OBSTETRİK BRAKİAL PLEKSUS PARALİZİSİNDE FARKLI YARALANMA TİPLERİNE SAHİP OLAN OKUL ÖNCESİ YAŞTAKİ ÇOCUKLARDA AKTİVİTE VE KATILIM

Yıl 2021, Cilt: 32 Sayı: 1, 51 - 59, 10.04.2021

Kıvanç Delioğlu , Akın Üzümcügil Ebru Öztürk Mintaze Kerem Günel

https://doi.org/10.21653/tjpr.753488

Cited By: 1

Öz

Amaç: Obstetrik brakiyal pleksus palsi (OBPP), kas-iskelet sisteminde çeşitli bozukluklara yol açmaktadır. Önceki çalışmaların birçoğu vücut yapı ve fonksiyon alanı incelenmiştir; ancak OBPP'nin farklı fonksiyonel seviyelerindeki aktivite ve katılım alanları hakkında çok az çalışma bulunmaktadır. Bu çalışma, farklı fonksiyonel düzeydeki OBPP'li çocukların aktivite ve katılım düzeylerinin belirlemeyi amaçlamaktadır.
Yöntem: Çalışmaya 44-77 aylık (56.55 ± 8.69) yüz on iki çocuk dahil oldu. Çocuklar Narakas Sınıflamasına göre gruplandırıldı: Grup 1: Narakas Tip 1; Grup 2: Narakas Tip 2; Grup 3: Hem Narakas Tip 3 hem de 4’ü içermektedir. Çocukların aktivite ve katılım alanları Pediatrik Sonuç Veri Toplama Aracı (PODCI) kullanılarak değerlendirildi.
Sonuçlar: PODCI Global'de grup 1 ve grup 2 en yüksek skora sahipti ve iki grup arasında fark yoktu, grup 3 ise en düşük skora sahipti (p <0.001). PODCI'nin Üst Ekstremite Fonksiyonu ve Mutluluk alt ölçeğinde, üç grubun puanları birbirinden farklıydı (p <0.001), ayrıca grup 1 en yüksek puanı ve grup 3 en düşük puanı aldı. PODCI'nin Spor ve Ağrı/Konfor alt ölçekleri sadece 3. grubun diğer gruplardan farklı olduğunu gösterdi (p <0.001) ve bu grubun skorları en düşüktü.
Tartışma: OBPP’nin üst pleksus yaralanması olan tipleri benzer şekilde yüksek skorlara sahipti; PODCI’nin tüm skalalarında, total pleksus yaralanması olan çocuklar en düşük skorları aldı ve diğer gruplardan kolayca ayırt edildi. PODCI'nin Ağrı/Konfor ve Mutluluk alt ölçeğinde, Grup 1 tavan etkisini gösterdi. PODCI, total pleksus yaralanması olan çocukları diğerlerinde ayırabilse de üst pleksus yaralanmalarına sahip çocuklar genellikle çok yüksek puanlara sahipti, bu nedenle aktivite / katılım alanlarını daha detaylı şekilde değerlendirmek için hastalığa özgü bir değerlendirmeye ihtiyaç vardır.

Anahtar Kelimeler

Brakiyal Pleksus, Doğum Yaralanması, Katılım, Günlük Yaşam Aktiviteleri, Sağlık Durumu

Proje Numarası

G0 18/1020-32

ACTIVITY AND PARTICIPATION IN PRESCHOOL CHILDREN WITH DIFFERENT INJURY TYPES OF OBSTETRIC BRACHIAL PLEXUS PARALYSIS

Öz

Purpose: Obstetric brachial plexus palsy (OBPP) causes various disorders in the musculoskeletal system. Studies investigating activity and participation in different types of injury are limited. This study aimed to determine the activity and participation levels of preschool children with different injury types of OBPP.
Methods: The 112 children with OBPP, aged between 44 and 77 months, were included. The children were grouped according to the Narakas Classification System: Type 1 (n=7), Type 2 (n=91), Type 3 (n=2), and Type 4 (n=12). Both Type 3 and Type 4 represented a total brachial plexus injury. The Pediatric Outcome Data Collection Instrument (PODCI) was used to evaluate activity and participation.
Results: Narakas Type 1 and Type 2 had similarly high scores in PODCI Global (p<0.001), and PODCI Upper Extremity (p<0.001), Pain/Comfort (p<0.001), and Sport (p<0.001) subscales as compared with Narakas Type 3/4. In the PODCI Happiness subscale, Narakas Type 1 had the highest score, followed by lower scores of Narakas Type 2 and Type 3/4 (p<0.001).
Conclusion: Preschool children with total OBPP had lower levels of activity and participation, less use of their arm in daily living activities, and express a lower level of sport participation compared to those with upper plexus injuries (Narakas Type 1 and Type 2). As activity and participation problems persist or even got worse as the children grow, it is essential to evaluate both activity and participation, particularly in those with total plexus injuries, in preschool age and preferably earlier.

Anahtar Kelimeler

Activities of Daily Living, Birth Injury, Brachial Plexus, Heath Status, Participation

Proje Numarası

G0 18/1020-32

Kaynakça

• 1. Andersen J, Watt J, Olson J, Van Aerde J. Perinatal brachial plexus palsy. Paediatr Child Health. 2006;11(2):93-100.
• 2. van Dijk JG, Pondaag W, Malessy MJ. Obstetric lesions of the brachial plexus. Muscle & nerve. 2001;24(11):1451-61.
• 3. Zafeiriou DI, Psychogiou K. Obstetrical brachial plexus palsy. Pediatric neurology. 2008;38(4):235-42.
• 4. Waters PM. Update on management of pediatric brachial plexus palsy. Journal of Pediatric Orthopaedics B. 2005;14(4):233-44.
• 5. Anguelova GV, Malessy MJ, Van Dijk JG. A cross-sectional study of hand sensation in adults with conservatively treated obstetric brachial plexus lesion. Developmental medicine and child neurology. 2013;55(3):257-63.
• 6. Acaroz Candan S, Firat T, Livanelioglu A. Assessment of Spinal Curvatures in Children With Upper Trunk Obstetrical Brachial Plexus Palsy. Pediatr Phys Ther. 2019;31(2):149-54.
• 7. Anguelova GV, Malessy MJ, Buitenhuis SM, van Zwet EW, van Dijk JG. Impaired Automatic Arm Movements in Obstetric Brachial Plexus Palsy Suggest a Central Disorder. Journal of child neurology. 2016;31(8):1005-9.
• 8. Bellew M, Kay S, Webb F, Ward A. Developmental and behavioural outcome in obstetric brachial plexus palsy. Journal of hand surgery. 2000;25(1):49-51.
• 9. Sarac C, Bastiaansen E, Van der Holst M, Malessy MJ, Nelissen RG, Vliet Vlieland TP. Concepts of functioning and health important to children with an obstetric brachial plexus injury: a qualitative study using focus groups. Developmental Medicine & Child Neurology. 2013;55(12):1136-42.
• 10. Sarac C, Duijnisveld BJ, van der Weide A, Schoones JW, Malessy MJ, Nelissen RG, et al. Outcome measures used in clinical studies on neonatal brachial plexus palsy: A systematic literature review using the International Classification of Functioning, Disability and Health. J Pediatr Rehabil Med. 2015;8(3):167-85; quiz 85-6.
• 11. Duff SV, DeMatteo C. Clinical assessment of the infant and child following perinatal brachial plexus injury. Journal of hand therapy : official journal of the American Society of Hand Therapists. 2015;28(2):126-34.
• 12. Chang KW, Justice D, Chung KC, Yang LJ. A systematic review of evaluation methods for neonatal brachial plexus palsy: a review. Journal of Neurosurgery: Pediatrics. 2013;12(4):395-405.
• 13. Al-Qattan MM, El-Sayed AA, Al-Zahrani AY, Al-Mutairi SA, Al-Harbi MS, Al-Mutairi AM, et al. Narakas classification of obstetric brachial plexus palsy revisited. The Journal of hand surgery, European volume. 2009;34(6):788-91.
• 14. Keskin Dilbay N, Günel KM, Timuçin A. Reliability and validity of Turkish version of Pediatric Outcome Data Collection Instrument (PODCI) for people with cerebral palsy [Pediatrik Veri Toplama Aracinm (PVTA) Türkçe versiyonunun serebral palsili bireylerde geçerlik ve güvenirliği]. 2013.
• 15. Merder-Coskun D, Kenis-Coskun O, Celenlioğlu AE, Akman M, Karadag-Saygi E, Uzuner A. Reliability of cross-cultural adapted Turkish version of the Pediatric Outcomes Data Collection Instrument (PODCI). Journal of pediatric rehabilitation medicine. 2016;9(2):101-5.
• 16. Bae DS, Waters PM, Zurakowski D. Correlation of pediatric outcomes data collection instrument with measures of active movement in children with brachial plexus birth palsy. Journal of pediatric orthopedics. 2008;28(5):584-92. 17. Hayran M. Sağlık araştırmaları için temel istatistik: Omega Araştırma; 2011.
• 18. Haynes RJ, Sullivan E. The Pediatric Orthopaedic Society of North America pediatric orthopaedic functional health questionnaire: an analysis of normals. Journal of Pediatric Orthopaedics. 2001;21(5):619-21.
• 19. Yang LJ. Neonatal brachial plexus palsy--management and prognostic factors. Seminars in perinatology. 2014;38(4):222-34.
• 20. Pondaag W, Malessy MJ. Recovery of hand function following nerve grafting and transfer in obstetric brachial plexus lesions. Journal of Neurosurgery: Pediatrics. 2006;105(1):33-40.
• 21. Kirjavainen M, Remes V, Peltonen J, Kinnunen P, Pöyhiä T, Telaranta T, et al. Long-term results of surgery for brachial plexus birth palsy. JBJS. 2007;89(1):18-26.
• 22. Huffman GR, Bagley AM, James MA, Lerman JA, Rab G. Assessment of children with brachial plexus birth palsy using the Pediatric Outcomes Data Collection Instrument. Journal of Pediatric Orthopaedics. 2005;25(3):400-4.
• 23. Spaargaren E, Ahmed J, van Ouwerkerk WJ, de Groot V, Beckerman H. Aspects of activities and participation of 7-8 year-old children with an obstetric brachial plexus injury. Eur J Paediatr Neurol. 2011;15(4):345-52.
• 24. Bae DS, Zurakowski D, Avallone N, Yu R, Waters PM. Sports participation in selected children with brachial plexus birth palsy. Journal of Pediatric Orthopaedics. 2009;29(5):496-503.
• 25. Dedini RD, Bagley AM, Molitor F, James MA. Comparison of pediatric outcomes data collection instrument scores and range of motion before and after shoulder tendon transfers for children with brachial plexus birth palsy. Journal of Pediatric Orthopaedics. 2008;28(2):259-64.