Quality of Life and Upper Limb Function of Children With Neonatal Brachial Plexus Palsy

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. Objetivo: Comparar a função do membro superior e a qualidade de vida entre crianças com paralisia obstétrica do plexo braquial e aquelas sem paralisia do plexo braquial (crianças usuais). Métodos: Foram avaliadas 24 crianças com paralisia obstétrica do plexo braquial e 24 crianças usuais, ambos os grupos com 10±3 anos. A função do membro superior foi avaliada pela Escala Mallet Modificada e Active Movement Scale, já a qualidade de vida foi analisada por meio das escalas Pediatric Outcome Data Collection Instrument e Child Health Questionnaire. Foram realizados testes U de Mann-Whitney para investigar diferenças entre os grupos nas escalas. Resultados: Crianças com paralisia obstétrica do plexo braquial apresentaram menor função do membro superior quando comparadas às crianças usuais, em ambas as escalas utilizadas. Essas crianças também apresentaram menores pontuações para a maioria dos domínios do Pediatric Outcome Data Collection, exceto para conforto/dor. Além disso, apresentaram escores inferiores nos seguintes domínios do Child Health Questionnaire: função física, dor, comportamento, saúde mental, percepção da saúde em geral, impacto emocional nos pais e pontuação psicossocial resumida. Conclusões: A paralisia obstétrica do plexo braquial tem uma influência negativa na função do membro superior e na qualidade de vida, principalmente em relação à saúde geral, mobilidade básica, funções física e psicossocial, felicidade, dor, comportamento, saúde mental, funcionalidade do membro superior e impacto emocional nos pais. Palavras-chave: Criança; Qualidade de vida; Extremidade superior; Movimento; Plexo braqu...

Intersection of physical and mental health of youth with brachial plexus birth injuries: A qualitative study

“…This research supports the findings of previous studies that youth with BPBI experience poorer HRQoL associated with mental health as well as participation restrictions. 3,9,26 Further, this study extends previous research in identifying that not only is participation reduced, but that this had direct Support for transitions to adulthood Anxiety of transitioning from pediatric services "We've been followed there for 18 years… and now all of a sudden, I'm starting to panic because I feel like I'm about to be thrown into the ocean without a life jacket on, and it's a horrible, horrible feeling" Megan's mom (17 years, she/her) negative effects on the mental health of these youth. Using mixed methods, previous studies have shown that these youth have appearance-related and body image concerns and socio-emotional health risks.…”

“… 2 At a basic level, the stress of living with physical impairments, pain, and ongoing medical care negatively affects their health-related quality of life (HRQoL). 3 , 4 Youth with BPBI report decreased participation in self-care and leisure activities such as bathing, handwriting, swimming and eventually, choice of employment and education pursuits. 5 , 6 Though youth report decreased participation in these domains, it is unknown how these difficulties affect their mental health.…”

“…Evidence from studies using patient-reported outcomes indicates that these youth have reduced self-confidence, subjective well-being, and psychosocial functioning. 3 , 7 , 8 , 9 However, it is unclear if these factors directly link to poor mental health outcomes and mental disorders in these children. As participation is influenced by mental and physical factors, exploring mental health experiences that include mental well-being and disorder, is an important step to characterizing participation of youth with BPBI.…”

Recent Advances in the Treatment of Brachial Plexus Birth Injury

“…[106][107][108] The 2016 iPLUTO consensus data (Table 1), although representing an important step forward, focused exclusively on motor recovery, with no inclusion of sensory outcome, pain, social integration, functional participation, or overall quality of life. 109 The current focus of iPLUTO is establishing global consensus for patient-reported outcome measures in children and in adolescents with BPBI with respect to functional status, health-related quality of life, and pain. 110 As of January of 2021, consensus has been reached on the Faces Pain Scale to evaluate pain in children 111 and the Brachial Plexus Outcome Measurement to evaluate functional status in adolescents.…”

A eficácia da terapia de movimento induzido por contensão em crianças menores de 3 anos: uma revisão sistemática

“…Ambas as condições, PCU e PBP, evoluem com dificuldade na utilização do membro superior acometido devido às alterações de força e amplitude de movimento, desenvolvendo o "não uso aprendido" [8,9]. Estes déficits interferem no uso do membro superior, bem como no desempenho bimanual, podendo resultar em limitações de atividades simples, tais como vestir e tirar as roupas, amarrar cadarços ou colocar os sapatos, escovar os dentes, abrir o pote de biscoitos, dentre outras [10][11][12].…”