Development of a new sling for improving function in people with brachial plexus injury: A mixed cohort

Traumatic brachial plexus injuries involving the C5 and C6 roots result in an inability to elevate and rotate the shoulder and flex the elbow, movements necessary to place the hand in a more functional position. To address this issue, we developed a prototype of a lower-cost and easy-to-wear modified sling designed to facilitate passive elbow flexion and maintain external shoulder rotation.

To analyze the effect of the modified sling on improving the ability to perform bimanual activities for adult patients with traumatic brachial plexus injuries.

Mixed cohort.

This study involved a cohort of 14 adults admitted between March and July 2024 with traumatic brachial plexus injuries involving the C5 and C6 roots. Participants were evaluated with and without the sling using bimanual functionality tests and questionnaires. Patient satisfaction was also assessed. Results were analyzed by comparing mean scores with and without the sling. This sample size ensured 95% power with a 5% significance level.

The most challenging activity reported by participants was holding a cup and filling it with the other hand. With the sling, all activities evaluated were performed with ease. The median score on the QUICKDASH questionnaire decreased from 47.9 (95% CI: 40.1-55.6) to 33.2 (95% CI: 25-41.5), indicating a statistically and clinically relevant improvement in functional capacity (p < 0.001). The BrAT score increased from 28 (95% CI: 22.4-33.6) to 46.1 (95% CI: 42.5-49.8), also indicating improvement (p < 0.001). All patients expressed satisfaction with the functionality provided by the sling. The effect size, measured by Cohen's d, indicate a large effect (d > 1).

This study demonstrates that the modified sling significantly enhances functionality in patients with C5 and C6 brachial plexus injuries. The unanimous positive feedback from patients highlights its practical relevance and their satisfaction with this intervention.