Abstract:
There is no consensus regarding strategies to optimally treat children with a brachial plexus birth injury (BPBI). Comparison of outcome data presented by different centers is impossible due to the use of (1) many different outcome measures to evaluate results; (2) different follow-up periods after interventions; and (3) different patient ages at the time of assessment. The goal of iPluto (international PLexus oUtcome sTudy grOup) was to define a standardized dataset which should be minimally collected to evaluate upper limb function in children with BPBI. This dataset must enable comparison of the treatment results of different centers if prospectively used. Three rounds of internet surveys were used to reach consensus on the dataset. A Delphi-derived technique was applied using a nine point Likert scale. Consensus was defined as having attained a rating of 7/8/9 by > = 75% of the participants. A total of 59 participants from five continents participated in the Second and Third Rounds of the survey. Consensus was reached regarding four elements: (1) evaluation should take place at the age of 1/3/5/7 years; range of motion in degrees should be measured for (2) passive joint movement; (3) active range of motion; and (4) the Mallet score should be determined. Consensus on how to asses and report outcome for BPBI was only reached on motor items from the \"Body Function and Structure\" domain. Consensus regarding additional ICF domains to obtain a more elaborate set of outcome items, should be addressed in future research. © 2018 The Authors. Journal of Orthopaedic Research® Published by Wiley Periodicals, Inc. on behalf of the Orthopaedic Research Society. J Orthop Res 36:2533-2541, 2018.
摘要:
关于最佳治疗臂丛神经产伤(BPBI)儿童的策略尚无共识。由于使用(1)许多不同的结局指标来评估结果;(2)干预后的随访时间不同;(3)评估时患者年龄不同,因此无法比较不同中心提供的结局数据。iPluto(国际PLexusoUtcomesTudygrOup)的目标是定义一个标准化的数据集,该数据集应最少收集以评估BPBI儿童的上肢功能。如果前瞻性使用,该数据集必须能够比较不同中心的治疗结果。使用三轮互联网调查就数据集达成共识。使用九点李克特量表应用了德尔菲衍生技术。共识被定义为>=75%的参与者获得了7/8/9的评级。共有来自五大洲的59名参与者参加了第二轮和第三轮调查。就四个要素达成共识:(1)评估应在1/3/5/7岁时进行;应测量(2)被动关节运动的运动范围;(3)主动运动范围;(4)应确定Mallet评分。关于如何评估和报告BPBI结果的共识仅在“身体功能和结构”领域的运动项目上达成。关于其他ICF领域的共识,以获得一套更详细的成果项目,应该在未来的研究中加以解决。©2018作者Wiley期刊出版的骨科研究杂志,公司代表骨科研究学会。JOrthopRes36:2533-2541,2018.