Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
Disabil Rehabil. 2023 Sep;45(18):2936-2945. doi: 10.1080/09638288.2022.2117426. Epub 2022 Sep 23.
(1) To determine the prevalence of musculoskeletal complaints (MSCs) in the non-affected bodily structures in individuals with brachial plexus injury (BPI) and (2) to analyse factors associated with MSCs and disability.
Survey among individuals with BPI and a control group. Multivariable logistic and linear regression analyses were used to identify factors associated with MSCs or disability.
Forty-nine percent of individuals (34/70) with BPI experienced MSC, which was not significantly different from controls (35%, = 40/113). Complaints were most often located in high back (OR = 3.6) or non-affected limb (OR = 2.2) or neck (OR = 2.1). Greater disability was associated with the presence of MSC in individuals with BPI (OR = 1.1, 95% confidence interval (95% CI) = 1.0; 1.1). Those with no or a low level of education ( = -10.2, 95% CI = -19.6; -1.4), a history of nerve surgery ( = 11.1, 95% CI = -0.2; 20.9), and moderately affected active range of motion (AROM) of the affected limb ( = 20.7, 95% CI = 8.8; 31.0) experienced most disability. Individuals with severely affected AROM showed a wide range of experienced disability.
Clinicians should be aware that almost half of individuals with BPI have MSCs in the non-affected bodily structures, which was associated with increased disability.Implications for rehabilitationMusculoskeletal complaints of the non-affected limb, back and neck are common among individuals with brachial plexus injury, and are associated with more disability.Disability was associated with loss of active range of motion (AROM) in the affected limb, although there was a wide variation in experienced disability among individuals with no or a very limited AROM.
(1) 确定臂丛神经损伤 (BPI) 患者非受累身体结构中肌肉骨骼症状 (MSCs) 的患病率，(2) 分析与 MSCs 和残疾相关的因素。
对 BPI 患者和对照组进行调查。采用多变量逻辑和线性回归分析来确定与 MSCs 或残疾相关的因素。
70 名 BPI 患者中有 49%（34/70）出现 MSCs，与对照组（35%，40/113）无显著差异。投诉最常发生在高背部（OR = 3.6）或非受累肢体（OR = 2.2）或颈部（OR = 2.1）。BPI 患者中存在 MSCs 与残疾程度更高相关（OR = 1.1，95%置信区间 [95%CI] = 1.0；1.1）。受教育程度低或无（ = -10.2，95%CI = -19.6；-1.4）、有神经手术史（ = 11.1，95%CI = -0.2；20.9）和受累肢体中度活动范围（AROM）（ = 20.7，95%CI = 8.8；31.0）的患者残疾程度最高。严重受累 AROM 的患者表现出广泛的残疾程度。
临床医生应意识到，近一半的 BPI 患者在非受累身体结构中存在 MSCs，这与残疾程度增加有关。
对康复的启示
非受累肢体、背部和颈部的肌肉骨骼症状在臂丛神经损伤患者中很常见，与残疾程度增加有关。
残疾与受累肢体 AROM 丧失有关，尽管在 AROM 无或非常有限的患者中，残疾程度存在很大差异。
