Quality of upper extremity skills and disability inventory via manual ability classification in children with neonatal brachial plexus palsy

Abstract

Purpose

The aim of study was to investigate the relationship between upper extremity skill quality and disability inventory according to manual ability classification system in children with neonatal brachial plexus palsy (NBPP).

Materials and methods

Children with NBPP were included between the ages of 4–7.5 years. Children were classified in Manual Ability Classification System (MACS). Upper extremity skill quality was evaluated with Quality of Upper Extremity Skills Test (QUEST), disability status was assessed with Pediatric Evaluation of Disability Inventory (PEDI).

Results

Total of 63 children (girls:31/boys:32), and mean age was 6.32 ± 1.73 years. 37 (58.73%) of children were at MACS Level-2. According to MACS classification, significant differences were noted in PEDI scores (p = 0.001), dissociated movements (p = 0.016) and grasp (p = 0.002) domains of QUEST. However, no significant differences between QUEST total scores (p = 0.079). PEDI (ROC; AuC = 0.762) and QUEST total score (ROC; AuC = 0.714) were sensitive to difference between groups across MACS in children with NBPP.

Conclusion

The PEDI and QUEST are sensitive in distinguishing the disability of children with NBPP at different MACS levels. Assessment of children with NBPP is not limited to functionality, disability, and quality of movement, it is multidimensional. Outcomes measures studies of movement’s quality in children with NBPP are needed.

Implications for Rehabilitation

• Functionality evaluation in children with neonatal brachial plexus palsy is multidimensional.

• Appropriate assessment of functionality in children with neonatal brachial plexus palsy provides accurate information about daily living activities and disability levels.

• We propose using Quality of Upper Extremity Skills Test (QUEST) and Pediatric Evaluation of Disability Inventory (PEDI) to evaluate the relationship between the quality of upper extremity movements and disability in school-aged children with neonatal brachial plexus palsy at different Manual Ability Classification System (MACS) levels.

Keywords:

• Disability
• neonatal brachial plexus palsy
• quality of movement
• skill
• upper extremity

Ethical approval

Our university local ethic committee approved the manuscript, and we certify that the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The families of children with neonatal brachial plexus palsy were informed consent and written consent was obtained.

Disclosure statement

No potential conflict of interest was reported by the author(s).