Gripforce reduction in children with an upper neonatal brachial plexus palsy.
Sophia M Buitenhuis, Willem Pondaag, Ron Wolterbeek and 1 others
PMID 34159390WHAT IT FOUND
Children with upper neonatal brachial plexus palsy had significantly weaker grip in their affected hand compared to healthy controls.
This weakness was not linked to reduced sensation, shoulder movement, or poor bimanual coordination, suggesting the cause is unclear rather than a simple sensory or mechanical deficit.
Key findings
01The mean gripforce of the non-dominant affected hand was 95 N in the NBPP group compared to 123 N in the control group, a statistically significant reduction.
02Gripforce in the affected hand was 76% of the unaffected hand in the NBPP group, whereas in controls the non-dominant hand was 92% of the dominant hand.
03No correlation was found between gripforce and sensibility, bimanual use, or shoulder external rotation scores.
STILL TO COME
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What it does not show
The study was conducted at a tertiary referral center, leading to an over-representation of surgically treated children and under-representation of those with good recovery. The authors did not systematically document actual hand usage patterns, relying instead on anecdotal reports from parents. The study design is cross-sectional, so it cannot prove that reduced grip causes reduced hand use, or vice versa. The cause of the grip weakness remains unknown, as it did not correlate with sensory, motor, or coordination measures.
Declared interests
The authors have no conflicts of interest to declare.
The easy way to misread this
Do not assume that improving shoulder range or sensation will automatically improve grip strength. The study found no correlation between these factors, suggesting the grip deficit has a different, currently unidentified cause.