Neonatal Brachial Plexus Palsy in Children Aged 0 to 2.5 Years; Parent-Perceived Family Impact, Quality of Life, and Upper Extremity Functioning

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• 作者：Menno van der Holst ; PT^a ; ^b ; ^{m.van_der_holst@lumc.nl" class="auth_mail" title="E-mail the corresponding author} ; Duco Steenbeek ; MD ; PhD^a ; ^b ; Willem Pondaag ; MD ; PhD^c ; Prof. Rob G.H.H. Nelissen ; MD ; PhD^a ; Prof. Thea P.M. Vliet Vlieland ; MD ; PhD^a ; ^b
• 关键词：brachial plexus neuropathy ; quality of life ; health impact assessment ; pediatrics ; nerve surgery ; rehabilitation
• 刊名：Pediatric Neurology
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：62
• 期：Complete
• 页码：34-42
• 全文大小：469 K

文摘

To investigate whether parents perceive impact of neonatal brachial plexus palsy on family and quality of life and upper extremity functioning in children less than 2.5 years.

Methods

This cross-sectional study used the PedsQL Family Impact Module (36 items/one total/four scales/scores 0 to 100), TNO-AZL (Dutch Organisation of Applied Natural Science and Academic Hospital Leiden) Preschool Children Quality of Life (43 items/12 scales/scores 0 to 100) and 21 upper extremity functioning questions. Associations between neonatal brachial plexus palsy/patient characteristics and family impact, perceived quality of life, and upper extremity functioning were investigated using regression analysis.

Results

Parents of 59 children (median age, 18 months) participated, 49 with C5–C6/C5–C7 lesions. Median Family Impact Module and TNO-AZL Preschool Children Quality of Life scores were 81.3 to 100.0/100.0 and 78.6 to 100.0/100.0. TNO-AZL Preschool Children Quality of Life scores did not differ significantly to healthy references except for stomach, skin, communication, and motor functioning problems. Parents reported around three upper extremity functioning problems. Greater lesion extent, lower age, still being in follow-up, and right-sided lesions were associated with greater family impact (P < 0.01 to P < 0.1). No clinically relevant associations were found for perceived quality of life. Greater lesion extent and nerve surgery history were associated with more upper extremity functioning problems (P < 0.01). Problems were associated with parental worrying (P < 0.05).

Conclusions

Parents perceive having a child with neonatal brachial plexus palsy as impacting on their family depending on the side and severity of the lesion, treatment history, still being in follow-up, and age. They perceive the child's quality of life as relatively normal and not significantly different to healthy peers. However, parents noticed upper extremity functioning problems which increased parental worrying. Health care specialists should take these findings into account to better inform or counsel parents in an early stage during treatment.