The brachial plexus is a neural network. These nerves carry information from the spine to the arm and hand. These signals activate the arm and hand muscles. A nerve injury is brachial plexus damage. Injury can occur at any moment, however, the majority of injuries occur during childbirth. Many neonates with Occupational Therapy for Brachial Plexus Injuries are larger than typical at delivery, however, these injuries can occur in newborns of any size. The severity of symptoms is determined by which nerves are impacted and how badly they are affected. At birth, some newborns have little or no movement in the afflicted arm. Some children are able to move their arms but not their hands and others are able to move their hands but not their shoulders or elbow.
Occupational therapy's major goal is to maintain the range of motion in the afflicted arm while also increasing strength and function. Furthermore, the occupational therapist will give the family home exercises and tasks to foster optimal developmental abilities. If splinting or restriction therapy is indicated for the youngster, the therapist will offer it. Duke's pediatric occupational therapists are experienced in treating children with this problem and will collaborate with your child's doctor to improve movement in the afflicted arm. If your kid has issues with neck movement (torticollis) or delays in gross motor abilities, they will be referred to a physical therapist.
- Maintain joint integrity during the rehabilitation process.
- To ensure maximum muscular use while maintaining a tolerable discomfort level while the nerve heals.
- Educate on the importance of safety and protection in the face of sensory loss.
- Maintain muscle strength in unaffected areas.
- Aid in the return to productive activity
Interventions could include the following:
- Stretching and range of motion exercises
- Weight-bearing and joint compression to enhance muscular contraction
- Activities involving bilateral motor planning
- promoting fluid movement in all directions by facilitating ideal alignment in the shoulder and scapula
- When needed, aquatic therapy
Initial therapy for patients with motor nerve injury includes patient education and the protection of the joints, especially the ligaments and tendons, from further stress. Therapy is initiated early after nerve damage to maintain a passive range of motion in affected joints and muscle strength in unaffected muscles. Support may be required in the form of slings, splints, or both. To reduce the risk of contractures, patients are instructed to maintain a good passive range of motion. If the C5-6 nerves are involved in the shoulder, continuous downward force at the glenohumeral joint might result in a subluxation due to a loss of support in the rotator cuff muscles.
Pain can be a significant issue following a nerve injury and throughout the recovery process. Problems with sensation, paresthesia, and persistent pain may necessitate therapy, which is normally provided by a primary care physician or a pain specialist. TENS, moist heat packs, sensory desensitization treatments, and ultrasound are some of the therapy modalities available.
Following surgery, patients are usually immobile for 6 weeks. Once therapy has been ordered, the initial treatment comprises a mild range of motion of the immobilized joints and soft tissue. As needed, splints and supports are used. Patients are taught exercises to help them preserve strength in their unaffected muscles. Sensory and motor reeducation are used to maximize movement and function as recovery proceeds.