Assessment of the relationship between Brachial Plexus Profile activity short form scores and modified Mallet scores

Stephanie A Russo; Matthew T Topley; R Tyler Richardson; James G Richards; Ross S Chafetz; Elizabeth A Rapp van Roden; Dan A Zlotolow; Mary Jane Mulcahey; Scott H Kozin

doi:10.1016/j.jht.2020.10.003

Assessment of the relationship between Brachial Plexus Profile activity short form scores and modified Mallet scores

J Hand Ther. 2022 Jan-Mar;35(1):51-57. doi: 10.1016/j.jht.2020.10.003. Epub 2020 Oct 31.

Authors

Stephanie A Russo¹, Matthew T Topley², R Tyler Richardson³, James G Richards², Ross S Chafetz⁴, Elizabeth A Rapp van Roden², Dan A Zlotolow⁴, Mary Jane Mulcahey⁵, Scott H Kozin⁴

Affiliations

¹ University of Pittsburgh Medical Center - Hamot, Erie, PA, USA. Electronic address: sarusso@udel.edu.
² University of Delaware, Newark, DE, USA.
³ Pennsylvania State University Harrisburg, Middletown, PA, USA.
⁴ Shriners Hospital for Children, Philadelphia, PA, USA.
⁵ Thomas Jefferson University, Philadelphia, PA, USA.

PMID: 33308927
DOI: 10.1016/j.jht.2020.10.003

Abstract

Introduction: This study aims to assess the relationship between the modified Mallet classification and the Brachial Plexus Profile activity short form (BP-PRO activity SF). The therapist or surgeon classifies upper extremity movement for the modified Mallet classification, while the BP-PRO assesses parents' perceptions of difficulty performing activities.

Purpose: To provide a deeper understanding of the relationship of functional and perceived outcome measurements.

Study design: Prospective, correlational design.

Methods: Eighty children with brachial plexus birth injuries were evaluated using the modified Mallet classification, while parents simultaneously answered the BP-PRO activity SF questions. All patients had undergone one of three surgical interventions to improve shoulder function. The relationship between the two measures, patient injury levels, and surgical histories were assessed.

Results: The average modified Mallet scores and BP-PRO activity SF scores weakly correlated (r = 0.312, P = .005) and both measures differentiated between C5-6 and C5-7 injury levels (P = .03 and P = .02, respectively). Conversely, the modified Mallet scores could differentiate between the three surgical groups (F = 8.2, P < .001), while the BP-PRO activity SF could not (P = .54).

Conclusion: The results suggest that these tools measure different aspects of patient outcomes. The Mallet classification may be more focused on shoulder motion than the BP-PRO activity SF. Additional questions that specifically require shoulder function could be incorporated into the BP-PRO activity SF to improve understanding of patient/parent perceptions of shoulder function for children with brachial plexus injuries. Clinicians should be aware of the strengths, weaknesses, and limitations of each outcome assessment tool for appropriate use and interpretation of results.

Keywords: Birth injury; Brachial plexus; Functional outcomes; Patient-reported outcomes; Shoulder.

MeSH terms

Birth Injuries*
Brachial Plexus Neuropathies* / surgery
Brachial Plexus* / injuries
Child
Humans
Prospective Studies
Range of Motion, Articular
Shoulder Joint*
Treatment Outcome