Outcome measures used in clinical studies on neonatal brachial plexus palsy: A systematic literature review using the International Classification of Functioning, Disability and Health

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Article type: Research Article

Authors: Sarac, Cigdem^{a; *} | Duijnisveld, Bouke J.^a | Weide, Amber van der^a | Schoones, Jan W.^b | Malessy, Martijn J.A.^c | Nelissen, Rob G.H.H.^a | Vlieland, Thea P.M. Vliet^a

Affiliations: [a] Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands | [b] Walaeus Library, Leiden University Medical Center, Leiden, The Netherlands | [c] Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands

Correspondence: [*] Corresponding author: Cigdem Sarac, Department of Orthopedics, J11, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands. Tel.: +31 71 5263606; E-mail:[email protected]

Abstract: BACKGROUND: Symptoms of a neonatal brachial plexus palsy (NBPP) can vary widely among individuals and numerous clinical studies have been performed to identify the natural history and to improve treatment. The aim of this study was to identify and describe all outcome measures used in clinical studies on patients with an NBPP and categorize these outcome measures according to the International Classification of Functioning, Disability and Health (ICF). METHOD: Electronic searches of different databases were carried out. All clinical studies describing one or more outcomes of NBPP were selected. Data on outcome measures was systematically extracted and the contents were analyzed and linked to the ICF. RESULTS: A total of 217 full texts were selected and 59 different outcome measures were identified. The 5 most frequently used outcome measures included range of motion of the shoulder (n= 166 studies, 76%), range of motion of the elbow (n= 87 studies, 40%), the Mallet scale (n= 66 studies, 30%), Magnetic Resonance Imaging (n= 37 studies, 17%) and the Medical Research Council motor grading scale (n= 31 studies, 14%). Assessments related to Body functions and Structures were most frequent, whereas assessments associated with Activities and Participation and Environmental Factors were relatively uncommon. CONCLUSION: There was a high variability among the outcome measures used, with measures within the ICF component Body Functions being most common. These results underscore the need for the development and usage of outcome measures representing all domains of health status in patients with NBPP.

Keywords: Brachial plexus neuropathies, obstetric paralysis, international classification, treatment outcome, outcome assessment

DOI: 10.3233/PRM-150335

Journal: Journal of Pediatric Rehabilitation Medicine, vol. 8, no. 3, pp. 167-186, 2015