title: Hand Sensorimotor Function in Older Children With Neonatal Brachial Plexus Palsy.
abstract: BACKGROUND
  Routine sensory assessments in neonatal brachial plexus palsy are infrequently performed because it is generally assumed that sensory recovery exceeds motor recovery. However, studies examining sensory function in neonatal brachial plexus palsy have produced equivocal findings. The purpose of this study was to examine hand sensorimotor function in older children with neonatal brachial plexus palsy using standard clinical and research-based measures of tactile sensibility.
  
  
  METHODS
  Seventeen children with neonatal brachial plexus palsy (mean age: 11.6 years) and 19 age-matched controls participated in the study. Functional assessments included grip force, monofilament testing, and hand dexterity (Nine-Hole Peg, Jebsen-Taylor Hand Function). Tactile spatial perception involving the discrimination of pin patterns and movement-enhanced object recognition (stereognosis) were also assessed.
  
  
  RESULTS
  In the neonatal brachial plexus palsy group, significant deficits in the affected hand motor function were observed compared with the unaffected hand. Median monofilament scores were considered normal for both hands. In contrast, tactile spatial perception was impaired in the neonatal brachial plexus palsy group. This impairment was seen as deficits in both pin pattern and object recognition accuracy as well as the amount of time required to identify patterns and objects. Tactile pattern discrimination time significantly correlated with performance on both functional assessment tests (P < 0.01).
  
  
  CONCLUSIONS
  This study provides evidence that tactile perception deficits may accompany motor deficits in neonatal brachial plexus palsy even when measures of tactile registration (i.e., monofilament testing) are normal. These results may reflect impaired processing of somatosensory feedback associated with reductions in goal-directed upper limb use and illustrate the importance of including a broader range of sensory assessments in neonatal brachial plexus palsy.
authors.affiliation: Motor Control Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, Michigan. Electronic address: shcb@umich.edu.
authors.forename: Susan H
authors.initials: SH
authors.lastname: Brown
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Cory W
authors.initials: CW
authors.lastname: Wernimont
authors.affiliation: Motor Control Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Lauren
authors.initials: L
authors.lastname: Phillips
authors.affiliation: Motor Control Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Kathy L
authors.initials: KL
authors.lastname: Kern
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Virginia S
authors.initials: VS
authors.lastname: Nelson
authors.affiliation: Department of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Lynda J-S
authors.initials: LJ
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D020516:Brachial Plexus Neuropathies / Q000150:complications / Q000473:pathology*; D016022:Case-Control Studies; D002648:Child; D004192:Discrimination, Psychological / Q000502:physiology; D005260:Female; D006225:Hand / Q000503:physiopathology*; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D008297:Male; D010243:Paralysis / Q000150:complications / Q000473:pathology*; D013223:Statistics as Topic; D055698:Touch Perception / Q000502:physiology*
keywords: hand dexterity; sensory assessment; tactile perception