Home-based movement therapy in neonatal brachial plexus palsy: A case study

Study designCase report.IntroductionThe value of movement-based therapy in peripheral nerve injury conditions such as neonatal brachial plexus palsy (NBPP) is unclear.Purpose of the studyTo determine the effectiveness of a home-based movement therapy program in a 17 year old female patient with a right NBPP pan-plexopathy.MethodsHome training consisted of arm reaching and object manipulation tasks using devices which recorded performance. Training occurred for 1 h/day, 5 days/week for 6 weeks with periodic webcam supervision. Pre- and post clinical, functional and kinematic assessments were performed in a laboratory setting.ResultsFollowing training, shoulder flexion and elbow extension active range of motion increased by 13° and 9°, respectively, and functional ability also improved. Reach movement duration decreased significantly with a concomitant improvement in movement coordination.ConclusionsThese results demonstrate that movement therapy has the potential to improve motor function in NBPP years after the initial insult.Level of evidence4