Article

PURPOSE: To study the influence of obstetric brachial plexus lesion (OBPL) on
arm-hand function and daily functioning in adults, and to investigate the
relationship of arm-hand function and pain to daily functioning. METHOD: Adults
with unilateral OBPL who consulted the brachial plexus team at the VU University
Medical Center in the past were invited to participate. Daily functioning was
measured with the Disability of the Arm, Shoulder and Hand (DASH) questionnaire
and the SF36, pain with VAS Pain Scales and arm-hand function with the Nine Hole
Peg Test (9-HP-test) and the Action Research Arm Test (ARAT). Scores of the
affected arm were compared to those of the non-affected arm or norm values for
healthy controls. RESULTS: Twenty-seven persons (mean age 22, SD 4.2 years), of
whom 10 men, participated. The ARAT and 9-HP-test scores for the affected arm
were significantly worse than those for the non-affected arm. Moderate to severe
pain in the affected arm, the non-affected arm or the back was reported by 50% of
the participants. The DASH general, sports/music and SF36 physical functioning
scores were significantly worse than norm values. The ARAT/9-HP-test and daily
functioning showed little association. Low to moderate associations were found
between pain and daily functioning. CONCLUSIONS: Many young adults with OBPL
experience limitations in daily functioning. Pain, rather than arm-hand function,
seems to explain these limitations. Implications for Rehabilitation Obstetric
brachial plexus lesion (OBPL) is caused by traction to the brachial plexus during
labour, resulting in denervation of the muscles of the arm and shoulder girdle.
Adults with OBPL are hardly seen in rehabilitation medicine. This study shows
that many young adults with OBPL experience limitations in daily functioning.
Pain, rather than arm-hand function, seems to explain these limitations. Fifty
percent of the participants complained about moderate or severe pain, which was
located in the affected arm, the back and the non-affected arm. There seems an
age-related increase in pain prevalence. Persons who had undergone plexus surgery
had a significantly worse arm-hand function, but comparable scores on daily
functioning scales compared to persons without plexus surgery. When limitations
in daily functioning or pain occur, referral to a rehabilitation physician is
indicated.

Langue : ANGLAIS