Knowledge of neonatal brachial plexus palsy among medical professionals in North America

McNeely, Molly M.; Chang, Kai-Ting; Smith, Brandon W.; Justice, Denise; Daunter, Alecia K.; Yang, Lynda J.‐S.; McGillicuddy, John E.

doi:10.1007/s00381-021-05310-9

Cited by 4 publications

(2 citation statements)

References 37 publications

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“…Historically, early initiation of therapy or passive range of motion exercises was discouraged to allow for nerve recovery; however, we previously demonstrated that no increased shoulder subluxation occurs with early initiation of range of motion exercises 29 . Unfortunately, knowledge of appropriate treatment of patients with NBPP is still lacking in the community; in a study of pediatric providers, including occupational and physical therapists, 71% reported discomfort with the diagnosis and management of NBPP 30 . Thus, while some of the children seen later than 30 days probably received physical or occupational therapy before evaluation at our clinic, it is unlikely that they received therapies aimed specifically at NBPP.…”

Section: Discussionmentioning

confidence: 99%

“…29 Unfortunately, knowledge of appropriate treatment of patients with NBPP is still lacking in the community; in a study of pediatric providers, including occupational and physical therapists, 71% reported discomfort with the diagnosis and management of NBPP. 30 Thus, while some of the children seen later than 30 days probably received physical or occupational therapy before evaluation at our clinic, it is unlikely that they received therapies aimed specifically at NBPP.…”

Section: Initiation and Duration Of Therapymentioning

confidence: 99%

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Early referral to multidisciplinary specialty centers to optimize outcomes in children with neonatal brachial plexus palsy

Muhlestein

Smith

Chang

et al. 2023

Develop Med Child Neuro

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AimTo demonstrate the trajectory of long‐term recovery of upper‐extremity movement and determine optimal timing of evaluation at multidisciplinary specialty centers in children with neonatal brachial plexus palsy (NBPP).MethodAll children with conservatively managed NBPP seen at one institution from 2005 to 2020 were considered for inclusion. The cohort was divided according to age at formal evaluation (≤30 or > 30 days). Active range of motion (AROM) for shoulder and elbow movements collected at each appointment were compared in local age windows between early and late cohorts. Locally estimated scatterplot smoothing was used to demonstrate the trajectory of recovery for the overall cohort.ResultsMore than 13 000 prospectively collected data points for 429 children (220 males, 209 females) were analysed. Elbow flexion improved to nearly full AROM for both groups over the course of the study. Shoulder abduction, forward flexion and external rotation, and forearm supination improved for the entire cohort, although greater absolute improvement, particularly at the shoulder, was seen in the early cohort (age at formal evaluation ≤30 days). AROM for elbow extension remained roughly stable for the early cohort but decreased for the late cohort (age at formal evaluation >30 days). AROM for forearm pronation decreased over time for both cohorts.InterpretationOur data demonstrate good long‐term functional recovery for children with conservatively managed NBPP. However, early referral to multispecialty brachial plexus centers may optimize outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Initiation and Duration Of Therapymentioning

confidence: 99%

Early referral to multidisciplinary specialty centers to optimize outcomes in children with neonatal brachial plexus palsy

Muhlestein

Smith

Chang

et al. 2023

Develop Med Child Neuro

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Passive Range of Motion for Conservative Management of Brachial Plexus Birth Injury: A Survey of Expert Therapists

Wingrat,

Berger,

Bauer

2023

Occupational Therapy In Health Care

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Frequency, facilitators, and barriers for range of motion to prevent shoulder contracture in brachial plexus birth injury: A pilot study

Wingrat

Elrick

2023

PRM

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PURPOSE: This pilot study investigated the efficacy of passive range of motion (PROM) during the first year of life to prevent development of shoulder contractures in children with brachial plexus birth injury (BPBI) and identified facilitators and barriers to caregiver adherence with daily PROM. METHODS: Five caregivers of children with upper trunk BPBI participated in retrospective interviews about the frequency with which they performed PROM during their child’s first year of life including facilitators and barriers to daily adherence. Medical records were reviewed for documentation of caregiver-reported adherence and documented evidence of shoulder contracture by age one. RESULTS: Three of the five children had documented shoulder contractures; all three had delayed initiation or inconsistent PROM in the first year of life. Two without shoulder contractures received consistent PROM throughout the first year of life. Making PROM part of the daily routine was a facilitator to adherence while family contextual factors were barriers. CONCLUSION: Absence of shoulder contracture may be related to consistent PROM throughout the first year of life; decreased frequency of PROM after the first month of life did not increase the risk of shoulder contracture. Consideration of family routines and context may facilitate adherence with PROM.

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Knowledge of neonatal brachial plexus palsy among medical professionals in North America

Cited by 4 publications

References 37 publications

Early referral to multidisciplinary specialty centers to optimize outcomes in children with neonatal brachial plexus palsy

Early referral to multidisciplinary specialty centers to optimize outcomes in children with neonatal brachial plexus palsy

Passive Range of Motion for Conservative Management of Brachial Plexus Birth Injury: A Survey of Expert Therapists

Frequency, facilitators, and barriers for range of motion to prevent shoulder contracture in brachial plexus birth injury: A pilot study

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