Pediatric Neurology ( IF 3.8 ) Pub Date : 2022-06-16 , DOI: 10.1016/j.pediatrneurol.2022.06.008 Bilge Nur Yardımcı-Lokmanoğlu 1 , Tüzün Fırat 2 , Kıvanç Delioğlu 3 , Doğan Porsnok 1 , Gülsen Sırtbaş 1 , Akmer Mutlu 1
Background
Obstetric brachial plexus palsy (OBPP) is a birth injury that affects upper extremity performance. However, some children with OBPP might have central nervous system disorder or developmental disabilities. This study aimed to investigate (1) the early spontaneous movements using General Movements Assessment (GMA) in infants with OBPP according to the Narakas classification, (2) the differences from typical infants, and (3) the relationship between the GMA and the affected upper extremity movements score.
Methods
Fifty-six infants with OBPP (39 females; median gestational age 40 weeks, range = 34 to 42) and 50 typical infants (20 females; median gestational age 38 weeks, range = 37 to 41) were assessed at age three to five months using the GMA, which is a determined Motor Optimality Score (MOS) for fidgety movements and concurrent motor repertoire, and using the Active Movement Scale (AMS) for affected upper extremity movements.
Results
There were no differences in MOS and its subcategories between Narakas types in infants with OBPP (P > 0.05); however, infants with OBPP had a higher degree of aberrant fidgety movements and a lower score in MOS and its subcategories than typical infants (P < 0.05). There was no relationship between AMS scores, and MOS and its subcategories.
Conclusions
Infants with OBPP, except Narakas type I, might have an increased risk of central nervous disorder and developmental problems in addition to peripheral nerve injury. Each test, GMA and AMS, contributes to the identification of their own specific risk in these infants.
中文翻译:
所有 Narakas 类型的产科臂丛神经麻痹婴儿的早期自发运动和上肢运动评分
背景
产科臂丛神经麻痹 (OBPP) 是一种影响上肢功能的产伤。然而,一些患有 OBPP 的儿童可能有中枢神经系统疾病或发育障碍。本研究旨在调查 (1) 根据 Narakas 分类,使用一般运动评估 (GMA) 对患有 OBPP 的婴儿进行早期自发运动,(2) 与典型婴儿的差异,以及 (3) GMA 与受影响的婴儿之间的关系上肢运动评分。
方法
56 名 OBPP 婴儿(39 名女性;中位胎龄 40 周,范围 = 34 至 42)和 50 名典型婴儿(20 名女性;中位胎龄 38 周,范围 = 37 至 41)在 3 至 5 个月大时进行了评估使用 GMA,这是一个确定的运动最佳分数 (MOS),用于烦躁的运动和并发运动曲目,并使用主动运动量表 (AMS) 来测量受影响的上肢运动。
结果
OBPP 患儿 Narakas 分型 MOS 及其亚类差异无统计学意义(P > 0.05);与典型婴儿相比,OBPP 患儿的异常烦躁运动程度更高,MOS 及其子类别评分更低(P < 0.05)。AMS 分数与 MOS 及其子类别之间没有关系。
结论
除 I 型 Narakas 外,患有 OBPP 的婴儿除了周围神经损伤外,中枢神经紊乱和发育问题的风险可能增加。GMA 和 AMS 的每项测试都有助于确定这些婴儿自身的特定风险。