Spring Arbor University and the Brachial Plexus Program at the University of Michigan Health System recently created the MedSAU Fund in an effort to address Neonatal Brachial Plexus Palsy (NBPP), a debilitating condition occurring during the perinatal period that results in paralysis and loss of sensation in the affected arm. Through this fund, main campus undergraduate faculty and students at SAU will work with specialist Dr. Lynda Yang, M.D., Ph.D., and other U of M medical professionals and students to conduct groundbreaking studies.
NBPP is a chronic problem that affects a family and their child’s entire life. These problems range from the child’s physical limitations, to school-yard bullying, and includes significant emotional and financial distress on the family unit.
The number of children impacted by this debilitating condition rivals cerebral palsy—one to four of every 1,000 children born in the United States. However, unlike cerebral palsy, NBPP is largely unknown. This anonymity results in fewer treatment options for children who are afflicted.
While surgery and physical therapy can correct some of the issues, there is still a critical need for funding to support new studies that will improve the management of chronic lifetime conditions. Most funding today for medical studies addresses the cause and cure for disease, but stops short of supporting projects to find what will be required to improve the quality of life and management of the condition for a lifetime.
NBPP projects will be conducted under the direction of Dr. Yang, clinical associate professor of neurological surgery and board-certified surgeon at the University of Michigan Health System. Dr. Yang has special interest areas that include the treatment of adult and pediatric brachial plexus and peripheral nerve disorders. She actively participates in the multi-disciplinary Pediatric Brachial Plexus Program.
Dr. Yang received her medical training at Johns Hopkins Hospital and completed her residency at the University of Michigan Health System, Neurosurgery. After completing her residency, Dr. Yang continued her studies on improving nerve regeneration as a visiting faculty in Dr. R Schnaar’s laboratory at Johns Hopkins. Before returning to the University of Michigan, Dr. Yang also completed clinical training as a peripheral nerve surgeon in the Netherlands, specifically in treating patients with pediatric brachial plexus palsy.
A number of issues will be covered in the MedSAU initial projects including:
- Childhood apprehensions: This project will study the incidence, prevalence and severity of bullying compared to age-matched norms and other children with disabilities via a cross-sectional survey study. Interventions will be discovered and proposed to ameliorate and educate the school system and reduce bullying of children with NBPP and other physical disabilities.
- Motor apraxia: Children with NBPP may be able to move the affected arm in response to examiner’s stimulus, but some children who do have adequate movement do not move/use the affected area spontaneously. A study will determine the incidence of this phenomenon in NBPP patients in the non-surgical versus surgical population, seeking to discover why once the surgery to repair the nerve damage is successfully completed children still do not use the affected limb.
- Transition to adulthood: Transition to adulthood among children with all types of disabilities is currently a topic of widely-based discussion. This project will focus on children with NBPP beginning with a thorough review of literature that has already been compiled about children through their adolescents. The study will establish specific problems adolescents with NBPP have making the transition to adulthood.
- Self-reported health-related quality of life studies: Currently there are no published, validated patient reported outcome measures of health-related quality of life for use in NBPP. Similarly, no consensus NBPP scale exists to evaluate the results from conservative or operative management. A sensitive measure is needed to evaluate treatment effectiveness and the timing of treatment in this population. The MedSAU collaborative project will examine the utility of several newly-developed, patient-reported outcome measures in children with NBPP.
- Sensorimotor Testing: The ability to efficiently manipulate objects with the hands requires both muscle strength and sensory feedback. Today, most clinical assessment tools lack the sensitivity to detect potentially important changes in hand sensorimotor function. This project will assess hand sensorimotor performance in both typically developing children and adolescents with those who have NBPP. The work is part of a larger commercialization initiative aimed at providing better clinical assessment tools for use in populations with impaired arm and hand function.
- Patient Educational materials: This phase of our work will focus upon the production of multimedia patient educational materials of interest to both University of Michigan Health System patients and Spring Arbor University faculty. These publications can also be used to help educate medical professionals, school administrators and teachers, as well as the general public about NBPP.
- Nursing: The final phase of the initial activity plans will focus on a clinical project of interest to both University of Michigan patients and Spring Arbor University faculty.