Doğumsal Brakiyal Pleksus Yaralanmasında 9-Delikli Peg Testi: Total Palsiden Üst Trunkus Yaralanmalarına Kadar Ne Anlama Gelebilir?
Year 2025,
Volume: 13 Issue: 1, 59 - 66, 02.01.2025
Kıvanç Delioğlu
,
Tüzün Fırat
Abstract
Amaç: Çalışmamızın amacı, farklı yaralanma tiplerine sahip doğumsal brakiyal pleksus yaralanmalarında 9-delikli peg testinin öz bakım aktiviteleri ve motor fonksiyon ile ilişkisini araştırmaktır. Gereç ve Yöntem: Çalışmaya, yaşları 5-16 arasında değişen, 18'inde total brakiyal pleksus ve 73'ünde üst trunkus hasarı olan 91 çocuk dahil edilmiştir. Tüm çocuklar 9-delikli peg testi, aktif hareket ölçeği ve Wee-FIM öz bakım bölümü ile değerlendirilmiştir. 9-delikli peg testi, aktif hareket ölçeği ve Wee-FIM skorları arasındaki ilişki Spearman korelasyon katsayısı hesaplanarak incelenmiştir. Sonuçlar: Üst trunkus yaralanması olan 73 çocukta, 9-delikli peg testi ile öz bakım aktiviteleri skoru arasında güçlü bir negatif korelasyon (p<0.01, r=-0.73) ve toplam üst ekstremite fonksiyonu ile orta düzeyde negatif korelasyon (p<0.01, r=-0.68) vardı. Aktif hareket ölçeği ile değerlendirilen 15 eklem hareketi ile 9-delikli peg testi arasında orta derecede negatif korelasyon vardır (p<0.01, -0.59
Ethical Statement
Bu çalışma Hacettepe Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu (GO 23/132) tarafından onaylandı. Ailelere çalışma hakkında bilgi verildi ve katılmak isteyenlere yazılı onam formları imzalatıldı..
Supporting Institution
Destekleyen kuruluş yoktur.
References
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- Al-Qattan, M. M. (2003). Assessment of the motor power in older children with obstetric brachial plexus palsy. J Hand Surg Br, 28(1), 46-49. https://doi.org/10.1054/JHSB.2002.0831.
- Andersen, J., Watt, J., Olson, J., & Van Aerde, J. (2006). Perinatal brachial plexus palsy. Paediatr Child Health, 11(2), 93-100. https://doi.org/10.1093/pch/11.2.93.
- Aybay, C., Erkin, G., Elhan, A. H., Sirzai, H., & Ozel, S. (2007). ADL assessment of nondisabled Turkish children with the Wee-FIM instrument. Am J Phys Med Rehabil, 86(3), 176-182. https://doi.org/10.1097/PHM.0b013e31802b8f8d.
- Brown, S. H., Wernimont, C. W., Phillips, L., Kern, K. L., Nelson, V. S., & Yang, L. J. S. (2016). Hand sensorimotor function in older children with neonatal brachial plexus palsy. Pediatr Neurol, 56, 42-7. https://doi.org/10.1016/j.pediatrneurol.2015.12.012.
- Buesch, F. E., Schlaepfer, B., de Bruin, E. D., Wohlrab, G., Ammann-Reiffer, C., & Meyer-Heim, A. (2010). Constraint-induced movement therapy for children with obstetric brachial plexus palsy: two single-case series. International Journal of Rehabilitation Research, 33(2), 187-192. https://doi.org/10.1097/mrr.0b013e3283310d6e.
- Chang, K. W., Justice, D., Chung, K. C., & Yang, L. J. (2013). A systematic review of evaluation methods for neonatal brachial plexus palsy: a review. J Neurosurg Pediatr, 12(4), 395-405. https://doi.org/10.3171/2013.6.peds12630.
- Curtis, C., Stephens, D., Clarke, H. M., & Andrews, D. (2002). The active movement scale: an evaluative tool for infants with obstetrical brachial plexus palsy. J Hand Surg Am, 27(3), 470-478. https://doi.org/10.1053/jhsu.2002.32965.
- de Heer, C., Beckerman, H., & Groot, V. D. (2015). Explaining daily functioning in young adults with obstetric brachial plexus lesion. Disabil Rehabil, 37(16), 1455-1461. https://doi.org/10.3109/09638288.2014.972578.
- Delioğlu, K., Uzumcugil, A., & Gunel, M. K. (2022). Activity-based hand-function profile in preschool children with obstetric brachial plexus palsy. Hand Surg Rehabil, 41(4), 487-493. https://doi.org/10.1016/j.hansur.2022.05.007.
- Delioglu, K., Üzümcügil, A., Öztürk, E., & Günel, M. K. (2021). Activity and participation in preschool children with different injury types of obstetric brachial plexus paralysis. Turk J Physiother Rehabil, 32(1), 51-59. https://doi.org/10.21653/tjpr.753488.
- Duff, S. V., & DeMatteo, C. (2015). Clinical assessment of the infant and child following perinatal brachial plexus injury. J Hand Ther, 28(2), 126-134. https://doi.org/10.1016/j.jht.2015.01.001.
- Hale, H. B., Bae, D. S., & Waters, P. M. (2010). Current concepts in the management of brachial plexus birth palsy. J Hand Surg Am, 35(2), 322-331. https://doi.org/10.1016/j.jhsa.2009.11.026.
- Hayran M, Hayran M. (2011). Sağlık araştırmaları için temel istatistik. Ankara: Omega Araştırma.
- Ho, E. S., Curtis, C. G., & Clarke, H. M. (2012). The brachial plexus outcome measure: development, internal consistency, and construct validity. J Hand Ther, 25(4), 406-417. https://doi.org/10.1016/j.jht.2012.05.002.
- Immerman, I., Alfonso, D. T., Ramos, L. E., Grossman, L. A., Alfonso, I., Ditaranto, P., et al. (2012). Hand function in children with an upper brachial plexus birth injury: results of the nine‐hole peg test. Dev Med Child Neurol, 54(2), 166-169. https://doi.org/10.1111/j.1469-8749.2011.04120.x.
- Leblebicioğlu, G., & Pondaag, W. (2024). Brachial plexus birth injury: advances and controversies. J Hand Surg(Eur Vol), 0. https://doi.org/10.1177/17531934241231173.
- Mukaka, M. M. (2012). A guide to appropriate use of correlation coefficient in medical research. Malawi Med J, 24(3), 69-71.
- Ottenbacher, K. J., Msall, M. E., Lyon, N., Duffy L. C., Ziviani, J., Granger, C.V., et al. (2000). The WeeFIM instrument: its utility in detecting change in children with developmental disabilities. Arch Phys Med Rehabil, 81(10), 1317-26. https://doi.org/10.1053/apmr.2000.9387.
- Öksüz, Ç., Alemdaroglu, I., Kilinç, M., Abaoğlu, H., Demirci, C., Karahan, S., et al. (2017). Reliability and validity of the Turkish version of ABILHAND-Kids’ questionnaire in a group of patients with neuromuscular disorders. Physiotherapy Theory and Practice, 33(10), 780-7. https://doi.org/10.1080/09593985.2017.1346026.
- Partridge, C., & Edwards, S. (2004). Obstetric brachial plexus palsy: Increasing disability and exacerbation of symptoms with age. Physiotherapy Research International, 9(4), 157-63. https://doi.org/10.1002/pri.319.
- Pondaag, W., & Malessy, M. J. A. (2018). Outcome assessment for brachial plexus birth injury. Results from the ipluto world-wide consensus survey. J Orthop Res, 36(9), 2533-41. https://doi.org/10.1002/jor.23901.
- Poole, J. L., Burtner, P. A., Torres, T. A., McMullen, C. K., Markham, A., Marcum, M. L., et al. (2005). Measuring dexterity in children using the nine-hole peg test. J Hand Ther, 18(3), 348-51. https://doi.org/10.1197/j.jht.2005.04.003.
- Schober, P., Boer, C., & Schwarte, L. A. (2018) Correlation coefficients: appropriate use and interpretation. Anesth Analg, 126(5), 1763-8. https://doi.org/10.1213/ane.0000000000002864.
- Strömbeck, C., Krumlinde-Sundholm, L., Remahl, S., & Sejersen, T. (2007). Long-term follow-up of children with obstetric brachial plexus palsy I: functional aspects. Dev Med Child Neurol, 49(3), 198-203. https://doi.org/10.1111/j.1469-8749.2007.00198.x.
- van Dijk, J. G., Pondaag, W., & Malessy, M. J. (2001). Obstetric lesions of the brachial plexus. Muscle & Nerve, 24(11), 1451-61. https://doi.org/10.1002/mus.1168.
- Zuo, K. J., Ho, E. S., Hopyan, S., Clarke, H. M., & Davidge, K. M. (2023). Recent advances in the treatment of brachial plexus birth injury. Plast Reconstr Surg, 151(5), 857e-874e. https://doi.org/10.1097/prs.0000000000010047
9-Hole Peg Test in Brachial Plexus Birth Injury: What May It Mean from Total Palsy to Upper Trunk Injuries?
Year 2025,
Volume: 13 Issue: 1, 59 - 66, 02.01.2025
Kıvanç Delioğlu
,
Tüzün Fırat
Abstract
Purpose: The aim of our study is to investigate the relationship of the 9-hole-peg test with self-care activities and motor function in brachial plexus birth injury with different injury types. Material and Methods: The study included 91 children aged 5-16 years, 18 had total brachial plexus injury and 73 had upper trunk injury. All children were assessed with the 9-hole-peg test, active movement scale (AMS) and Wee-FIM self-care section. The relationship between 9-hole-peg test, AMS and Wee-FIM scores were examined by calculating Spearman correlation coefficient. Results: In 73 children with upper trunk injury, there was a strong negative correlation between the 9-hole-peg test and self-care activities (p<0.01, r=-0.73), and a moderate negative correlation between the 9-hole-peg test and total upper limb function (p<0.01, r=-0.68). There was a moderate negative correlation between all 15 joint movements assessed AMS and the 9-hole peg test (p<0.01, -0.59
Ethical Statement
This study was approved by Hacettepe University Non-Interventional Clinical Research Ethics Board (GO 23/132). The families were informed about the study and those willing to participate signed written consent forms.
Supporting Institution
There is no supporting institution.
References
- Aktaş, D., Eren, B., Keniş-Coşkun, Ö., Karadag-Saygi, E. (2018). Function in unaffected arms of children with obstetric brachial plexus palsy. Eur J Paediatr Neurol, 22(4), 610-614. https://doi.org/10.1016/j.ejpn.2018.03.005.
- Al-Qattan, M. M. (2003). Assessment of the motor power in older children with obstetric brachial plexus palsy. J Hand Surg Br, 28(1), 46-49. https://doi.org/10.1054/JHSB.2002.0831.
- Andersen, J., Watt, J., Olson, J., & Van Aerde, J. (2006). Perinatal brachial plexus palsy. Paediatr Child Health, 11(2), 93-100. https://doi.org/10.1093/pch/11.2.93.
- Aybay, C., Erkin, G., Elhan, A. H., Sirzai, H., & Ozel, S. (2007). ADL assessment of nondisabled Turkish children with the Wee-FIM instrument. Am J Phys Med Rehabil, 86(3), 176-182. https://doi.org/10.1097/PHM.0b013e31802b8f8d.
- Brown, S. H., Wernimont, C. W., Phillips, L., Kern, K. L., Nelson, V. S., & Yang, L. J. S. (2016). Hand sensorimotor function in older children with neonatal brachial plexus palsy. Pediatr Neurol, 56, 42-7. https://doi.org/10.1016/j.pediatrneurol.2015.12.012.
- Buesch, F. E., Schlaepfer, B., de Bruin, E. D., Wohlrab, G., Ammann-Reiffer, C., & Meyer-Heim, A. (2010). Constraint-induced movement therapy for children with obstetric brachial plexus palsy: two single-case series. International Journal of Rehabilitation Research, 33(2), 187-192. https://doi.org/10.1097/mrr.0b013e3283310d6e.
- Chang, K. W., Justice, D., Chung, K. C., & Yang, L. J. (2013). A systematic review of evaluation methods for neonatal brachial plexus palsy: a review. J Neurosurg Pediatr, 12(4), 395-405. https://doi.org/10.3171/2013.6.peds12630.
- Curtis, C., Stephens, D., Clarke, H. M., & Andrews, D. (2002). The active movement scale: an evaluative tool for infants with obstetrical brachial plexus palsy. J Hand Surg Am, 27(3), 470-478. https://doi.org/10.1053/jhsu.2002.32965.
- de Heer, C., Beckerman, H., & Groot, V. D. (2015). Explaining daily functioning in young adults with obstetric brachial plexus lesion. Disabil Rehabil, 37(16), 1455-1461. https://doi.org/10.3109/09638288.2014.972578.
- Delioğlu, K., Uzumcugil, A., & Gunel, M. K. (2022). Activity-based hand-function profile in preschool children with obstetric brachial plexus palsy. Hand Surg Rehabil, 41(4), 487-493. https://doi.org/10.1016/j.hansur.2022.05.007.
- Delioglu, K., Üzümcügil, A., Öztürk, E., & Günel, M. K. (2021). Activity and participation in preschool children with different injury types of obstetric brachial plexus paralysis. Turk J Physiother Rehabil, 32(1), 51-59. https://doi.org/10.21653/tjpr.753488.
- Duff, S. V., & DeMatteo, C. (2015). Clinical assessment of the infant and child following perinatal brachial plexus injury. J Hand Ther, 28(2), 126-134. https://doi.org/10.1016/j.jht.2015.01.001.
- Hale, H. B., Bae, D. S., & Waters, P. M. (2010). Current concepts in the management of brachial plexus birth palsy. J Hand Surg Am, 35(2), 322-331. https://doi.org/10.1016/j.jhsa.2009.11.026.
- Hayran M, Hayran M. (2011). Sağlık araştırmaları için temel istatistik. Ankara: Omega Araştırma.
- Ho, E. S., Curtis, C. G., & Clarke, H. M. (2012). The brachial plexus outcome measure: development, internal consistency, and construct validity. J Hand Ther, 25(4), 406-417. https://doi.org/10.1016/j.jht.2012.05.002.
- Immerman, I., Alfonso, D. T., Ramos, L. E., Grossman, L. A., Alfonso, I., Ditaranto, P., et al. (2012). Hand function in children with an upper brachial plexus birth injury: results of the nine‐hole peg test. Dev Med Child Neurol, 54(2), 166-169. https://doi.org/10.1111/j.1469-8749.2011.04120.x.
- Leblebicioğlu, G., & Pondaag, W. (2024). Brachial plexus birth injury: advances and controversies. J Hand Surg(Eur Vol), 0. https://doi.org/10.1177/17531934241231173.
- Mukaka, M. M. (2012). A guide to appropriate use of correlation coefficient in medical research. Malawi Med J, 24(3), 69-71.
- Ottenbacher, K. J., Msall, M. E., Lyon, N., Duffy L. C., Ziviani, J., Granger, C.V., et al. (2000). The WeeFIM instrument: its utility in detecting change in children with developmental disabilities. Arch Phys Med Rehabil, 81(10), 1317-26. https://doi.org/10.1053/apmr.2000.9387.
- Öksüz, Ç., Alemdaroglu, I., Kilinç, M., Abaoğlu, H., Demirci, C., Karahan, S., et al. (2017). Reliability and validity of the Turkish version of ABILHAND-Kids’ questionnaire in a group of patients with neuromuscular disorders. Physiotherapy Theory and Practice, 33(10), 780-7. https://doi.org/10.1080/09593985.2017.1346026.
- Partridge, C., & Edwards, S. (2004). Obstetric brachial plexus palsy: Increasing disability and exacerbation of symptoms with age. Physiotherapy Research International, 9(4), 157-63. https://doi.org/10.1002/pri.319.
- Pondaag, W., & Malessy, M. J. A. (2018). Outcome assessment for brachial plexus birth injury. Results from the ipluto world-wide consensus survey. J Orthop Res, 36(9), 2533-41. https://doi.org/10.1002/jor.23901.
- Poole, J. L., Burtner, P. A., Torres, T. A., McMullen, C. K., Markham, A., Marcum, M. L., et al. (2005). Measuring dexterity in children using the nine-hole peg test. J Hand Ther, 18(3), 348-51. https://doi.org/10.1197/j.jht.2005.04.003.
- Schober, P., Boer, C., & Schwarte, L. A. (2018) Correlation coefficients: appropriate use and interpretation. Anesth Analg, 126(5), 1763-8. https://doi.org/10.1213/ane.0000000000002864.
- Strömbeck, C., Krumlinde-Sundholm, L., Remahl, S., & Sejersen, T. (2007). Long-term follow-up of children with obstetric brachial plexus palsy I: functional aspects. Dev Med Child Neurol, 49(3), 198-203. https://doi.org/10.1111/j.1469-8749.2007.00198.x.
- van Dijk, J. G., Pondaag, W., & Malessy, M. J. (2001). Obstetric lesions of the brachial plexus. Muscle & Nerve, 24(11), 1451-61. https://doi.org/10.1002/mus.1168.
- Zuo, K. J., Ho, E. S., Hopyan, S., Clarke, H. M., & Davidge, K. M. (2023). Recent advances in the treatment of brachial plexus birth injury. Plast Reconstr Surg, 151(5), 857e-874e. https://doi.org/10.1097/prs.0000000000010047