One-Year Recovery After Traumatic Brachial Plexus Injury: Mixed-Methods Study of Patient Outcomes

Background. Recovery after traumatic brachial plexus injury (BPI) involves complex interactions between injury, physical, psychosocial, and environmental factors that affect occupational performance and participation in life roles. This study examined the interrelationships between these outcomes. Method. This cross-sectional, mixed-methods study included 41 adults one-year postsurgical BPI repair. Quantitative measures included the Disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) (upper-extremity disability), the Canadian Occupational Performance Measure (COPM: performance, satisfaction), and the Participation Behaviour Questionnaire (PBQ). Qualitative data from semistructured COPM interviews were thematically analyzed (interpretive description) and linked to International Classification of Functioning Disability and Health categories using standard linking rules. Results. Self-care (88%) and productivity (68%) were the most frequently reported challenges. The mean QuickDASH score was 38.40/100 (SD = 22.70); COPM performance and satisfaction scores averaged 4.6/10 (SD = 1.61) and 4.0/10 (SD = 1.80); COPM performance showed a moderate, nonsignificant negative correlation with QuickDASH scores ( r = –.32, P = 0.093) and a strong positive correlation with satisfaction ( r = .90, P < 0.001). The QuickDASH scores were strongly correlated with PBQ participation restriction ( r = .84, P < 0.001). Qualitative findings revealed a capacity–performance gap and psychosocial impacts, emotional regulation difficulties, altered identity, and existential concerns, that were not captured by quantitative measures. Implications. One year after BPI, participants showed partial functional recovery but continued to face personal and environmental barriers to real-world participation. Qualitative interviews identified areas of concern not sufficiently revealed by quantitative outcomes. Rehabilitation should incorporate physical restoration, environmental adaptation, and psychosocial support to rebuild occupational competence, identity, and participation.