Correlation between motor function recovery and daily living activity outcomes after brachial plexus surgery

Sonia Regina Ferreira; Roberto Sérgio Martins; Mário G. Siqueira

doi:10.1590/0004-282X20170090

Arquivos de Neuro-Psiquiatria, Table of Contents

CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(09): 631-634
DOI: 10.1590/0004-282X20170090

ARTICLES

Correlation between motor function recovery and daily living activity outcomes after brachial plexus surgery

Correlação entre a recuperação motora funcional e as atividades de vida diária após cirurgia do plexo braquial

Sonia Regina Ferreira

¹Universidade de São Paulo, Faculdade de Medicina, Instituto de Psiquiatria, Divisão de Neurocirurgia Funcional, Unidade de Cirurgia de Nervo Periférico, São Paulo, SP, Brasil.

,

Roberto Sérgio Martins

¹Universidade de São Paulo, Faculdade de Medicina, Instituto de Psiquiatria, Divisão de Neurocirurgia Funcional, Unidade de Cirurgia de Nervo Periférico, São Paulo, SP, Brasil.

,

Mário G. Siqueira

¹Universidade de São Paulo, Faculdade de Medicina, Instituto de Psiquiatria, Divisão de Neurocirurgia Funcional, Unidade de Cirurgia de Nervo Periférico, São Paulo, SP, Brasil.

› Author Affiliations

Abstract

ABSTRACT

Objective To establish the correlation between clinical evaluation of motor function recovery and daily living activities in 30 patients with upper traumatic brachial plexus injury submitted to surgery.

Methods The score of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and the Louisiana State University Health Sciences Center (LSUHSC) scale were determined in 30 patients. Epidemiologic factors were also examined and correlations were determined.

Results There was a significant correlation between the clinical evaluation and the daily living activities after a 12-month period (r = 0.479 and p = 0.007). A direct correlation was observed between the functional recovery of the upper limb and the time between injury and surgery (r = 0.554 and p = 0.001). The LSUHSC scores (p = 0.049) and scores from the DASH questionnaire (p = 0.013) were better among patients who returned to work.

Conclusions Clinical evaluation and daily living activities in adult patients who underwent nerve transfer after brachial plexus injury showed significant and measurable improvements.

RESUMO

Objetivo Avaliar a correlação entre a avaliação clínica e as atividades de vida diária em 30 paciente adultos com lesão do plexo braquial superior.

Métodos O valor do questionário Dash (Disabilities of the Arm, Shoulder and Hand) e da escala Louisiana State University Health Sciences Center (LSUHSC) foram quantificados prospectivamente em 30 pacientes. Fatores epidemiológicos foram também examinados e correlações específicas determinadas.

Resultados Houve correlação significativa entre avaliação clínica e as atividades de vida diária 12 meses após a cirurgia (r = 0.479 e p = 0.007). Uma correlação direta foi observada entre a recuperação funcional do membro superior e o tempo entre a lesão e a cirurgia (r = 0.554 e p = 0.001). Os valores da escala LSUHSC (p = 0.049) e do DASH (p = 0.013) foram melhores entre aqueles que retornaram ao trabalho.

Conclusões A avaliação clínica e as atividades de vida diária em pacientes submetidos à cirurgia de transferência de nervos após lesão do plexo braquial mostraram correlação significativa.

brachial plexus - nerve transfer - activities of daily living

plexo braquial - transferência de nervo - atividades cotidianas

Full Text

References

References
1 Bertelli JA, Ghizoni MF. Results and current approach for Brachial Plexus reconstruction. J Brachial Plex Peripher Nerve Inj. 2011;6(1):2.
2 Bertelli JA, Ghizoni MF. Clinical findings in C5-C6 and C5-C7 root palsies with brachial plexus traction lesions. J Hand Surg Eur. 2013;38(3):237-41. https://doi.org/10.1177/1753193412471009
3 Franchignoni F, Giordano A, Sartorio F, Vercelli S, Pascariello B, Ferriero G. Suggestions for refinement of the Disabilities of the Arm, Shoulder and Hand Outcome Measure (DASH): a factor analysis and Rasch validation study. Arch Phys Med Rehabil. 2010;91(9):1370-7. https://doi.org/10.1016/j.apmr.2010.06.022
4 Siqueira MG, Martins RS. Surgical treatment of adult traumatic brachial plexus injuries: an overview. Arq Neuropsiquiatr. 2011;69(3):528-35. https://doi.org/10.1590/S0004-282X2011000400023
5 Dy CJ, Garg R, Lee SK, Tow P, Mancuso CA, Wolfe SW. A systematic review of outcomes reporting for brachial plexus reconstruction. J Hand Surg (Am). 2015;40(2):308-13. https://doi.org/10.1016/j.jhsa.2014.10.033
6 Hunsaker FG, Cioffi DA, Amadio PC, Wright JG, Caughlin B. The American Academy of Orthopaedic Surgeons outcomes instruments:normative values from the general population. J Bone Joint Surg (Am). 2002;84-A(2):208-15. https://doi.org/10.2106/00004623-200202000-00007
7 The Institute for Work & Health.The Dash and Quick Dash e-bulletin.fall, 2012 [acess 2017 Mar 03]. Available at: http:/www.dash.iwh.on.ca/sites/dash/files/dash_e-bulletin_2012_winter
8 Orfale AG, Araújo PM, Ferraz MB, Natour J. Translation into Brazilian Portuguese, cultural adaptation and evaluation of the reliability of the Disabilities of the Arm, Shoulder and Hand questionnaire. Braz J Med Biol Res. 2005;38(2):293-302. https://doi.org/10.1590/S0100-879X2005000200018
9 Mancuso CA, Lee SK, Dy CJ, Landers ZA, Model Z, Wolfe SW. Compensation by the uninjured arm after brachial plexus injury. Hand (NY). 2016;11(4):410-5. https://doi.org/10.1177/1558944715627635
10 Ahmed-Labib M, Golan JD, Jacques L. Functional outcome of brachial plexus reconstruction after trauma. Neurosurgery. 2007;61(5):1016-22. https://doi.org/10.1227/01.neu.0000303197.87672.31
11 Novak CB, Anastakis DJ, Beaton DE, Mackinnon SE, Katz J. Validity of the Patient Specific Functional Scale in patients following upper extremity nerve injury. Hand (NY). 2013;8(2):132-8. https://doi.org/10.1007/s11552-013-9506-9
12 Kline DG. Surgical repair of brachial plexus injury. J Neurosurg. 2004;101(3):361-3. https://doi.org/10.3171/jns.2004.101.3.0361
13 Faglioni W Jr, Siqueira MG, Martins RS, Heise CO, Foroni L. The epidemiology of adult traumatic brachial plexus lesions in a large metropolis. Acta Neurochir (Wien). 2014;156(5):1025-8. https://doi.org/10.1007/s00701-013-1948-x
14 Hudak PL, Amadio PC, Bombardier C, Beaton D, Cole D, Davis A et al. Development of an upper extremity outcome measure:the DASH (disabilities of the arm, shoulder and hand). The Upper Extremity Collaborative Group (UECG). Am J Ind Med. 1996;29(6):602-8. https://doi.org/10.1002/(SICI)1097-0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-L
15 Hill, BE, Williams G, Bialocerkowski AE. Clinimetric evaluation of questionnaires used to Acess activitiy after traumatic brachial plexus injury in adults:a systematic review. Phys Med Rehabil. 2011;92(12):2082-9. https://doi.org/10.1016/j.apmr.2011.07.188
16 Novak CB, Anastakis DJ, Beaton DE, Mackinnon SE, Katz J. Biomedical and psychosocial factors associated with disability after peripheral nerve injury. J Bone Joint Surg Am. 2011;93(10):929-36. https://doi.org/10.2106/JBJS.J.00110
17 Flores LP. [Epidemiologic study of the traumatic brachial plexus injuries in adults]. Arq Neuropsiquiatr. 2006;64(1):88-94. Portuguese. https://doi.org/10.1590/S0004-282X2006000100018 PMID:16622560
18 Kline DG. Timing for brachial plexus injury: a personal experience. Neurosurg Clin N Am. 2009;20(1):24-6. https://doi.org/10.1016/j.nec.2008.07.030
19 Novak CB, Anastakis DJ, Beaton DE, Katz J. Patient reported outcome following peripheral nerve injury. J Hand Surg. 2009;34A(2):281-7. https://doi.org/10.1016/j.jhsa.2008.11.017