Division of Pediatric Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Division of Occupational and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
J Pediatr Rehabil Med. 2020;13(1):47-55. doi: 10.3233/PRM-190603.
The brachial plexus is a network of nerves exiting the spinal cord through the fifth, sixth, seventh, and eighth cervical nerves (C5-C8) as well as the first thoracic nerve (T1) to conduct signals for motion and sensation throughout the arm. Brachial plexus birth injuries (BPBI) occur in 1.5 per 1,000 live births. The purpose of this study was to determine the perceived change in musculoskeletal health-related quality of life of brachial plexus patients utilizing the Pediatric Outcomes Data Collection Instrument (PODCI). PODCI scores were examined along with the patient's procedure history (surgical or Botulinum Toxin), extent of involvement and demographics.
A total of 81 patients from two to eighteen years of age from nine different states met the inclusion criteria of having a pre-procedure and post-procedure PODCI score along with a Narakas score from 2002-2017. These patients were seen at the Brachial Plexus Center, which is an interdisciplinary clinic at a large academic medical centerMETHODS: This retrospective study utilized PODCI data collected annually during their regular brachial plexus clinic visits. Upper extremity (UE) and global functioning (GFx) scores pre- and post-procedure were stratified by Narakas Classification. Data were analyzed using paired t-test and ANOVA testing.
Patients with a Brachial Plexus Birth Injury (BPBI) had lower PODCI scores for UE and GFx when compared with the pediatric normative scores for age-matched healthy children. Scores in both UE and GFx domains were higher after procedure in the groups of Narakas I and IV. There was significant correlation between UE and GFx scores and documented first PODCI score (2 years of age) and age at intervention (5 years of age).
Procedures increased the perceived quality of life for children with a BPBI and increased their overall PODCI scores for both UE and GFx.
臂丛是一组神经，从脊髓通过第五、六、七和第八颈椎神经（C5-C8）以及第一胸椎神经（T1）出来，传递手臂运动和感觉的信号。臂丛神经出生损伤（BPBI）在每 1000 例活产中发生 1.5 例。本研究的目的是利用儿科结果数据采集工具（PODCI）确定臂丛神经患者的肌肉骨骼健康相关生活质量的感知变化。检查了 PODCI 评分以及患者的手术史（手术或肉毒杆菌毒素）、受累程度和人口统计学特征。
来自九个州的年龄在 2 至 18 岁之间的 81 名患者符合纳入标准，即有术前和术后 PODCI 评分，以及 2002-2017 年的 Narakas 评分。这些患者在臂丛神经中心就诊，该中心是一家大型学术医疗中心的跨学科诊所。
本回顾性研究利用每年在其常规臂丛神经诊所就诊期间收集的 PODCI 数据。根据 Narakas 分类，对术前和术后上肢（UE）和整体功能（GFx）评分进行分层。使用配对 t 检验和 ANOVA 检验分析数据。
与年龄匹配的健康儿童的儿科正常评分相比，臂丛神经出生损伤（BPBI）患者的 PODCI 上肢和 GFx 评分较低。Narakas I 组和 IV 组术后 UE 和 GFx 评分均升高。UE 和 GFx 评分与记录的第一份 PODCI 评分（2 岁）和干预年龄（5 岁）之间存在显著相关性。
手术增加了 BPBI 患儿的生活质量感知，并提高了他们上肢和整体 GFx 的 PODCI 评分。
