Correlation of pediatric outcomes data collection instrument with measures of active movement in children with brachial plexus birth palsy

Donald S Bae, Peter M Waters, David Zurakowski
Journal of Pediatric Orthopedics 2008, 28 (5): 584-92

BACKGROUND: The purpose of this investigation was to characterize the range of Pediatric Outcomes Data Collection Instrument (PODCI) scores in children with brachial plexus birth palsy (BPBP) and determine its correlation with 3 published measures of active motion and function.

METHODS: One hundred fifty children with BPBP between the ages of 2 and 10 years were evaluated. Active upper-extremity motion was assessed using the modified Mallet Classification (MC), the Toronto Test score (TTS), and the Hospital for Sick Children Active Movement Scale. At the time of evaluation, patients and/or families were administered the age-appropriate PODCI questionnaire, and PODCI scores were compared with published normative data. Linear regression analysis was used to assess the correlation between MC, TTS, and Active Movement Scale as predictors of PODCI scores.

RESULTS: Mean PODCI global function score in the BPBP patients was 82.4 (range, 35.1-100), significantly lower than the published value of 93.3 in healthy, age-matched norms (P < 0.01). The mean upper-extremity subscore was 70.8 versus 92.0 in healthy age-matched controls (P < 0.01). Sports/physical functioning scores averaged 81 points among BPBP patients compared with 90 points in healthy norms (P < 0.01). Mean mobility, comfort/pain, and happiness subscores were also significantly lower than normative values by 5, 7, and 4 points, respectively (P < 0.01). While significant correlations were observed between PODCI scores and all measures of active movement, the modified MC correlated most highly with PODCI global function scores in patients aged 2 to 5 years, whereas the TTSs best correlated with global function in patients aged 6 to 10 years.

CONCLUSION: Brachial plexus birth palsy patients have lower global and upper-extremity function compared with their healthy, age-matched peers, as measured by the PODCI. Physician-derived measures of active movement correlate with the patient/parent-derived PODCI scores and may be used to predict global function, upper-extremity function, and sports/physical activity in children 2 to 10 years of age with BPBP.

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