Comparison of pediatric outcomes data collection instrument scores and range of motion before and after shoulder tendon transfers for children with brachial plexus birth palsy

Russell D. Dedini, Anita M. Bagley, Fred Molitor, Michelle James

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

BACKGROUND: Children with brachial plexus birth palsy (BPBP) may undergo shoulder external rotation tendon transfers (ERTT) to improve function. In terms of outcome measurements, and according to the World Health Organization International Classification of Functioning, Disability, and Health model, ERTT reduces impairment as measured by range of motion (ROM), but has not been shown to improve activity and participation. Furthermore, correlation between these outcome measures has not been established. The Pediatric Outcomes Data Collection Instrument (PODCI) is a well-validated musculoskeletal health questionnaire that addresses activity and participation components of function. The aim of this study is to determine whether PODCI scores improve after ERTT, and whether this improvement correlates with improvement in ROM. METHODS: A total of 23 children with a mean age of 6.3 years (range, 4.4-12.8 years) with BPBP and standard indications for ERTT underwent preoperative and 1-year postoperative shoulder ROM measurements, and parental completion of the PODCI. Change in ROM was compared with change in PODCI scores to determine if these were correlated. RESULTS: Average range of active shoulder abduction improved 35 degrees (P < 0.001), and average range of active external rotation improved 41 degrees (P < 0.001). The PODCI scores for Upper Extremity Function, Sports Function, and Global Function improved (12 points [P < 0.001], 4 points [P = 0.04], and 6 points [P = 0.001], respectively). Improvement in ROM did not correlate with improvement in PODCI scores. However, postoperative peak active abduction correlated strongly with postoperative PODCI scores for Upper Extremity Function, and Global Function (rs = 0.712 [P < 0.001], rs = 0.735 [P < 0.001], respectively), and moderately with Transfers and Basic Mobility and Sports Function scores (rs = 0.496 [P=0.016], rs = 0.449 [P = 0.032], respectively). CONCLUSIONS: For children with BPBP, ERTT is associated with reduced impairment and improved activity and participation. Maximum postoperative abduction is positively associated with PODCI scores, but change in ROM is not. Further study is needed to determine if ceiling effects or other factors account for the lack of correlation between these outcome measures. LEVEL OF EVIDENCE: Level of evidence IV, case series.

Original languageEnglish (US)
Pages (from-to)259-264
Number of pages6
JournalJournal of Pediatric Orthopaedics
Volume28
Issue number2
DOIs
StatePublished - Mar 2008

Fingerprint

Tendon Transfer
Brachial Plexus
Articular Range of Motion
Paralysis
Parturition
Pediatrics
Upper Extremity
Sports
Outcome Assessment (Health Care)
International Classification of Functioning, Disability and Health

Keywords

  • Brachial plexus birth palsy
  • External rotation tendon transfer
  • Functional outcomes
  • Pediatric Outcomes Data Collection Instrument
  • PODCI

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Orthopedics and Sports Medicine

Cite this

@article{3f69ec98d8df49649df6f30c4fbbfd26,
title = "Comparison of pediatric outcomes data collection instrument scores and range of motion before and after shoulder tendon transfers for children with brachial plexus birth palsy",
abstract = "BACKGROUND: Children with brachial plexus birth palsy (BPBP) may undergo shoulder external rotation tendon transfers (ERTT) to improve function. In terms of outcome measurements, and according to the World Health Organization International Classification of Functioning, Disability, and Health model, ERTT reduces impairment as measured by range of motion (ROM), but has not been shown to improve activity and participation. Furthermore, correlation between these outcome measures has not been established. The Pediatric Outcomes Data Collection Instrument (PODCI) is a well-validated musculoskeletal health questionnaire that addresses activity and participation components of function. The aim of this study is to determine whether PODCI scores improve after ERTT, and whether this improvement correlates with improvement in ROM. METHODS: A total of 23 children with a mean age of 6.3 years (range, 4.4-12.8 years) with BPBP and standard indications for ERTT underwent preoperative and 1-year postoperative shoulder ROM measurements, and parental completion of the PODCI. Change in ROM was compared with change in PODCI scores to determine if these were correlated. RESULTS: Average range of active shoulder abduction improved 35 degrees (P < 0.001), and average range of active external rotation improved 41 degrees (P < 0.001). The PODCI scores for Upper Extremity Function, Sports Function, and Global Function improved (12 points [P < 0.001], 4 points [P = 0.04], and 6 points [P = 0.001], respectively). Improvement in ROM did not correlate with improvement in PODCI scores. However, postoperative peak active abduction correlated strongly with postoperative PODCI scores for Upper Extremity Function, and Global Function (rs = 0.712 [P < 0.001], rs = 0.735 [P < 0.001], respectively), and moderately with Transfers and Basic Mobility and Sports Function scores (rs = 0.496 [P=0.016], rs = 0.449 [P = 0.032], respectively). CONCLUSIONS: For children with BPBP, ERTT is associated with reduced impairment and improved activity and participation. Maximum postoperative abduction is positively associated with PODCI scores, but change in ROM is not. Further study is needed to determine if ceiling effects or other factors account for the lack of correlation between these outcome measures. LEVEL OF EVIDENCE: Level of evidence IV, case series.",
keywords = "Brachial plexus birth palsy, External rotation tendon transfer, Functional outcomes, Pediatric Outcomes Data Collection Instrument, PODCI",
author = "Dedini, {Russell D.} and Bagley, {Anita M.} and Fred Molitor and Michelle James",
year = "2008",
month = "3",
doi = "10.1097/BPO.0b013e3181652135",
language = "English (US)",
volume = "28",
pages = "259--264",
journal = "Journal of Pediatric Orthopaedics",
issn = "0271-6798",
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}

TY - JOUR

T1 - Comparison of pediatric outcomes data collection instrument scores and range of motion before and after shoulder tendon transfers for children with brachial plexus birth palsy

AU - Dedini, Russell D.

AU - Bagley, Anita M.

AU - Molitor, Fred

AU - James, Michelle

PY - 2008/3

Y1 - 2008/3

N2 - BACKGROUND: Children with brachial plexus birth palsy (BPBP) may undergo shoulder external rotation tendon transfers (ERTT) to improve function. In terms of outcome measurements, and according to the World Health Organization International Classification of Functioning, Disability, and Health model, ERTT reduces impairment as measured by range of motion (ROM), but has not been shown to improve activity and participation. Furthermore, correlation between these outcome measures has not been established. The Pediatric Outcomes Data Collection Instrument (PODCI) is a well-validated musculoskeletal health questionnaire that addresses activity and participation components of function. The aim of this study is to determine whether PODCI scores improve after ERTT, and whether this improvement correlates with improvement in ROM. METHODS: A total of 23 children with a mean age of 6.3 years (range, 4.4-12.8 years) with BPBP and standard indications for ERTT underwent preoperative and 1-year postoperative shoulder ROM measurements, and parental completion of the PODCI. Change in ROM was compared with change in PODCI scores to determine if these were correlated. RESULTS: Average range of active shoulder abduction improved 35 degrees (P < 0.001), and average range of active external rotation improved 41 degrees (P < 0.001). The PODCI scores for Upper Extremity Function, Sports Function, and Global Function improved (12 points [P < 0.001], 4 points [P = 0.04], and 6 points [P = 0.001], respectively). Improvement in ROM did not correlate with improvement in PODCI scores. However, postoperative peak active abduction correlated strongly with postoperative PODCI scores for Upper Extremity Function, and Global Function (rs = 0.712 [P < 0.001], rs = 0.735 [P < 0.001], respectively), and moderately with Transfers and Basic Mobility and Sports Function scores (rs = 0.496 [P=0.016], rs = 0.449 [P = 0.032], respectively). CONCLUSIONS: For children with BPBP, ERTT is associated with reduced impairment and improved activity and participation. Maximum postoperative abduction is positively associated with PODCI scores, but change in ROM is not. Further study is needed to determine if ceiling effects or other factors account for the lack of correlation between these outcome measures. LEVEL OF EVIDENCE: Level of evidence IV, case series.

AB - BACKGROUND: Children with brachial plexus birth palsy (BPBP) may undergo shoulder external rotation tendon transfers (ERTT) to improve function. In terms of outcome measurements, and according to the World Health Organization International Classification of Functioning, Disability, and Health model, ERTT reduces impairment as measured by range of motion (ROM), but has not been shown to improve activity and participation. Furthermore, correlation between these outcome measures has not been established. The Pediatric Outcomes Data Collection Instrument (PODCI) is a well-validated musculoskeletal health questionnaire that addresses activity and participation components of function. The aim of this study is to determine whether PODCI scores improve after ERTT, and whether this improvement correlates with improvement in ROM. METHODS: A total of 23 children with a mean age of 6.3 years (range, 4.4-12.8 years) with BPBP and standard indications for ERTT underwent preoperative and 1-year postoperative shoulder ROM measurements, and parental completion of the PODCI. Change in ROM was compared with change in PODCI scores to determine if these were correlated. RESULTS: Average range of active shoulder abduction improved 35 degrees (P < 0.001), and average range of active external rotation improved 41 degrees (P < 0.001). The PODCI scores for Upper Extremity Function, Sports Function, and Global Function improved (12 points [P < 0.001], 4 points [P = 0.04], and 6 points [P = 0.001], respectively). Improvement in ROM did not correlate with improvement in PODCI scores. However, postoperative peak active abduction correlated strongly with postoperative PODCI scores for Upper Extremity Function, and Global Function (rs = 0.712 [P < 0.001], rs = 0.735 [P < 0.001], respectively), and moderately with Transfers and Basic Mobility and Sports Function scores (rs = 0.496 [P=0.016], rs = 0.449 [P = 0.032], respectively). CONCLUSIONS: For children with BPBP, ERTT is associated with reduced impairment and improved activity and participation. Maximum postoperative abduction is positively associated with PODCI scores, but change in ROM is not. Further study is needed to determine if ceiling effects or other factors account for the lack of correlation between these outcome measures. LEVEL OF EVIDENCE: Level of evidence IV, case series.

KW - Brachial plexus birth palsy

KW - External rotation tendon transfer

KW - Functional outcomes

KW - Pediatric Outcomes Data Collection Instrument

KW - PODCI

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U2 - 10.1097/BPO.0b013e3181652135

DO - 10.1097/BPO.0b013e3181652135

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VL - 28

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JO - Journal of Pediatric Orthopaedics

JF - Journal of Pediatric Orthopaedics

SN - 0271-6798

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