title: Do existing patient-report activity outcome measures accurately reflect day-to-day arm use following adult traumatic brachial plexus injury?
abstract: OBJECTIVE
  To identify the range of activities limited following adult traumatic brachial plexus injury and triangulate these with existing patient-reported outcome measures identified from the literature.
  
  
  METHODS
  A qualitative cross-sectional design.
  
  
  METHODS
  Adults with traumatic brachial plexus injury and expert clinicians.
  
  
  METHODS
  Using an International Classification of Functioning, Disability and Health (ICF) framework, participants identified day-to-day activities that are limited following traumatic brachial plexus injury. Two independent reviewers classified all reported activities into the Comprehensive ICF Core Set of Hand Conditions (CCS-HC) activity domains. Reported activities were triangulated with patient-reported outcome measures identified from the brachial plexus injury literature.
  
  
  RESULTS
  Fifty-one participants (21 adults with brachial plexus injury, 30 expert clinicians) generated a total of 522 items. The inter-rater reliability for classification to CCS-HC domains was excellent (k = 0.94, 95% confidence interval (95% CI) 0.92-0.96). Activities reported by patients and clinicians represented all 29 CCS-CH activity domains. Five activities (2%) could not be classified to any ICF domain. Fifteen CCS-HC activity domains were represented in the Disabilities of Arm, Shoulder and Hand (DASH) and ABILHAND, 2 measures currently used in the brachial plexus injury literature.
  
  
  CONCLUSIONS
  Adults with a brachial plexus injury report a range of activities that are limited following injury, and are under-represented in currently used patient-reported outcome measures. The activities reported in this study could be used to inform the development of a new brachial plexus injury targeted questionnaire.
authors.affiliation: , Menzies Health Institute, Griffith University,, Queensland, Australia. bridget.hill@epworth.org.au.
authors.forename: Bridget
authors.initials: B
authors.lastname: Hill
authors.forename: Gavin
authors.initials: G
authors.lastname: Williams
authors.forename: John H
authors.initials: JH
authors.lastname: Olver
authors.forename: Andrea
authors.initials: A
authors.lastname: Bialocerkowski
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D001132:Arm / Q000503:physiopathology*; D001917:Brachial Plexus / Q000293:injuries*; D020516:Brachial Plexus Neuropathies / Q000503:physiopathology / Q000534:rehabilitation*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation; D005260:Female; D006225:Hand / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires