Article

The aim of this cross-sectional study was to assess systematically motor
function and motor misrouting in adults with conservatively treated obstetric
brachial plexus lesion (OBPL). METHOD: Seventeen adults with OBPL (median age
38y; five males, 12 females) and 16 comparison participants (median age 26y;
eight males, eight females) were investigated. Motor function in the group with
OBPL was assessed through passive and active motion, muscle strength of the
deltoid, biceps, and triceps muscles, and Mallet aggregate score and five
subscores. Motor misrouting was quantified by electrically stimulating each of 10
arm muscles and recording activity from the other nine in response to this. Motor
function and motor misrouting were statistically analysed using the Mann-Whitney
U test and Spearman's correlation coefficient. RESULTS: Motor function testing
showed excellent strength but poor functional Mallet scores. Participants with
OBPL had significantly more motor misrouting than comparison participants
(Mann-Whitney U=31.5 [df=28], p<0.001, median difference=-4.00, 95% confidence
interval [CI]=-7.00 to -1.00). Most misrouting was observed when stimulating the
biceps (Mann-Whitney U=38.5 [df=31], p<0.001, median difference=-3.00, 95% CI
-3.00 to -1.00), deltoid (Mann-Whitney U=68.5 [df=31], p=0.003, median
difference=-1.0, 95% CI=-4.00 to 0.00 <0.001) and brachioradialis muscles
(Mann-Whitney U=72.0 [df=31], p=0.002, median difference <0.001, 95% CI=-3.00 to
0.00 <0.001). There were no significant correlations between the presence of
motor misrouting and impairment of motor function. INTERPRETATION: There is
extensive motor misrouting in conservatively treated OBPL. The presence of this,
in addition to motor functional impairment, suggests that motor misrouting should
be further studied in OBPL.
CI - (c) 2014 Mac Keith Press.

Langue : ANGLAIS