These results suggest that Kinesio Tape may be associated with improvement in upper-extremity control and function in the acute pediatric rehabilitation setting. The use of Kinesio Tape as an adjunct to treatment may assist with the goal-focused occupational therapy treatment during the child's inpatient stay. Further study is recommended to test the effectiveness of this method and to determine the lasting effects on motor skills and functional performance once the tape is removed.
A common upper extremity deformity with hemiplegia is pronation contracture of the forearm in association with flexion contracture of the elbow. Early management of the child with hemiplegic cerebral palsy is critical in optimizing overall function. The use of inhibitory upper extremity casting can enhance function and improve arm-hand position. The present paper describes the evaluation process before casting, the goals of each phase of the casting program, and the follow-up.
Evidence suggests that the NMES treatment protocol affected wrist extension by improving the strength of the wrist extensor muscles, possibly through decreased flexor coactivation. Further studies are required, however, to determine whether electrical stimulation itself or other facets of the therapy paradigm played the key role in improvement.
Children with obstetric brachial plexus palsy often present with shoulder alignment issues. Shoulder subluxation may occur as a result of shoulder girdle muscle weakness and overstretching of the ligamentous support structure around the glenohumeral joint. Optimal alignment and support of the glenohumeral joint is essential for active functional shoulder movement and distal control. Shoulder support options are limited for children, because materials may not be suitable for daily wear and compliance is often poor. The purpose of this case study was to evaluate the effectiveness of a custom-fitted shoulder orthosis, the Dynamic Movement Orthosis (DMO), and its ability to support and improve upper limb function during active wear. The Wolf Motor Function Test assesses 17 tasks (2 strength based, measured by weight lifted and grip, and 15 function based, measured using time to completion). This test was used to objectively quantify active shoulder and elbow movements with and without the use of a custom-fitted DMO. This case study suggests that the DMO supported the shoulder during functional task and optimized active strength distally in the wrist and elbow. (J Prosthet Orthot. 2011;23:159 -164.)
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