title: Outcome measures used in clinical studies on neonatal brachial plexus palsy: A systematic literature review using the International Classification of Functioning, Disability and Health.
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).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Cigdem
authors.initials: C
authors.lastname: Sarac
authors.affiliation: Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Bouke J
authors.initials: BJ
authors.lastname: Duijnisveld
authors.affiliation: Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Amber
authors.initials: A
authors.lastname: van der Weide
authors.affiliation: Walaeus Library, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Jan W
authors.initials: JW
authors.lastname: Schoones
authors.affiliation: Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Martijn J A
authors.initials: MJ
authors.lastname: Malessy
authors.affiliation: Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Rob G H H
authors.initials: RG
authors.lastname: Nelissen
authors.affiliation: Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Thea P M Vliet
authors.initials: TP
authors.lastname: Vlieland
mesh_terms: D020516:Brachial Plexus Neuropathies / Q000534:rehabilitation*; D002675:Child, Preschool; D004185:Disability Evaluation; D019988:Children with Disabilities / Q000534:rehabilitation; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017063:Outcome Assessment, Health Care / Q000379:methods*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: Brachial plexus neuropathies; international classification; obstetric paralysis; outcome assessment; treatment outcome