Home Exercise DVD Promotes Exercise Accuracy by Caregivers of Children and Adolescents With Brachial Plexus Palsy

The researchers’ aim for this study evaluate the accuracy of home exercise performance by caregivers of children with neonatal brachial plexus palsy (NBPP) who use digital versatile disc (DVD) guidance. They conducted this prospective cohort study at the Brachial Plexus Clinic at the University of Michigan. The study consisted of 77 adult caregivers of a consecutive cohort of pediatric patients with NBPP. The participants received the Home Exercise Program for Brachial Plexus Palsy DVD and an initial demonstration of proper hand placement and movement patterns by 1 of 2 occupational therapists. At times A, B, and C (approximately 3, 6, and 12 months), caregiver accuracy in exercise performance at each joint and standard measurements of arm function were recorded. Caregiver accuracy in correct hand placement and movement pattern during exercise performance was evaluated with use of a dichotomy scale (yes/no) at each joint. Active and passive range of motion were assessed as indicators of arm function. The mean patient age was 38 months, and the median Narakas score was 2. No significant difference in exercise accuracy for all upper extremity joints between the initial evaluation and times A, B, and C or between individual times was observed, except at the shoulder (98.9% initially to 88.3% at time A; P = .0002) and elbow (100% initially to 96.6% at time A; P = .04). As for arm function, they observed an increase in active range of motion for shoulder flexion, elbow flexion, forearm supination, wrist extension, and finger flexion during the study period.

Their study concluded that shoulder and elbow exercises could be more complicated and require more frequent performance review with the caregiver. However, the home exercise DVD may benefit patients with NBPP and their caregivers and could offer an adjunct to formal therapy sessions.

 

 

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Comments

Kathleen MallozziI
Kathleen MallozziI
December 18, 2013 at 4:00 pm

This looks like a great help for children and teenagers but I notice that the adult birth injured are not included. Is that because we require different care. As a 74 year old NBPP II find it impossible to find doctors or PT that understand or know the needs of a birth injured adult. Birth injured adults are for the most ignored instead of being studied. We can and have been major support for parents to help prevent the secondary injuries due to compensatory movements. Granted some of our secondary injuries could not be prevented but many are due to a lack of education regarding the long term effects of NBPP. I am attending a meeting of approximately 20 birth injured adults the first weekend in Jan. We all search for PT support from knowledgeable care takers. Unfortunately it is rare to find one who understands or truthfully even acknowledges we have/are injured. PT is cradle to grave for us and yet no one address it. Perhaps you could look into some methods of exercise to help the adult population. Thank you

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