Research Article|Articles in Press

Linking assessment instruments for brachial plexus injury to the international classification of functioning, disability and health

Published:April 14, 2021DOI:


      • The instruments developed for traumatic brachial plexus injuries were Brachial Assessment Tool and Impact of Brachial Plexus Injury Questionnaire.
      • The questionnaires’ items are mostly related to activities and participation.
      • Environmental factors were poorly addressed on the questionnaires’ items.



      Brachial plexus injuries (BPI) affect not only body structure and function, but also several aspects of individual's well-being. Considering the crescent need for assessing such patients through a biopsychosocial perspective, linking meaningful concepts of BPI instruments to the International Classification of Functioning, Disability and Health (ICF) provides a useful overview of how the ICF components are contemplated on the current measurements available.


      To identify patient-reported outcome measures (PROMs) specifically designed for BPI assessment and link the content with the ICF.

      Study design

      Content Analysis through ICF linking.


      The study was conducted in two steps: the first one encompassed a literature review to identify questionnaires specifically designed for assessing patients with BPI, where two PROMs were eligible: the Brachial Assessment Tool (BrAT) and the Impact of Brachial Plexus Injury Questionnaire (IBPIQ); in the second phase, the items of such instruments were linked to the ICF by two independent reviewers, in accordance to the methodology proposed by Cieza et al.


      54 different significant concepts were identified from the 74 questionnaire items and linked to 49 distinct ICF categories. The categories were mostly related to the activities and participation component (56.9%, n = 29), followed by body functions (27.45%, n = 14), body structures (9.8%, n = 5) and environmental factors component (1.96%, n = 1).


      The questionnaires developed for adults with BPI were BrAT and IBPIQ. Although both instruments presented with a diverse coverage of ICF components, their content had a major focus on activities and participation domain and poorly or did not addressed environmental factors. Thus, other instruments could be considered in a complementary way for clinical assessment.


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