‘Switch’ technique to restore pronation and radial deviation in 17 patients with brachial plexus birth palsy

2019 ◽  
Vol 44 (9) ◽  
pp. 905-912
Author(s):  
Türker Özkan ◽  
Hasan Utkan Aydin ◽  
Ömer Berköz ◽  
Safiye Özkan ◽  
Erol Kozanoğlu
Keyword(s):  
Brachial Plexus ◽  
Performance Measure ◽  
Occupational Performance ◽  
Level Of Evidence ◽  
Ulnar Deviation ◽  
Canadian Occupational Performance Measure ◽  
Brachial Plexus Birth Palsy ◽  
Activity Performance ◽  
Birth Palsy

We report outcomes of 17 children with brachial plexus birth palsy that underwent extensor carpi ulnaris to brachioradialis and brachioradialis to abductor pollicis longus transfers to correct supination and ulnar deviation deformity. Mean age at the time of surgery was 8.7 years and mean follow-up time was 21 months (8–44). These patients had marked increases in active forearm rotation and Canadian Occupational Performance Measure scores. Activity performance score on the measure increased from 1.1 to 6.7 and satisfaction score increased from 0.8 to 8.7 at final follow-up. We conclude from our patient series that these tendon transfers are effective in correction of the supination and ulnar deviation deformities in brachial plexus birth palsy. Level of evidence: IV

Activity gains after upper limb surgery for spasticity in patients with spinal cord injury

2018 ◽  
Vol 43 (6) ◽  
pp. 613-620 ◽  
Author(s):  
Johanna Wangdell ◽  
Carina Reinholdt ◽  
Jan Fridén
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Upper Limb ◽  
Performance Measure ◽  
Occupational Performance ◽  
Level Of Evidence ◽  
Canadian Occupational Performance Measure ◽  
Upper Limb Surgery ◽  
Cord Injury ◽  
Activity Performance

Spasticity is a common and increasingly prevalent secondary complication of spinal cord injury. The aim of the study was to evaluate patient-experienced gains in prioritized activities after surgery to reduce the effects of spasticity in upper limbs in tetraplegia. The study includes evaluation of 30 operations for 27 patients performed on hypertonic tetraplegic hands during 2007–2015 using the Canadian Occupational Performance Measure. Activity performance increased at both 6 months and 12 months by a mean of 3.0 and 2.9 points, respectively. Satisfaction increased by 3.3 and 3.4, respectively. All types of activities improved, with wheelchair manoeuvring as one of the highest rated. The intervention increased prioritized activity performance and persisted at least 12 months after surgery. Patients with mild upper limb impairment showed greater improvement after surgery. After operation, patients were able to perform 71% of their prioritized activities, which they could not perform before. Patients’ satisfaction with the performance was high. Level of evidence: IV

Clinical Report: Use of the Canadian Occupational Performance Measure in Vision Technology

2005 ◽  
Vol 72 (5) ◽  
pp. 309-312 ◽  
Author(s):  
Linda S. Petty ◽  
Laurie McArthur ◽  
Jutta Treviranus
Keyword(s):  
Assistive Technology ◽  
Performance Measure ◽  
Funding Agency ◽  
Clinical Report ◽  
Occupational Performance ◽  
Wide Acceptance ◽  
Canadian Occupational Performance Measure ◽  
Technology Service ◽  
Client Needs

Background. The Canadian Occupational Performance Measure (COPM) has gained wide acceptance in general occupational therapy research and practice, however, the use of the COPM in assistive technology assessments and outcomes is not as well documented. Purpose. This clinical report discusses the utility of the COPM in assistive technology, as illustrated by the assessment and follow-up of clients requiring high technology vision aids. Results. The COPM makes important contributions to the outcomes of providing vision aids. The COPM ensures a needs review that incorporates all areas of occupational performance, which in turn directs the clinician to match the technology to client needs. From a clinical perspective, the quantitative follow-up data are helpful to determine clients' improvement in occupational performance as well as their satisfaction with the assistive technology. For administrative purposes, the COPM results provides accountability to the funding agency. Practice Implications. The COPM can be readily integrated into the assessment and follow-up of assistive technology service delivery and adds value to both components of the process.

Functional outcomes of tendon transfer for brachial plexus birth palsy using the Hoffer technique

2020 ◽  
Vol 102-B (2) ◽  
pp. 246-253 ◽  
Author(s):  
Ram K. Alluri ◽  
Nina Lightdale-Miric ◽  
Erin Meisel ◽  
Gina Kim ◽  
Jesse Kaplan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Brachial Plexus ◽  
Functional Outcomes ◽  
External Rotation ◽  
Shoulder Abduction ◽  
Active Movement ◽  
Brachial Plexus Birth Palsy ◽  
Derotational Osteotomy ◽  
Birth Palsy

Aims To describe and analyze the mid-term functional outcomes of a large series of patients who underwent the Hoffer procedure for brachial plexus birth palsy (BPBP). Methods All patients who underwent the Hoffer procedure with minimum two-year follow-up were retrospectively reviewed. Active shoulder range of movement (ROM), aggregate modified Mallet classification scores, Hospital for Sick Children Active Movement Scale (AMS) scores, and/or Toronto Test Scores were used to assess functional outcomes. Subgroup analysis based on age and level of injury was performed. Risk factors for subsequent humeral derotational osteotomy and other complications were also assessed. A total of 107 patients, average age 3.9 years (1.6 to 13) and 59% female, were included in the study with mean 68 months (24 to 194) follow-up. Results All patients demonstrated statistically significant improvement in all functional outcomes and active shoulder abduction and external rotation ROM (p < 0.001). Patients < 2.5 years of age had higher postoperative AMS, abduction ROM and strength scores, and aggregate postoperative Toronto scores (p ≤ 0.035) compared to patients ≥ 2.5 years old. There were 17 patients (16%) who required a subsequent humeral derotational osteotomy; lower preoperative AMS external rotation scores and external rotation ROM were predictive risk factors (p ≤ 0.016). Conclusion Patients with BPBP who underwent the Hoffer procedure demonstrated significant improvement in postoperative ROM, strength, and functional outcome scores at mid-term follow-up. Patients younger than 2.5 years at the time of surgery generally had better functional outcomes. Limited preoperative external rotation strength and ROM were significantly associated with requirement for subsequent humeral derotational osteotomy. In our chort significant improvements in shoulder function were obtained after the Hoffer procedure for BPBP. Cite this article: Bone Joint J 2020;102-B(2):246–253.

Structures contributing to the shoulder contracture in brachial plexus birth palsy. An intraoperative biomechanical study

2021 ◽  
pp. 175319342110349
Author(s):  
Krister Jönsson ◽  
Fredrik Roos ◽  
Tomas Hultgren
Keyword(s):  
Brachial Plexus ◽  
External Rotation ◽  
Biomechanical Study ◽  
Subscapularis Tendon ◽  
Level Of Evidence ◽  
Anatomical Structures ◽  
Brachial Plexus Birth Palsy ◽  
Birth Palsy ◽  
Shoulder Contracture ◽  
Surgical Release

Internal rotation contracture of the shoulder is a common sequel of the brachial plexus birth palsy. The purpose of this study is to describe the surgical method used in our centre and to measure the effect of sequentially releasing several anatomical structures that have been ascribed as the cause of the contracture. Twenty-four consecutive patients were operated on with an open release. We documented the increase in passive external rotation after each surgical step. We found small gains in passive external rotation when performing coracoidectomy and division of the upper part of the subscapularis tendon; 4° (95% confidence interval [CI] 2°–6° p < 0.01) and 6° (95% CI 4°–8° p < 0.01), respectively. A substantial gain in external rotation occurred when dividing the entire subscapularis tendon, 43° (95% CI 38°–48°, p < 0.01). Our findings indicate that a clinically relevant surgical release of the contracture requires lengthening of the entire subscapularis musculo-tendinous unit. Level of evidence: IV

scholarly journals The Canadian Occupational Performance Measure: A Feasible Multidisciplinary Outcome Measure for Pediatric Telerehabilitation

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Lynn R Tanner ◽  
Kathy Grinde ◽  
Cristin McCormick
Keyword(s):  
Clinical Utility ◽  
Outcome Measure ◽  
Performance Measure ◽  
Functional Change ◽  
Occupational Performance ◽  
Clinical Change ◽  
Time Points ◽  
Reasonable Amount ◽  
Canadian Occupational Performance Measure

This study describes the feasibility of using the Canadian Occupational Performance Measure (COPM) as a multidisciplinaryoutcome measure for pediatric telerehabilitation (TR). The COPM was administered at monthly time points over four months. A follow-up survey was conducted with the therapists to assess clinical utility of the COPM. Seventy-three percent of the children seen in TR > one month had at least two administrations of the COPM. Eighty percent of therapists agreed or strongly agreed that the COPM was easy to use in a reasonable amount of time, helped identify functional goals, could be used with various children with varied diagnoses, and measured functional change. In 37 children, the median clinical change in performance and satisfaction was two points or greater on the COPM over the episode of TR. The COPM is a feasible measure perceived positively by pediatric therapists for TR use.

scholarly journals Self-reported Reasons for Changes in Performance of Everyday Activities During a 2-Year Multidisciplinary Multiple Sclerosis Rehabilitation

2021 ◽  
Author(s):  
Maarit E. Karhula ◽  
Katja Kanelisto ◽  
Päivi Hämäläinen ◽  
Juhani Ruutiainen ◽  
Pertti Era ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Environmental Factors ◽  
Severe Disabilities ◽  
Rehabilitation Program ◽  
Performance Measure ◽  
The Self ◽  
Outpatient Rehabilitation ◽  
Occupational Performance ◽  
Canadian Occupational Performance Measure ◽  
Activity Performance

Abstract Background: Few multidisciplinary rehabilitation studies with a heterogeneous design have focused on people with multiple sclerosis (MS). This study compared subjective-reported changes in performance and satisfaction with daily activities among moderately and severely disabled people with MS during a 2-year, multidisciplinary, group-based, outpatient rehabilitation program comprising education in self-management and compensatory techniques, exercise, and guided peer support. Methods: Thirty-eight adults with moderate disability (Expanded Disability Status Scale [EDSS] score of 4.0–5.5, 74% women, mean age of 48 years) and 41 persons with severe disability (EDSS 6.0–8.5, 63% women, mean age of 48 years) were assessed at baseline and after 12 and 21 months of outpatient rehabilitation using the Canadian Occupational Performance Measure. Group × time interactions were analyzed using mixed analysis of variance. Participants’ explanations of reasons for changes in activity performance were collected via semistructured interviews and content analyzed. Results: Statistically significant improvements in Canadian Occupational Performance Measure performance and satisfaction scores were reported in both groups from baseline to 21 months of rehabilitation. No significant between-group differences in improvement were observed. The self-reported reasons for improvement were mainly linked to environmental factors. Conclusions: The outpatient rehabilitation program, including four themes—cognition, mood, energy conservation, and body control—improved the self-reported performance of patients with MS with moderate and severe disabilities. Environmental factors warrant consideration during rehabilitation.

The Use and Validity of the Canadian Occupational Performance Measure in a Posttraumatic Stress Program

2006 ◽  
Vol 26 (2) ◽  
pp. 45-55 ◽  
Author(s):  
Kim Harper ◽  
Carol A. Stalker ◽  
Gillian Templeton
Keyword(s):  
Performance Measure ◽  
Occupational Performance ◽  
Post Discharge ◽  
Standardized Measures ◽  
Group Format ◽  
Canadian Occupational Performance Measure ◽  
Perceived Change ◽  
The Mean ◽  
Care Relationships

The Canadian Occupational Performance Measure (COPM) was adapted to a group format and used to investigate self-perceived change over time with respect to treatment goals in a sample of adults with histories of child abuse who participated in a 6-week inpatient trauma program. Using the COPM, 177 adults developed individualized goals and rated their performance and satisfaction with performance of these goals at admission, discharge, and 3, 6, and 12 months post-discharge. Goals were classified into six categories and changes in self-ratings were analyzed. Results indicated that the mean scores on the COPM were significantly improved over admission levels at all points in time with respect to goals of self-care, relationships and communication, coping with feelings, and spirituality. However, many participants did not maintain discharge levels at follow-up points. Comparison of the adapted COPM to other standardized measures used in this study supported concurrent criterion validity. Implications for helping professionals are discussed.

Measuring the Outcomes of Word Cueing Technology

2005 ◽  
Vol 72 (5) ◽  
pp. 301-308 ◽  
Author(s):  
Cynthia Tam ◽  
Janice Archer ◽  
Jennifer Mays ◽  
Gretchen Skidmore
Keyword(s):  
Assistive Technology ◽  
Change Score ◽  
Outcome Data ◽  
Performance Measure ◽  
Occupational Performance ◽  
Telephone Interviews ◽  
Canadian Occupational Performance Measure ◽  
Background Measurement ◽  
The Impact

Background. Measurement of assistive technology outcomes is complex because many factors (e.g., environment and model of service delivery) influence the successful use of the technology. Purpose. Using the example of measuring the outcomes of word cueing technology, this paper presents an approach for measuring assistive technology outcomes. Method. The Canadian Occupational Performance Measure (COPM) was administered to 29 children with physical and learning disabilities, between the ages of 3.9 and 19 years. Participants were provided with WordQ, a software program designed to assist the development of writing skills. Follow-up data were collected through telephone interviews. Results. The COPM findings supported the effectiveness of WordQ Version 1 to enhance written productivity, with a mean performance change score of 3.5 (SD = 1.5). The COPM was an effective tool for measuring clients' perceived outcome of word cueing technology. Telephone interview was considered a successful method for collecting outcome data. Practice Implications. A mix of tools and methodologies should be used to gain a comprehensive understanding of the impact of assistive technology.

Participant-perceived occupational outcomes after two years of yoga for chronic pain

2021 ◽  
pp. 030802262098577
Author(s):  
Caroline M Rose ◽  
Karen E Atler ◽  
Jennifer Dickman Portz ◽  
Alexandra P Andrews ◽  
Arlene A Schmid
Keyword(s):  
Chronic Pain ◽  
Qualitative Interviews ◽  
Performance Measure ◽  
Measure Data ◽  
Occupational Performance ◽  
Community Based ◽  
Canadian Occupational Performance Measure ◽  
Perceived Impact

Introduction The study aim was to investigate the perceived impact and experience of long-term involvement in community-based group yoga for people with chronic pain. Methods Eleven participants, who previously completed an 8-week yoga intervention and continued attending yoga at a community pain clinic for 2 years, participated in the study. A mixed-methods approach was employed. Canadian Occupational Performance Measure data were collected during the 8-week yoga study (baseline) and after 2 years of yoga (follow-up). Baseline and follow-up Canadian Occupational Performance Measure data were compared to measure change in perceived occupational performance and satisfaction. Individual qualitative interviews were conducted to explore participants’ perceived impact and experience of long-term yoga involvement. Canadian Occupational Performance Measure data were analyzed using Wilcoxon signed-rank tests, and qualitative interviews were analyzed using an inductive approach. Findings Canadian Occupational Performance Measure scores significantly improved between baseline and follow-up. Three main themes emerged from qualitative interviews: (a) Occupational shift from “existing” to “living,” (b) The change process is “progressive,” and (c) Yoga is “a positive thing I do in my life.” Conclusion Long-term involvement in community-based group yoga may improve and sustain occupational performance and satisfaction. Occupational therapists may consider yoga as a tool to promote occupational gains in people with chronic pain.

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