TY - JOUR
T1 - Evaluation of shoulder function after secondary surgery in children with Neonatal Brachial Plexus Palsy
AU - Van Der Holst, Menno
AU - Vlieland, Thea P M Vliet
AU - Meesters, Jorit J L
AU - Bekkering, W. Peter
AU - Nagels, Jochem
AU - Nelissen, Rob G H H
PY - 2015/9/6
Y1 - 2015/9/6
N2 - PURPOSE: Shoulder function in children with Neonatal Brachial Plexus Palsy (NBPP) can be impaired. Functional gain is possible by an internal contracture release and muscle tendon transfer (ICL+MTT) for external rotation. This study evaluates the functional results of this intervention. METHODS: Assessments were done pre-operatively and 3, 6 and 12 months thereafter and included joint-mobility (ROM), muscle strength, arm function (Assisting Hand Assessment (AHA) and Mallet-score), Quality of Life (QoL) (Pediatric Outcome Data Collecting Instrument (PODCI)) and parental satisfaction. Changes were examined using Wilcoxon's Signed-Rank test and Cohen's effect size. RESULTS: Ten children (5 boys) aged 3-10 years who underwent a combined ICL+MTT (mm. Latissimus Dorsi/Teres Major) were included. Active and passive external rotation ROM and muscle strength improved (p<0.05). Arm function improved according to the Mallet-score (Hand-to-Head, Hand-to-Mouth, External-Rotation) (p<0.05) and the arm use and pace scales of the AHA (p<0.05). The PODCI Upper Extremity/Physical Functioning and Global Functioning subscales also showed improvements (p<0.05). Parents were highly satisfied concerning daily life activities and sports. CONCLUSION: ICL+MTT leads to improvement of ROM, strength, arm function, QoL and high parental satisfaction in this studies' patients and is therefore a good intervention to consider in children with NBPP with limited shoulder function.
AB - PURPOSE: Shoulder function in children with Neonatal Brachial Plexus Palsy (NBPP) can be impaired. Functional gain is possible by an internal contracture release and muscle tendon transfer (ICL+MTT) for external rotation. This study evaluates the functional results of this intervention. METHODS: Assessments were done pre-operatively and 3, 6 and 12 months thereafter and included joint-mobility (ROM), muscle strength, arm function (Assisting Hand Assessment (AHA) and Mallet-score), Quality of Life (QoL) (Pediatric Outcome Data Collecting Instrument (PODCI)) and parental satisfaction. Changes were examined using Wilcoxon's Signed-Rank test and Cohen's effect size. RESULTS: Ten children (5 boys) aged 3-10 years who underwent a combined ICL+MTT (mm. Latissimus Dorsi/Teres Major) were included. Active and passive external rotation ROM and muscle strength improved (p<0.05). Arm function improved according to the Mallet-score (Hand-to-Head, Hand-to-Mouth, External-Rotation) (p<0.05) and the arm use and pace scales of the AHA (p<0.05). The PODCI Upper Extremity/Physical Functioning and Global Functioning subscales also showed improvements (p<0.05). Parents were highly satisfied concerning daily life activities and sports. CONCLUSION: ICL+MTT leads to improvement of ROM, strength, arm function, QoL and high parental satisfaction in this studies' patients and is therefore a good intervention to consider in children with NBPP with limited shoulder function.
KW - Brachial plexus neuropathy
KW - joint capsule release
KW - pediatrics
KW - physical therapy
KW - rehabilitation
KW - tendon transfer
KW - treatment outcome
UR - http://www.scopus.com/inward/record.url?scp=84941285835&partnerID=8YFLogxK
U2 - 10.3233/PRM-150332
DO - 10.3233/PRM-150332
M3 - Article
C2 - 26410061
AN - SCOPUS:84941285835
SN - 1874-5393
VL - 8
SP - 187
EP - 196
JO - Journal of Pediatric Rehabilitation Medicine
JF - Journal of Pediatric Rehabilitation Medicine
IS - 3
ER -