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Joint contributions of the shoulder complex and cervical spine in children withobstetric brachial plexus palsy during reaching tasks

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Author(s):
Daiane Lazzeri de Medeiros
Total Authors: 1
Document type: Doctoral Thesis
Press: Ribeirão Preto.
Institution: Universidade de São Paulo (USP). Faculdade de Medicina de Ribeirão Preto (PCARP/BC)
Defense date:
Examining board members:
Anamaria Siriani de Oliveira; Marisa de Cássia Registro Fonseca
Advisor: Anamaria Siriani de Oliveira; Luis Mochizuki
Abstract

Objectives: To compare the upper limb function and quality of life (QOL) between children with neonatal brachial plexus palsy and unaffected controls. Moreover, we aimed to investigate the movement patterns and intersegmental coordination in NBPP children and matched controls during reaching tasks at different execution speeds. Methods: Children with NBPP and typical children aged 4 to 14 years were evaluated. The upper limb function was assessed using the Modified Mallet Scale (MMS) and Active Movement Scale (AMS). The quality of life was evaluated through the Pediatric Outcome Data Collection Instrument (PODCI) and the Child Health Questionnaire (CHQ). The three-dimensional kinematic evaluation was recorded by the 3 SPACE Liberty (Polhemus. Inc, Colchester, VT) with 120 Hz sampling frequency. Kinematic of the injured limb of NBPP children and the dominant limb of unaffected controls were recorded during a high-reach task (touch a ball), hand-toback-pocket task, hand-to-head task and elevation and lowering of the arm in the frontal plane. The first three tasks were performed in two conditions within two speeds, preferred speed and as fast as possible speed. We analyzed the range of motion of the upper limb, scapula and cervical during the reach tasks, and the scapula movements during the arm elevation and lowering. We also performed the vector coding analysis of the shoulder flexion - head flexion coupling angle in the hand to head task, shoulder flexion - elbow extension coupling angle during high reach task, and the coupling angle of scapula movements - shoulder abduction/aduction in the elevation and lowering of the arm. Results: Children with NBPP presented lower scores for most of the QOL domains evaluated through PODCI and CHQ. The NBPP children has lower limb upper arm function compared to the unaffected controls evaluated through MMS and AMS. The NBPP children and controls used different scapulothoracic, shoulder, elbow and head kinematic movement patterns in the reach tasks. In the arm elevation and lowering the scapula movement were similar between the groups, however, the coordination strategy of scapula protraction during the arm lowering was different. Furthermore, the coordination of NBPP children was different compared to unaffected controls in the hand on ball task, and presented similar coordination in the hand to head task. Conclusions: The NBPP has a negative influence on the quality of life and upper limb funcion of these children. The NBPP children and controls used differentscapulothoracic, shoulder, elbow and head kinematic movement patterns in the reach tasks. The coordination of NBPP children was different compared to unaffected controls when performing arm movements in the external environment (hand on ball task), and presented similar coordination when movements were made to their own body, as in the hand to head task. The NBPP children present similar scapular movement patterns to execute the arm elevation and lowering in the frontal plane, but the coordination strategy of scapula protraction movement during the lowering arm was different between the groups (AU)

FAPESP's process: 15/16254-7 - Joint contributions of the shoulder complex and cervical spine in children with obstetric brachial plexus palsy during reaching tasks
Grantee:Daiane Lazzeri de Medeiros
Support type: Scholarships in Brazil - Doctorate