Status of Injury Induced Hand Dominance Transfer in Patients with Global Brachial Plexopathy - A Comparison with Age Matched Normal

Background: Traumatic brachial plexus injury is a catastropic injury leading to functional impairment of upper limb. Injury to the dominant side is more devastating because the skills endowed to the dominant hand must be transferred to the non-dominant hand which is known as injury induced hand dominance transfer (I-IHDT). Hand grip strength, manual dexterity and handwriting skills form integral part of activities of daily living which must be trained for. Methodology: Hand grip strength, manual dexterity and quality of writing of the unaffected side of 30 patients with global brachial plexopathy (Group A) was compared with the non-dominant side of 30 age matched healthy adults (Group B). Results: Group A showed significantly higher values in the mean for hand grip strength. (Group A -13.47; Group B – 12.03; p- 0.0254). Group A showed significantly lower values in the mean for manual dexterity. (Group A -57.37, Group B -63.05; p-0.0070). Group A showed no significant change for quality of handwriting using Handwriting Eligibility Scale. (Group A –16.00, Group B – 16.07; p - 0.7706). Group A showed significantly lower no. of words written in 6 minutes compared to group B (Group A - 28.20, Group B - 46.40, P - <0.0001) Conclusion: The present study concludes that the hand grip strength of the uninjured, non-dominant hand of brachial plexus injury patients was higher than grip strength of non-dominant hand of age matched healthy normals whereas the dexterity and handwriting scores were lower when compared to non-dominant side of age matched normals. Key words: Brachial plexus injury, injury induced hand dominance transfer, hand grip strength, dexterity, handwriting, functional training