title: Explaining daily functioning in young adults with obstetric brachial plexus lesion.
abstract: OBJECTIVE
  To study the influence of obstetric brachial plexus lesion (OBPL) on arm-hand function and daily functioning in adults, and to investigate the relationship of arm-hand function and pain to daily functioning.
  
  
  METHODS
  Adults with unilateral OBPL who consulted the brachial plexus team at the VU University Medical Center in the past were invited to participate. Daily functioning was measured with the Disability of the Arm, Shoulder and Hand (DASH) questionnaire and the SF36, pain with VAS Pain Scales and arm-hand function with the Nine Hole Peg Test (9-HP-test) and the Action Research Arm Test (ARAT). Scores of the affected arm were compared to those of the non-affected arm or norm values for healthy controls.
  
  
  RESULTS
  Twenty-seven persons (mean age 22, SD 4.2 years), of whom 10 men, participated. The ARAT and 9-HP-test scores for the affected arm were significantly worse than those for the non-affected arm. Moderate to severe pain in the affected arm, the non-affected arm or the back was reported by 50% of the participants. The DASH general, sports/music and SF36 physical functioning scores were significantly worse than norm values. The ARAT/9-HP-test and daily functioning showed little association. Low to moderate associations were found between pain and daily functioning.
  
  
  CONCLUSIONS
  Many young adults with OBPL experience limitations in daily functioning. Pain, rather than arm-hand function, seems to explain these limitations. Implications for Rehabilitation Obstetric brachial plexus lesion (OBPL) is caused by traction to the brachial plexus during labour, resulting in denervation of the muscles of the arm and shoulder girdle. Adults with OBPL are hardly seen in rehabilitation medicine. This study shows that many young adults with OBPL experience limitations in daily functioning. Pain, rather than arm-hand function, seems to explain these limitations. Fifty percent of the participants complained about moderate or severe pain, which was located in the affected arm, the back and the non-affected arm. There seems an age-related increase in pain prevalence. Persons who had undergone plexus surgery had a significantly worse arm-hand function, but comparable scores on daily functioning scales compared to persons without plexus surgery. When limitations in daily functioning or pain occur, referral to a rehabilitation physician is indicated.
authors.affiliation: Department of Rehabilitation Medicine, VU University Medical Center , Amsterdam , The Netherlands and.
authors.forename: Conny
authors.initials: C
authors.lastname: de Heer
authors.forename: Heleen
authors.initials: H
authors.lastname: Beckerman
authors.forename: Vincent de
authors.initials: Vd
authors.lastname: Groot
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D020516:Brachial Plexus Neuropathies / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands; D007744:Obstetric Labor Complications / Q000534:rehabilitation*; D010147:Pain Measurement; D011247:Pregnancy; D057566:Self Report; D062606:Tertiary Care Centers; D034941:Upper Extremity / Q000503:physiopathology*; D055815:Young Adult
keywords: Obstetric brachial plexus lesion; pain; participation; quality of life; work; young adults