Developmental and biomechanical considerations in the provision of wrist orthoses in children with obstetrical brachial plexus palsy
Bibliographic record
Abstract
Introduction Children with obstetrical brachial plexus palsy may have motor deficits in wrist extension that impact optimal hand function. Wrist orthoses are recommended for such impairment to address biomechanical and functional needs. The functional need of the child should be considered within the context of their developmental expectation. Methods A review of the literature pertaining to brachial plexus, wrist joint and injuries, orthotics devices and splints in children was conducted. The databases MEDLINE, AMED (Allied and Complementary Medicine) and CINAHL (Cumulative Index to Nursing and Allied Health Literature) were searched from 1950, 1985 and 1981, respectively, to July 2009 using the Medical Subject Headings (MeSH) brachial plexus, wrist joint and injuries, orthotics devices and splints under the limits of children aged 0–18 years. Results There is a paucity of literature on the orthotic management for this impairment. Therefore, an evaluation of the literature on development and the biomechanics of the wrist joint is necessary to develop clinical guidelines for the provision of wrist orthoses in children with obstetrical brachial plexus palsy. An algorithm for providing wrist orthoses in this population is proposed. Discussion A balance between biomechanical risks and functional needs at each developmental stage is needed to optimize hand function in the prescription of wrist orthoses.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".