Functional capacity of individuals with brachial plexus injury

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.

Musculoskeletal complaints, physical work demands, and functional capacity in individuals with a brachial plexus injury: An exploratory study

“…Individuals with MSCs performed the test one-handedly more often than those without MSCs. It is known that individuals with BPI who performed the test two-handedly performed worse, probably because their affected sides limited the time of their overhead working [ 25 ]. This factor may also explain the higher number of mismatches in the MSC- group.…”

“…Between February 2016 and July 2017 and between October 2018 and May 2019, we recruited 23 individuals with unilateral BPI (19 males, 4 females, mean age 49.7±10.4 years), all of whom had participated in a previous study aimed at determining their functional capacity, and asked for permission to observe them at their workplaces to evaluate their upper extremity work demands [ 25 ]. There had been a pause in recruitment because of unforeseen absence of the main researcher.…”

“…During the previous study all participants underwent a physical examination to determine remaining activity on the affected side and to check if the unaffected side retained normal function [ 25 ]. Their active range of motion was assessed, and the strength of hand and wrist muscles was determined using the Medical Research Council (MRC) scale, which has good concurrent validity (Spearman’s rho (r) = 0.78) and satisfactory inter-rater and intra-rater reliability (kappa values 0.78–0.88) [ 27 ].…”

“…Functional capacity was assessed using the FCE-OH [ 12 ], and was administered as a component of a previous study [ 25 ]. The FCE-OH is a short-form FCE for persons with only one functional hand or one functional hand and one hand with limited functionality.…”