Article

OBJECTIVE: To develop recommendations regarding outcome measures and topics to be
addressed in rehabilitation for persons with neuralgic amyotrophy (NA), this
study explored which functions and activities are related to persisting pain in
NA and which questionnaires best capture these factors. DESIGN: A
questionnaire-based survey from 2 cross-sectional cohorts, one of patients
visiting the neurology outpatient clinic and a cohort seen at a multidisciplinary
plexus clinic. SETTING: Two tertiary referral clinics based in the Department of
Neurology and Rehabilitation from a university medical center provided the data.
PARTICIPANTS: A referred sample of patients (N=248) with either idiopathic or
hereditary NA who fulfilled the criteria for this disorder, in whom the last
episode of NA had been at least 6 months ago and included brachial plexus
involvement. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Two custom
clinical screening questionnaires were used as well as the Shoulder Rating
Questionnaire-Dutch Language Version, the Shoulder Pain and Disability Index
(SPADI), the Shoulder Disability Questionnaire (SDQ), and Overall Disability Sum
Score. RESULTS: The survey confirms the high prevalence of persisting pain and
impairments. More than half of the patients were restricted by pain, while in
those without pain 60% experienced residual paresis. Correlations show an
intimate relation between pain, scapular instability, problems with overhead
activities, and increased fatigability. A standard physical therapy approach was
ineffective or aggravated symptoms in more than 50%. CONCLUSIONS: Pain and
fatigue are strongly correlated to persisting scapular instability and increased
fatigability of the affected muscles in NA. Our results suggest that an
integrated rehabilitation approach is needed in which all of these factors are
addressed. We further recommend using the SPADI and SDQ in future studies to
evaluate the natural course and treatment effects in NA.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS