1
|
Millkvist H, Källströmer A, Bernspång B, Wiberg M. The impact of a soft robotic glove on activity performance and body function for brachial plexus birth injury patients-A longitudinal case series. J Hand Ther 2024:S0894-1130(24)00023-1. [PMID: 38937162 DOI: 10.1016/j.jht.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 02/23/2024] [Accepted: 02/26/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND A brachial plexus birth injury (BPBI) can cause reduced ability to use the arm and hand in daily activities due to reduced grip strength and endurance. A soft robotic glove can increase the number of activities performed and improve activity performance for patients with neurological disease. The use of a soft robotic glove for patients with BPBI has not been studied. PURPOSE To investigate if a soft robotic glove can improve activity performance and body function for patients with BPBI. STUDY DESIGN Longitudinal Case Series. METHODS A convenience sample of patients with BPBI, treated by the Brachial plexus injury service in Umeå, Sweden were studied. Eight patients used a soft robotic glove, (Carbonhand®), at home for three months. Data on activity performance and satisfaction with activity performance, active range of motion and strength were collected at baseline, and at three and four months. A patient evaluation form was filled out at three months, all patients kept a diary for three out of 12 weeks. RESULTS Six out of eight patients wanted to continue using the device and improved their self-perception of activity performance and satisfaction with the performance due to a more secure grip, compared to when not using the device. All patients had improved maximum strength and endurance in elbow flexion at three months. The device was useful as an assisting device and as a training tool. CONCLUSION A soft robotic glove (Carbonhand) may improve activity performance and perceived satisfaction and increase the number of activities that a person with BPBI can perform in everyday life. It is possible to increase strength in elbow flexion after using such a device. Due to this limited material, more research is needed.
Collapse
Affiliation(s)
- Helena Millkvist
- Hand and Plastic Surgery Clinic, University Hospital of Umeå, Umeå, Sweden; Department of Diagnostics and Intervention, Umeå University, Umeå, Sweden; Department of Community Medicine, Umeå University, Umeå, Sweden.
| | - Anna Källströmer
- Hand and Plastic Surgery Clinic, University Hospital of Umeå, Umeå, Sweden; Department of Diagnostics and Intervention, Umeå University, Umeå, Sweden
| | | | - Mikael Wiberg
- Hand and Plastic Surgery Clinic, University Hospital of Umeå, Umeå, Sweden; Department of Diagnostics and Intervention, Umeå University, Umeå, Sweden
| |
Collapse
|
2
|
Delioğlu K, Oksuz C, Fırat T. Bimanual ability for brachial plexus birth injury: a validity and reliability study of the ABILHAND-Kids. Disabil Rehabil 2024:1-8. [PMID: 38437156 DOI: 10.1080/09638288.2024.2325042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/24/2024] [Indexed: 03/06/2024]
Abstract
PURPOSE ABILHAND-Kids is a structured parent report that assesses manual ability in activities of daily living in children with cerebral palsy, and also brachial plexus birth injury (BPBI). This study investigated the validity, test-retest reliability, and internal consistency of the ABILHAND-Kids in children with BPBI. MATERIALS AND METHODS The ABILHAND-Kids was administered to parents of 119 children with BPBI between 6 and 15 years for validity and internal consistency, also 92 parents were re-interviewed after two weeks to establish test-retest reliability. Its concurrent validity was examined by correlating scores on the ABILHAND-Kids with Active Movement Scale-Total Score. RESULTS ABILHAND-Kids were strongly correlated with AMS-Total score (p < 0.001, r = 0.87) ABILHAND-Kids test-retest reliability was excellent (ICC: 0.93, %95 CI: 0.90-0.95). The internal consistency for the total score of ABILHAND-Kids was excellent (alpha = 0.94). For 20 items, item-total correlations were adequate (corrected item-total correlations, 0.27-0.85), one item which was "switching on a bedside lamb" had no adequate correlation (corrected item-total correlations, 0.011). The ABILHAND-Kids score showed a statistically significant difference between the Narakas types (p < 0.001). CONCLUSION The ABILHAND-Kids has excellent reliability and strong validity for measuring manual ability or bimanual performance in activities of daily living in children with BPBI.
Collapse
Affiliation(s)
- Kıvanç Delioğlu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Cigdem Oksuz
- Department of Occupational Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Tüzün Fırat
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| |
Collapse
|
3
|
Brown H, van der Looven R, Ho ES, Pondaag W. Patient reported outcomes in brachial plexus birth injury: results from the iPLUTO world-wide consensus survey. Disabil Rehabil 2024:1-7. [PMID: 38178598 DOI: 10.1080/09638288.2023.2298708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 12/16/2023] [Indexed: 01/06/2024]
Abstract
PURPOSE Brachial plexus birth injuries (BPBI) can have lifelong effects on the development and functional use of the upper extremity. Currently there is no agreement with regards to what patient-reported outcome (PRO) measures should be used. Therefore, the ability to compare the effects of treatment between individuals and institutions is challenging. This study aimed to achieve consensus among clinicians on the use of PRO measures within this patient group to allow for improved comparison of treatments and outcomes in the future. MATERIALS AND METHODS Online, a 3 round Delphi survey was completed by 35 international multi-disciplinary specialist centers. RESULTS All respondents (100%) agreed that PRO measures are useful for clinical evaluation and patient treatment. None of the outcome measures scored >75% agreement for ability to assess responsiveness and current state in children with BPBI as most outcome measures were judged as not specific for BPBI. Additionally, participant centers were asked their perspective on the best available PRO option for each of the 3 categories: functional use of the upper limb, quality of life and pain. This resulted in endorsement by the participant centers of the Brachial Plexus Outcome Measure - Self-Evaluation, the Pediatric Quality of Life Inventory, and Visual Analogue Scale/Brief Pain Inventory respectively. CONCLUSION International specialists in BPBI agree that PRO measures are important to use both clinically and in research in children aged 5 years and above.
Collapse
Affiliation(s)
- Hazel Brown
- Peripheral Nerve Injury Unit, Royal National Orthopaedic Hospital, Stanmore, London and Clinical Research Fellow, Centre for Nerve Engineering, University College London, London, UK
| | - Ruth van der Looven
- Child Rehabilitation, Department of Physical Medicine and Rehabilitation, Ghent University Hospital, Ghent, Belgium
| | - Emily S Ho
- Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Willem Pondaag
- Department of Neurosurgery, Leiden Nerve Center, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|
5
|
Koshinski JL, Russo SA, Zlotolow DA. Brachial Plexus Birth Injury: A Review of Neurology Literature Assessing Variability and Current Recommendations. Pediatr Neurol 2022; 136:35-42. [PMID: 36084421 DOI: 10.1016/j.pediatrneurol.2022.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 07/10/2022] [Accepted: 07/12/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Publications regarding the epidemiology and management of brachial plexus birth injury (BPBI) were evaluated to investigate treatment guidelines for children with BPBI. METHODS A search of neurology literature from 1990 to 2019 was performed using PubMed, Scopus, and Medline. Data including incidence, risk factors, spontaneous recovery rates, imaging studies, treatment recommendations, and indications and timing for surgery were collected. RESULTS A total of 46 total studies were reviewed. Reported incidence rates for BPBI ranged from 0.3 to 3 per 1000 births. Spontaneous recovery rates had an average reported range from 66% to 75%. Physical and occupational therapy were recommended in 37% of articles. Computed tomographic myelogram and magnetic resonance imaging of the brachial plexus were the most commonly recommended imaging studies for BPBI. Timelines for surgical interventions ranged from age three to nine months. Early referral was recommended in 28% of the articles included in the review. CONCLUSIONS Given the inconsistencies in spontaneous recovery rates, imaging recommendations, and timing of referral, establishing consistent clinical guidelines for patients with BPBI is crucial for management. Early referral to specialists for evaluation and treatment may improve outcomes in children with BPBI.
Collapse
Affiliation(s)
| | - Stephanie A Russo
- Department of Orthopaedic Surgery, Akron Children's Hospital, Akron, Ohio.
| | - Dan A Zlotolow
- Department of Orthopaedic Surgery, Shriners Hospital for Children, Philadelphia, Pennsylvania; The Hospital for Special Surgery, New York, New York
| |
Collapse
|
6
|
Tarakci E, Arman N, Tarakci D, Kasapcopur O. Leap Motion Controller-based training for upper extremity rehabilitation in children and adolescents with physical disabilities: A randomized controlled trial. J Hand Ther 2021; 33:220-228.e1. [PMID: 31010703 DOI: 10.1016/j.jht.2019.03.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 03/10/2019] [Accepted: 03/20/2019] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Randomized controlled trial. INTRODUCTION Juvenile idiopathic arthritis (JIA), cerebral palsy (CP), and brachial plexus birth injury (BPBI) are the most common disorders that cause upper extremity impairments in children and adolescents. Leap Motion Controller-based training (LMCBT) is a novel therapeutic method for upper extremity rehabilitation. PURPOSE OF THE STUDY The aim of the present study was to investigate the potential efficacy of an 8-week LMCBT program set as an upper extremity rehabilitation program by comparing conventional rehabilitation program in children and adolescents with physical disabilities such as JIA, CP, and BPBI. METHODS A randomized control trial which included children and adolescents of different disabilities (JIA, CP, BPBI) were grouped according to their diagnosis. All patients were randomized into 2 groups namely LMCBT (group I) and conventional treatment (group II) for the treatment (3 days/8 weeks). Duruoz Hand Index and Jebson Taylor Hand Function Test were used as primary outcomes. Secondary outcomes included the nine-hole peg test, Childhood Health Assessment Questionnaire, and assessments of grip and pinch strength using a dynamometer. RESULTS One hundred three patients were included in the study, and 92 of them completed the treatment. After treatment, significant differences were found in Childhood Health Assessment Questionnaire, Duruoz Hand Index, Jebson Taylor Hand Function Test, nine-hole peg test, and grip and pinch strength scores in almost all groups (effect size [ES] = 0.10 to -0.77 for group I and 0.09 to -0.70 for group II in CP; ES = 0.31 to 2.65 for the group I and 0.12 to 1.66 for group II in JIA; and ES = 0 to -0.44 for group I and 0.08 to -0.62 for group II in BPBI) (P < .05). Comparisons between LMCBT and conventional treatment groups showed similar results in all parameters in all disease groups (P > .05). CONCLUSIONS This study has quantitatively shown that LMCBT should be used as an effective alternative treatment option in children and adolescents with physical disabilities.
Collapse
Affiliation(s)
- Ela Tarakci
- Faculty of Health Sciences, Department of Neurological Physiotherapy and Rehabilitation, Istanbul University-Cerrahpasa, Bakirkoy, Istanbul, Turkey.
| | - Nilay Arman
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul University-Cerrahpasa, Bakirkoy, Istanbul, Turkey
| | - Devrim Tarakci
- Faculty of Health Sciences, Department of Ergotherapy, Istanbul Medipol University, Bakirkoy, Istanbul, Turkey
| | - Ozgur Kasapcopur
- Medical Faculty of Cerrahpasa, Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa, Bakirkoy, Istanbul, Turkey
| |
Collapse
|
7
|
Van der Looven R, Le Roy L, Tanghe E, Samijn B, Roets E, Pauwels N, Deschepper E, De Muynck M, Vingerhoets G, Van den Broeck C. Risk factors for neonatal brachial plexus palsy: a systematic review and meta-analysis. Dev Med Child Neurol 2020; 62:673-683. [PMID: 31670385 DOI: 10.1111/dmcn.14381] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/17/2019] [Indexed: 02/02/2023]
Abstract
AIM To provide a comprehensive update on the most prevalent, significant risk factors for neonatal brachial plexus palsy (NBPP). METHOD Cochrane CENTRAL, MEDLINE, Web of Science, Embase, and ClinicalTrials.gov were searched for relevant publications up to March 2019. Studies assessing risk factors of NBPP in relation to typically developing comparison individuals were included. Meta-analysis was performed for the five most significant risk factors, on the basis of the PRISMA statement and MOOSE guidelines. Pooled odds ratios (ORs), 95% confidence intervals (CIs), and across-study heterogeneity (I2 ) were reported. Reporting bias and quality of evidence was rated. In addition, we assessed the incidence of NBPP. RESULTS Twenty-two observational studies with a total sample size of 29 419 037 live births were selected. Significant risk factors included shoulder dystocia (OR 115.27; 95% CI 81.35-163.35; I2 =92%), macrosomia (OR 9.75; 95% CI 8.29-11.46; I2 =70%), (gestational) diabetes (OR 5.33; 95% CI 3.77-7.55; I2 =59%), instrumental delivery (OR 3.8; 95% CI 2.77-5.23; I2 =77%), and breech delivery (OR 2.49; 95% CI 1.67-3.7; I2 =70%). Caesarean section appeared as a protective factor (OR 0.13; 95% CI 0.11-0.16; I2 =41%). The pooled overall incidence of NBPP was 1.74 per 1000 live births. It has decreased in recent years. INTERPRETATION The incidence of NBPP is decreasing. Shoulder dystocia, macrosomia, maternal diabetes, instrumental delivery, and breech delivery are risk factors for NBPP. Caesarean section appears as a protective factor. WHAT THIS PAPER ADDS The overall incidence of neonatal brachial plexus palsy is 1.74 per 1000 live births. The incidence has declined significantly. Shoulder dystocia, macrosomia, maternal diabetes, instrumental delivery, and breech delivery are the main risk factors. Prevention is difficult owing to unpredictability and often labour-related risk.
Collapse
Affiliation(s)
- Ruth Van der Looven
- Department of Physical and Rehabilitation Medicine, Child Rehabilitation, Ghent University Hospital, Ghent, Belgium
| | - Laura Le Roy
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - Emma Tanghe
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - Bieke Samijn
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - Ellen Roets
- Department of Obstetrics and Gynaecology, Prenatal Diagnosis Centre, Ghent University Hospital, Ghent, Belgium
| | - Nele Pauwels
- Knowledge Centre for Health Ghent, Ghent University Hospital, Ghent, Belgium
| | - Ellen Deschepper
- Biostatistics Unit, Department of Public Health, Ghent University, Ghent, Belgium
| | - Martine De Muynck
- Department of Physical and Rehabilitation, Ghent University Hospital, Ghent, Belgium
| | - Guy Vingerhoets
- Department of Experimental Psychology, Faculty of Psychological and Educational Sciences, Ghent University, Ghent, Belgium
| | | |
Collapse
|
8
|
Medeiros DLD, Agostinho NB, Mochizuki L, Oliveira ASD. QUALITY OF LIFE AND UPPER LIMB FUNCTION OF CHILDREN WITH NEONATAL BRACHIAL PLEXUS PALSY. ACTA ACUST UNITED AC 2020; 38:e2018304. [PMID: 32159646 PMCID: PMC7063594 DOI: 10.1590/1984-0462/2020/38/2018304] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 12/23/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To compare the upper limb function and quality of life between children with neonatal brachial plexus palsy and controls with unaffected brachial plexus (typical children). METHODS Twenty-four children with neonatal brachial plexus palsy and 24 typical ones were evaluated, both groups with 10±3 years of age. The upper limb function was assessed by the Modified Mallet Scale and the Active Movement Scale, whereas quality of life was analyzed by the Pediatric Outcome Data Collection Instrument and the Child Health Questionnaire. Mann-Whitney U tests investigated the differences between groups in such scales. RESULTS Children with neonatal brachial plexus palsy presented lower limb function compared to typical children in both scales. These children also presented lower scores for most of the Pediatric Outcome Data Collection Instrument domains, except for comfort/pain. In addition, they had lower scores in the following domains of the Child Health Questionnaire: physical functioning, pain, behavior, mental health, overall health perception, emotional impact on parents, and psychosocial summarized score. CONCLUSIONS Neonatal brachial plexus palsy has a negative influence on upper limb function and quality of life, mainly considering overall health, basic mobility, physical and psychosocial functions, happiness, pain, behavior, mental health, upper limb function, and emotional impact on their parents.
Collapse
|
9
|
Reliability and validity of the Brachial Plexus Outcome Measure in children with obstetric brachial plexus palsy. J Hand Ther 2020; 32:382-387. [PMID: 29395601 DOI: 10.1016/j.jht.2017.10.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 10/09/2017] [Accepted: 10/09/2017] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Clinical measurement and cross-sectional study. INTRODUCTION Numerous scales have been developed to examine activities of daily living and function in children with brachial plexus palsy. The Brachial Plexus Outcome Measure (BPOM) scale was developed in 2012 by Emily S. Ho and contains 14 items that measure activity and self-evaluation. PURPOSE OF THE STUDY The aim of the study was to cross-culturally translate the BPOM scale into Turkish and test its measurement properties in children with brachial plexus palsy. METHODS The scale was translated into Turkish using standard cross-cultural translation procedures. Forty-eight children with obstetric brachial plexus palsy (OBPP) were included in psychometric evaluations. Internal structure consistency and test-retest reliability were measured for reliability analyses. For each item on the scale, Cronbach alpha coefficient and item-total score correlations for all subscales were calculated. The scale was administered at baseline and 1 week later by 2 different physiotherapists to evaluate test-retest reliability. Concurrent construct validity was assessed using Pearson correlations between the OBPP and the Mallet classification system. RESULTS Eighteen (37.5%) girls and 30 (62%) boys, in total 48 children, whose mean age was 8.7 ± 2.4 (minimum-maximum = 5-14) years were included in the study; 9 (18.9%) have a history of both early microsurgery and tendon transfers and 39 (81.3%) have a history of only tendon transfer. Cronbach alpha ranged from 0.89 to 0.96, and for the whole scale, it was calculated as 0.938. DISCUSSION Test-retest reliability was high. Moderate correlations were observed between the measures. CONCLUSION The Turkish BPOM scale is a valid and reliable measurement for assessing function in children with OBPP in the Turkish population.
Collapse
|
10
|
Aktaş D, Eren B, Keniş-Coşkun Ö, Karadag-Saygi E. Function in unaffected arms of children with obstetric brachial plexus palsy. Eur J Paediatr Neurol 2018; 22:610-614. [PMID: 29627308 DOI: 10.1016/j.ejpn.2018.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 03/12/2018] [Accepted: 03/20/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The objective is to compare the fine and gross motor function of unaffected arms of children with obstetric brachial plexus palsy (OBBP) with typically developing children's dominant upper extremities. METHODS Fifty-three patients with OBBP and fifty-one typically developing children between the age of 4 and 13 were included in the study. For gross motor function evaluation in the upper extremity box-block test (BBT), for fine motor skill nine-hole peg (9HP) test was used. For grasp and pinch strength measurements, a Jamar dynamometer is used. RESULTS The patient group performed significantly worse in 9HP and BBT tests. When further divided into age groups, 4-8 age patient group performed significantly worse in 9HP and BBT tests, while there were no differences in children in the 9-13 age group. CONCLUSIONS The fine and gross motor functions of the unaffected arms of children with OBPP are significantly worse in children between the ages of four and eight but this deficit improves with age, and possibly with ongoing therapy.
Collapse
Affiliation(s)
- Dilek Aktaş
- Marmara University Medical Faculty, Physical Medicine and Rehabilitation Department, Istanbul, Turkey
| | - Beyhan Eren
- Mersin County Hospital, Physical Medicine and Rehabilitation Department, Mersin, Turkey
| | - Özge Keniş-Coşkun
- Marmara University Medical Faculty, Physical Medicine and Rehabilitation Department, Istanbul, Turkey.
| | - Evrim Karadag-Saygi
- Marmara University Medical Faculty, Physical Medicine and Rehabilitation Department, Istanbul, Turkey
| |
Collapse
|
11
|
van der Holst M, Groot J, Steenbeek D, Pondaag W, Nelissen RG, Vliet Vlieland TP. Participation restrictions among adolescents and adults with neonatal brachial plexus palsy: the patient perspective. Disabil Rehabil 2017; 40:3147-3155. [PMID: 28944700 DOI: 10.1080/09638288.2017.1380717] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To examine the impact of neonatal brachial plexus palsy (NBPP) on societal participation of adolescents and adults. METHODS This cross-sectional study was conducted among patients with NBPP, aged ≥16 years, who had visited our NBPP clinic. Patients completed questions on the influence of NBPP on their choices regarding education/work and their work-performance, the Impact on Participation/Autonomy questionnaire and the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P). In addition, health-related quality of life (HRQoL) was assessed. RESULTS Seventy-five patients participated (median age 20, inter quartile range 17-27). Twenty were full-time students, 28 students with a job, 21 employed, two unemployed, and four work-disabled. Sixty-six patients had had a job at some stage. Patients' overall HRQoL was comparable to the general population. 27/75 patients reported that NBPP had affected their choices regarding education and 26/75 those regarding work. 33/66 reported impact on their work performance. On the Impact on Participation/Autonomy questionnaire, 80% (49/61) reported restrictions in the work-and-education domain, 74% in social-relations and 67% in autonomy-outdoors. 37/61 reported participation restrictions on the USER-P. CONCLUSIONS Although their overall HRQoL was not impaired, a substantial proportion of adolescent/adult patients reported that NBPP had an impact on choices regarding education and profession, as well as on work-performance. Restrictions in participation, especially in work and education were also reported. Guiding patients in making choices on education and work at an early stage and providing tailored physical as well as psychosocial care may prevent or address restrictions, which may improve participation. Implications for Rehabilitation Adolescent and adult patients with neonatal brachial plexus palsy perceive restrictions in societal participation, especially regarding the work-and-education domain. All patients with neonatal brachial plexus palsy may perceive restrictions in societal participation regardless of lesion severity, treatment history and side of the lesion. Adolescents and adults with neonatal brachial plexus palsy report that their choices regarding education and work, as well as their work-performance are influenced by their neonatal brachial plexus palsy. Patients with neonatal brachial plexus palsy should be followed throughout their life in order to provide them with appropriate information and treatment when health- or participation-related issues arise. Rehabilitation treatment is the best option to address all of the aforementioned issues, as surgical options in adolescents and adults are limited.
Collapse
Affiliation(s)
- Menno van der Holst
- a Department of Orthopaedics, Rehabilitation and Physical Therapy , Leiden University Medical Center , Leiden , The Netherlands.,b Rijnlands Rehabilitation Center , Leiden , The Netherlands
| | - Jeroen Groot
- a Department of Orthopaedics, Rehabilitation and Physical Therapy , Leiden University Medical Center , Leiden , The Netherlands.,c Sophia Rehabilitation , The Hague , The Netherlands
| | - Duco Steenbeek
- a Department of Orthopaedics, Rehabilitation and Physical Therapy , Leiden University Medical Center , Leiden , The Netherlands.,b Rijnlands Rehabilitation Center , Leiden , The Netherlands
| | - Willem Pondaag
- d Department of Neurosurgery , Leiden University Medical Center , Leiden , The Netherlands
| | - Rob Ghh Nelissen
- a Department of Orthopaedics, Rehabilitation and Physical Therapy , Leiden University Medical Center , Leiden , The Netherlands
| | - Thea Pm Vliet Vlieland
- a Department of Orthopaedics, Rehabilitation and Physical Therapy , Leiden University Medical Center , Leiden , The Netherlands.,b Rijnlands Rehabilitation Center , Leiden , The Netherlands.,c Sophia Rehabilitation , The Hague , The Netherlands
| |
Collapse
|
12
|
Abstract
PURPOSE This study described physical and psychosocial limitations associated with adult brachial plexus injuries (BPI) and patients' expectations of BPI surgery. METHODS During in-person interviews, preoperative patients were asked about expectations of surgery and preoperative and postoperative patients were asked about limitations due to BPI. Postoperative patients also rated improvement in condition after surgery. Data were analyzed with qualitative and quantitative techniques. RESULTS Ten preoperative and 13 postoperative patients were interviewed; mean age was 37 years, 19 were men, all were employed/students, and most injuries were due to trauma. Preoperative patients cited several main expectations, including pain-related issues, and improvement in arm movement, self-care, family interactions, and global life function. Work-related expectations were tailored to employment type. Preoperative and postoperative patients reported that pain, altered sensation, difficulty managing self-care, becoming physically and financially dependent, and disability in work/school were major issues. All patients reported making major compensations, particularly using the uninjured arm. Most reported multiple mental health effects, were distressed with long recovery times, were self-conscious about appearance, and avoided public situations. Additional stresses were finding and paying for BPI surgery. Some reported BPI impacted overall physical health, life priorities, and decision-making processes. Four postoperative patients reported hardly any improvement, four reported some/a good deal, and five reported a great deal of improvement. CONCLUSIONS BPI is a life-altering event affecting physical function, mental well-being, financial situation, relationships, self-image, and plans for the future. This study contributes to clinical practice by highlighting topics to address to provide comprehensive BPI patient-centered care.
Collapse
|