{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:46:04Z","timestamp":1760147164568,"version":"3.37.3"},"reference-count":26,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2014,5,10]],"date-time":"2014-05-10T00:00:00Z","timestamp":1399680000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this cross\u2010sectional study was to assess systematically motor function and motor misrouting in adults with conservatively treated obstetric brachial plexus lesion (<jats:styled-content style=\"fixed-case\">OBPL<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Seventeen adults with <jats:styled-content style=\"fixed-case\">OBPL<\/jats:styled-content> (median age 38y; five males, 12 females) and 16 comparison participants (median age 26y; eight males, eight females) were investigated. Motor function in the group with OBPL was assessed through passive and active motion, muscle strength of the deltoid, biceps, and triceps muscles, and Mallet aggregate score and five subscores. Motor misrouting was quantified by electrically stimulating each of 10 arm muscles and recording activity from the other nine in response to this. Motor function and motor misrouting were statistically analysed using the Mann\u2013Whitney <jats:italic>U<\/jats:italic> test and Spearman's correlation coefficient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Motor function testing showed excellent strength but poor functional Mallet scores. Participants with <jats:styled-content style=\"fixed-case\">OBPL<\/jats:styled-content> had significantly more motor misrouting than comparison participants (Mann\u2013Whitney <jats:italic>U<\/jats:italic>=31.5 [df=28], <jats:italic>p<\/jats:italic>&lt;0.001, median difference=\u22124.00, 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>]=\u22127.00 to \u22121.00). Most misrouting was observed when stimulating the biceps (Mann\u2013Whitney <jats:italic>U<\/jats:italic>=38.5 [df=31], <jats:italic>p<\/jats:italic>&lt;0.001, median difference=\u22123.00, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> \u22123.00 to \u22121.00), deltoid (Mann\u2013Whitney <jats:italic>U<\/jats:italic>=68.5 [df=31], <jats:italic>p<\/jats:italic>=0.003, median difference=\u22121.0, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>=\u22124.00 to 0.00 &lt;0.001) and brachioradialis muscles (Mann\u2013Whitney <jats:italic>U<\/jats:italic>=72.0 [df=31], <jats:italic>p<\/jats:italic>=0.002, median difference &lt;0.001, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>=\u22123.00 to 0.00 &lt;0.001). There were no significant correlations between the presence of motor misrouting and impairment of motor function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>There is extensive motor misrouting in conservatively treated <jats:styled-content style=\"fixed-case\">OBPL<\/jats:styled-content>. The presence of this, in addition to motor functional impairment, suggests that motor misrouting should be further studied in <jats:styled-content style=\"fixed-case\">OBPL<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.12490","type":"journal-article","created":{"date-parts":[[2014,5,10]],"date-time":"2014-05-10T06:41:01Z","timestamp":1399704061000},"page":"984-989","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Extensive motor axonal misrouting after conservative treatment of obstetric brachial plexus lesions"],"prefix":"10.1111","volume":"56","author":[{"given":"Galia V","family":"Anguelova","sequence":"first","affiliation":[{"name":"Department of Neurology Leiden University Medical Centre Leiden the Netherlands"},{"name":"Department of Neurosurgery Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martijn J A","family":"Malessy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik W","family":"van Zwet","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics and Bioinformatics Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J Gert","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Department of Neurology Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,5,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016349309021133"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2004.tb00463.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1054\/jhsb.1999.0331"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199805000-00006"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.1168"},{"key":"e_1_2_8_7_1","first-page":"318","article-title":"Botulinum toxin and the pathophysiology of obstetric brachial plexus lesions","volume":"49","author":"Dijk JG","year":"2007","journal-title":"Dev Med Child Neurol"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.3171\/JNS\/2008\/109\/11\/0946"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3171\/2013.8.JNS122300"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(83)90113-2"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(79)90034-0"},{"key":"e_1_2_8_12_1","first-page":"225","article-title":"Intranervous regeneration of lower motor neuron. 1. Study of 1153 motor axon reflexes","volume":"18","author":"Roth G","year":"1978","journal-title":"Electromyogr Clin Neurophysiol"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0013-4694(60)90120-6"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.expneurol.2007.12.023"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0079-6123(09)17512-X"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.12019"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2012.04310.x"},{"key":"e_1_2_8_18_1","first-page":"1","volume-title":"Peripheral Nerve Injuries","author":"The Nerve Injury Committee of the Medical Research Council","year":"1954"},{"key":"e_1_2_8_19_1","first-page":"245","volume-title":"Muscles, Testing and Function with Posture and Pain","author":"Kendall FP","year":"2005"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199609000-00002"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.C.01614"},{"key":"e_1_2_8_22_1","first-page":"111","article-title":"Identification of a low\u2010threshold cutaneous reflex in the human arm","volume":"343","author":"McComas A","year":"1983","journal-title":"J Physiol (Lond)"},{"volume-title":"European Recommendations for Surface ElectroMyoGraphy: Results of the SENIAM project","year":"1999","author":"Hermens HJ","key":"e_1_2_8_23_1"},{"volume-title":"Anatomic Guide for the Electromyographer","year":"1975","author":"Delagi EF","key":"e_1_2_8_24_1"},{"volume-title":"R: A Language and Environment for Statistical Computing","year":"2013","author":"R Core Team","key":"e_1_2_8_25_1"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1054\/jhsb.1999.0282"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.4571-07.2007"}],"container-title":["Developmental Medicine &amp; Child Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fdmcn.12490","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dmcn.12490","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T17:11:10Z","timestamp":1695489070000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dmcn.12490"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,5,10]]},"references-count":26,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2014,10]]}},"alternative-id":["10.1111\/dmcn.12490"],"URL":"https:\/\/doi.org\/10.1111\/dmcn.12490","archive":["Portico"],"relation":{},"ISSN":["0012-1622","1469-8749"],"issn-type":[{"type":"print","value":"0012-1622"},{"type":"electronic","value":"1469-8749"}],"subject":[],"published":{"date-parts":[[2014,5,10]]},"assertion":[{"value":"2014-03-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-05-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}