Explaining daily functioning in young adults with obstetric brachial plexus lesion

Heer, Johannes; Beckerman, Heleen; Groot, Vincent de

doi:10.3109/09638288.2014.972578

Cited by 10 publications

(8 citation statements)

References 28 publications

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“…Deformities occur and may cause painful arthrosis in adults. Children with incomplete recovery have considerable risk for long‐term functional limitations, with financial burden, restricted daily life activities, limited participation, and important overall quality of life implications …”

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confidence: 99%

“…Children with incomplete recovery have considerable risk for long-term functional limitations, with financial burden, restricted daily life activities, limited participation, and important overall quality of life implications. 16,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] The potential impact of NBPP on the child's physical and psychological development, and their socio-economic future, highlights the need for the development of preventive strategies. Early identification of modifiable risk factors is therefore imperative.…”

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confidence: 99%

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Risk factors for neonatal brachial plexus palsy: a systematic review and meta‐analysis

Looven

Roy

Tanghe

et al. 2019

Develop Med Child Neuro

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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.

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confidence: 99%

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confidence: 99%

Risk factors for neonatal brachial plexus palsy: a systematic review and meta‐analysis

Looven

Roy

Tanghe

et al. 2019

Develop Med Child Neuro

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“…Obstetric brachial plexus injuries (OBPI) refer to injuries of the brachial plexus that occur during delivery ( 1 ). The incidence of OBPI is documented in Norway with 0.3%, with a relatively high recovery rate, nonetheless one in every 2,000 babies has to live with a permanent injury of the plexus ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

“…These limited options are reflected by the impaired hand function described by many adults after severe OBPI. Common clinical findings include problems in performing daily activities due to a lack of useful hand function, a high prevalence of pain as well as reduced sensation, arthritis, and an overall reduced quality of life ( 1 , 7 , 8 ). Despite their perceived disability, this patient group rarely receives rehabilitation measures ( 1 ) which might be related to the limited options available.…”

Section: Introductionmentioning

confidence: 99%

Case Report: Bionic Reconstruction in an Adult With Obstetric Brachial Plexus Injury

Boesendorfer

Sturma

Gstoettner

et al. 2022

Front. Rehabilit. Sci.

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Introduction: Many adults who had a severe Narakas IV obstetric brachial plexus injury (OBPI) suffer from extensive impairments in daily living due to limited hand-arm function. The dramatic loss of axonal support at this very early age of development often render the entire extremity a biologic wasteland and reconstructive methods and therapies often fail to recover any functional hand use. In this scenario bionic reconstruction, including an elective amputation and a subsequent prosthetic fitting, may enable functional improvement in adults suffering from the consequences of such severe brachial plexus injuries. We here describe our experience in treating such patients and lay out the surgical rational and rehabilitation protocol exemplified in one patient.Case Presentation/Methods: A 27-year-old adult with a unilateral OBPI contacted our center. He presented with globally diminished function of the affected upper extremity with minimal hand activity, resulting in an inability to perform various tasks of daily living. No biological reconstructive efforts were available to restore meaningful hand function. An interdisciplinary evaluation, including a psychosocial assessment, was used to assess eligibility for bionic reconstruction. Before the amputation and after the prosthetic fitting functional assessments and self-reported questionnaires were performed.Results: One month after the amputation and de-rotation osteotomy of the humerus the patient was fitted with a myoelectric prosthesis. At the 1.5 year-follow-up assessment, the patient presented with a distinct improvement of function: the ARAT improved from 12 to 20 points, SHAP score improved from 8 to 29, and the DASH value improved from 50 to 11.7. The average wearing times of the prosthesis were 5 to 6 h per day (on 4–5 days a week).Discussion: The options for adults suffering from the consequences of severe OBPIs to improve function are limited. In selected patients in whom the neurological deficit is so severe that biologic hand function is unsatisfactory, an elective amputation and subsequent restoration of the hand with mechatronic means may be an option. The follow-up results indicate that this concept can indeed lead to solid hand function and independence in daily activities after amputation, subsequent prosthetic fitting, and rehabilitation.

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“…Nesse estudo encontramos a média de 40,9 no DASH, o que indica, portanto, que as trabalhadoras apresentam perda parcial da capacidade funcional e esse valor também se encontra mais elevado do que em estudos na área da saúde, mesmo em pacientes com sequelas neurológicas (Heer, Beckerman, Groot, 2015).…”

Section: Discussionunclassified

Restrições em trabalhadores de enfermagem: perfil e intervenções da terapia ocupacional

Ratier¹

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Introduction: Hospital nursing workers have a high risk of developing Work-Related Musculoskeletal Disorders (WMSDs), mainly due to intense exposure to workloads. The individual and institutional consequences of WMSDs are devastating and even worse in the case of readjusted workers. Thus, it is imperative to understand their limitations and perform rehabilitation treatment, aiming to improve their symptoms and their functional capacity. Objective: to identify sociodemographic, health and occupational status of readjusted workers and to evaluate the impact of occupational therapy interventions. Method: a quantitative experimental uncontrolled randomized clinical trial, in a public hospital in the city of São Paulo. Data collection occurred from May to November 2017, with 25 readjusted nursing workers with limitations in the Upper Limbs (UL); instruments used were a questionnaire containing sociodemographic, occupational and health data and three standardized ones -Disabilities of the Arm, Shoulder and Hand (DASH), Nordic Musculoskeletal Questionnaire (NMQ) and the Visual Analogue Scale (VAS) of pain. After characterization, a subgroup underwent individual treatment of occupational therapy and was re-evaluated at the end of treatment. Data were submitted to descriptive analysis and descriptive and analytical statistical treatment. Results: 25 workers, women, being three nurses, four nursing aides and 18 nursing technicians, with 48 years old of average age and an average of 19 working years, followed the inclusion criteria. Working in 11 different hospital settings, they presented a mean BMI of 29,55, with eight athletes and an average of two WMSDs and two work limitations per person, also featuring a high number of comorbidities. The predominant work activities were: writing, checking vital signs and medication. According to the NMQ of the previous 12 months, the highest prevalences of symptoms were 92% in

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Explaining daily functioning in young adults with obstetric brachial plexus lesion

Cited by 10 publications

References 28 publications

Risk factors for neonatal brachial plexus palsy: a systematic review and meta‐analysis

Risk factors for neonatal brachial plexus palsy: a systematic review and meta‐analysis

Case Report: Bionic Reconstruction in an Adult With Obstetric Brachial Plexus Injury

Restrições em trabalhadores de enfermagem: perfil e intervenções da terapia ocupacional

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