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, the Netherlands
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13
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de Wind A, van der Beek AJ, Boezeman EJ, Swenneker R, Anema JR, de Boer AGEM, Beckerman H, Hoving JL, Nieuwenhuijsen K, Scharn M, Stam M, Terwee CB, Frings-Dresen MHW, Tamminga SJ. A qualitative study investigating the meaning of participation to improve the measurement of this construct. Qual Life Res 2019; 28:2233-2246. [PMID: 30993605 PMCID: PMC6620252 DOI: 10.1007/s11136-019-02179-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE The purpose of this study was to improve the measurement of participation. Research questions were as follows: (1) What constitutes participation according to adults? (2) Do they mention participation subdomains that are not covered in the Patient-Reported Outcomes Measurement Information System (PROMIS) item bank "Ability to Participate in Social Roles and Activities"? METHODS Semi-structured interviews were conducted with 46 adults from the general population. Interviews were thematically analysed using the International Classification of Functioning, Disability and Health (ICF) as conceptual framework. Thereafter, assigned codes were compared to PROMIS item bank. RESULTS Participants mentioned a variety of participation subdomains that were meaningful to them, such as socializing and employment. All subdomains could be classified into the ICF. The following subdomains were not covered by the PROMIS item bank: acquisition of necessities, education life, economic life, community life, and religion and spirituality. Also a distinction between remunerative (i.e. paid) and non-remunerative (i.e. unpaid) employment, and domestic life was missing. Several ICF sub-codes were not mentioned, such as ceremonies. CONCLUSIONS Many participation subdomains were mentioned to be meaningful. As several of these subdomains are not covered in the PROMIS item bank, it may benefit from extension with new (patient-)reported subdomains of participation.
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Affiliation(s)
- Astrid de Wind
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Edwin J Boezeman
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, AMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Rosalie Swenneker
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Johannes R Anema
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Angela G E M de Boer
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, AMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Heleen Beckerman
- Department of Rehabilitation Medicine, MS Center Amsterdam, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Jan L Hoving
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, AMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.,Research Center for Insurance Medicine: collaboration between AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| | - Karen Nieuwenhuijsen
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, AMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Micky Scharn
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Mariska Stam
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Caroline B Terwee
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, AMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Sietske J Tamminga
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, AMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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Al-Mohrej OA, Mahabbat NA, Khesheaim AF, Hamdi NB. Characteristics and outcomes of obstetric brachial plexus palsy in a single Saudi center: an experience of ten years. INTERNATIONAL ORTHOPAEDICS 2018; 42:2181-2188. [PMID: 29777271 DOI: 10.1007/s00264-018-3975-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 05/04/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Obstetric brachial plexus palsy (OBPP) is considered a rare, unpredictable, and unavoidable injury of the upper limb. In this study, we presented a retrospective cohort study over a period of ten years in King Faisal Specialists Hospital and Research Centre (KFSH&RC), Riyadh, Saudi Arabia, to assess the characteristics and functional outcomes of OBPP. METHODS Between January 2005 and December 2015, we carried out 125 repairs of OBPP in KFSH&RC. Out of 71 girls and 54 boys, two babies died of unrelated causes, so they were excluded from the review. All medical records of the patients who attended OBPP clinic at KFSH&RC were reviewed, and relative data were extracted. Descriptive measures for categorical variables and categorical variables were presented. Student's t test and Pearson's χ2 test were used. The level of statistical significance was set at P ≤ 0.05. RESULTS A total of 123 patients were included in the study with a mean follow-up of 6.1 ± 2.4 years. Of those, 71 (57.7%) were females. Mean age at presentation was 4.2 ± 2.7 months with a birth weight of 3965.9 ± 629.6 g. More than half of the patients (56.1%) sustained the injury in the right side, and 62 patients (50.4%) were classified as Narakas I. Most of the surgeries (96.7%) were nerve grafting. Only 32 (26.0%) patients needed one or more secondary interventions. In the last visit, the mean total score of Mallet was 16.6 ± 2.8. Also, passive external rotation in adduction improved to 38.3 ± 14.5. Last Raimondi hand function grade was 2 ± 1. DISCUSSION Our experience demonstrated the value of primary and secondary surgeries in patients with OBPP. Also, we presented the patterns of injury in Saudi patients presented to KFSH&RC.
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Affiliation(s)
- Omar A Al-Mohrej
- Department of Orthopedic Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Nehal A Mahabbat
- Department of Plastic Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Asad F Khesheaim
- Department of Orthopedic Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Nezar B Hamdi
- Department of Orthopedic Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
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