Obstetric Brachial Plexus Palsy and Rehabilitation Process: Case Presentation

Abstract

Obstetric brachial plexus palsy (OBPP) is a clinical situation induced by the damage to the plexus brachialis and the branches originating from its location. While the diagnosis of OBPP can be made with a detailed examination performed right after the baby is born, it may limit the daily life activities of the child throughout his/her life when the situation noticed at a late stage. Treatment for OBPP can be grouped as conservative treatment, palliative surgery during conservative treatment, surgical therapy and late period treatment. In addition to all these, the physical therapy and rehabilitation processes are initiated for the patient from the moment the patient is diagnosed. The aim of the study is to reveal the importance of the early physiotherapy and rehabilitation program and the significance of the regular exercise program not neglected after a series of operations, in OBPP treatment. In this case presentation, we will present a 9-year treatment program, physiotherapy and rehabilitation period of a female patient with OBPP diagnosed at the time of birth, and her condition before and after this process.

Comparison of the efficacy of electrotherapy and neuromuscular retraining techniques in restoring function of children with obstetric palsy

“…Electrotherapy can be applied from the very early stages to acute conditions and throughout the long-term treatment program. In cases of surgical treatment, it can also be used postoperatively for analgesia [13] . Electrotherapy includes galvanic and faradaic currents, iontophoresis (10-30 minutes) for analgesia, selective muscle electrostimulation to avoid muscle atrophy (mainly with square waves), TENS, ultraviolet and infrared radiation (5-20 minutes) [13,14,17] .…”

“…In cases of surgical treatment, it can also be used postoperatively for analgesia [13] . Electrotherapy includes galvanic and faradaic currents, iontophoresis (10-30 minutes) for analgesia, selective muscle electrostimulation to avoid muscle atrophy (mainly with square waves), TENS, ultraviolet and infrared radiation (5-20 minutes) [13,14,17] . Neuromuscular retraining techniques are applied after the 2 nd week of the life of the infant; initially with the Vojta method, in 3-4 months with NDT-Bobath and in 11-18 months with PNF, which requires the highest level of cooperation [8] .…”

“…Regarding the efficacy of electrotherapy, many articles mention its useful application in the physiotherapy program for children with OP. Canbay Durmaz et al [13] suggest applying electrotherapy before or after surgery. Their case study involved a girl diagnosed with OP on the left side.…”