Individuals with limited or no function of one upper limb due to upper limb absence are at higher risk for musculoskeletal complaints (MSCs). This may also be the case in individuals with brachial plexus injury (BPI), because they also have to compensate for a limited arm/hand function.
This thesis of Tallie van der Laan explores the consequences of BPI on the development of MSCs, disability, functional capacity, and physical work demands (part 1) and describes the development of observational rating systems assessing movement patterns and postures during functional capacity evaluations (part 2).
In part 1, a questionnaire revealed that 49% of people with brachial plexus injury had MSCs during the past year. The upper back, unaffected arm, and neck were most often affected. The presence of MSCs was associated with increased disability. The functional capacity of the unaffected arm of individuals with BPI was similar to that of controls, but their two-handed capacity was lower. No significant relationship was found between the presence of MSCs, functional capacity, and physical work demands. Unexamined factors like daily activities, leisure activities, and psychosocial factors may have influenced these results.
Part 2 showed that assessing postures and movement patterns of individuals with brachial plexus injury by observation is complicated, likely because of the great variation in movement patterns. However, postures and movement patterns of upper limb prosthesis wearers appear to be rated reliably using the developed observational rating system. This rating system may be valuable in the prevention and treatment of MSCs in upper limb prosthesis wearers.
