Brachial Plexus Injury, Respiratory Evaluation
Conditions
Brief summary
To evaluate the surgical repercussions in patients with traumatic brachial plexus injury in the respiratory and motor systems, trunk biomechanics, functional capacity and quality of life.
Detailed description
Type of study will be a prospective cohort. The study will be performed at the Laboratory of Cardiopulmonary Physiotherapy of the Federal University of Pernambuco (UFPE). The sample will be calculated from a pilot study to be previously performed. The pilot study should have 10 individuals, 5 patients in each of the two groups. A group of patients who has brachial plexus injury and a group of healthy individuals for the pairing by sex and age. Eligibility criteria: patients who will undergo surgical intervention (within one year of the trauma), of both sexes, between 20 and 45 years of age, sedentary (oriented and encouraged to perform the activities of daily living at home, however , outside of any rehabilitation program) and encouraged to refrain from using tobacco. Patients with pulmonary contusions, severe pneumopathies, patients with congestive heart failure (NYHA class III or IV), diabetes mellitus, coronary artery disease, hemodynamic instability (MAP \<60 mmHg), multiple thorax fractures, amputation of one limb cognitive changes. Physiotherapeutic evaluations will be performed by a single physiotherapist trained in the preoperative one, three and six months after surgery for brachial plexus injury. The instruments of evaluation included are: optoelectronic plethysmography, spirometry, manovacuometry, diaphragmatic ultrasound, g-walk, upper limb dynamometry, pain questionnaires (Mcgill and DN4), upper limb functionality questionnaire (DASH) minutes and the quality of life questionnaire (Whoquol). Expected Results: The greatest impact should be to assist the patient in the prevention and physiotherapeutic treatment in relation to the possible sequels arising from the surgical process, besides fomenting the literature, expanding the knowledge about the subject and determining the applicability of the existing therapeutic resources, so that these are not used indiscriminately in daily practice.
Interventions
Evaluates the thoracoabdominal kinematics and the ventilatory pattern of the patient through the filming with cameras, simple and non-invasive examinations
Evaluates the diaphragmatic mobility through images, simple and non-invasive use
Evaluates the patient's posture through photos and filming, rapid examination, simple and non-invasive
by means of questionnaires
through questionnaires
Evaluated through the six-minute walk test, where the patient walks along a 30-meter corridor, simple, fast and safe assessment
through questionnaire
Sponsors
Study design
Eligibility
Inclusion criteria
Patients who will undergo surgical intervention; male; between 20 and 45 years of age; sedentary.
Exclusion criteria
Pulmonary contusions; Severe pneumopathies; Diabetes mellitus; Coronary artery disease; Multiple thorax fractures; Amputation of one limb; Cognitive changes \-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| thoracoabdominal kinematics | There will be two evaluations: one evaluation before surgery, another after six month | It will be evaluated through optoelectronic plethysmography |
| mobility diaphragmatic | There will be two evaluations: one evaluation before surgery, another after six month | It will be evaluated by means of an ultrasound |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Evaluation of the function | There will be two evaluations: one evaluation before surgery, another after six month | through questionnaire - Arm, Shoulder and Hand Disability (DASH). The score is given by a formula: Sum of the first 30 questions, subtract 30 and then divide by 1.2 The higher the score, the worse the function of the upper limbs (always evaluating the two limbs at the same time). |
| Postural evaluation | There will be two evaluations: one evaluation before surgery, another after six month | evaluates the patient's posture through photos, rapid examination, simple and non-invasive. Only the registration of images will be reactivated |
| Quality of life assessment | There will be two evaluations: one evaluation before surgery, another after six month | through questionnaire - World Health Organization Quality of Life Instrument (WHOQOL-Brief) - DOMAINS: Physical, Psychological, Social Relations, Environment and Self-evaluation of QOL. Score the higher the score, the better the quality of life of the patient. |
| Functional capacity assessment | There will be four evaluations: one evaluation before surgery, another with one month, three and six months after the surgery | Evaluated through the six-minute walk test, where the patient walks along a 30-meter corridor, simple, fast and safe assessment |
| Pain | There will be two evaluations: one evaluation before surgery, another after six month | evaluation by means of questionnaire |
Countries
Brazil