Explaining daily functioning in young adults with obstetric brachial plexus lesion

Area of Science:

• Neurology
• Rehabilitation Medicine
• Orthopedics

Background:

• Obstetric brachial plexus lesion (OBPL) results from brachial plexus traction during birth, causing arm and shoulder muscle denervation.
• Adults with OBPL are infrequently encountered in rehabilitation medicine settings.
• This study focuses on the long-term functional impact of OBPL in adulthood.

Purpose of the Study:

• To assess the impact of OBPL on adult arm-hand function and daily activities.
• To explore the relationship between arm-hand function, pain, and daily functioning in OBPL patients.
• To identify factors influencing functional limitations in adults with OBPL.

Main Methods:

• Adults with unilateral OBPL were recruited from a specialized brachial plexus clinic.
• Arm-hand function was evaluated using the Action Research Arm Test (ARAT) and Nine Hole Peg Test (9-HP-test).
• Daily functioning was assessed via the Disability of the Arm, Shoulder and Hand (DASH) and SF-36 questionnaires; pain was measured using VAS scales.

Main Results:

• Affected arms showed significantly poorer performance on ARAT and 9-HP-test compared to non-affected arms.
• Fifty percent of participants reported moderate to severe pain in affected or non-affected arms, or the back.
• Daily functioning (DASH, SF-36 physical) was significantly impaired compared to normative values, with limited correlation to arm-hand function but moderate association with pain.

Conclusions:

• Many young adults with OBPL experience significant limitations in daily functioning.
• Pain, rather than impaired arm-hand function, appears to be the primary factor contributing to functional deficits.
• Referral to a rehabilitation physician is recommended for individuals experiencing functional limitations or pain related to OBPL.