Effects Of Physiotherapy on Strength, Range and Function in Children with Erb’s Palsy; An Experimental Study

Abstract

Children who sustain brachial plexus injuries after birth face significant functional limitations due to a variety of sequelae affecting the shoulder, elbow, or forearm. These effects could be permanent or temporary. It is critical for proper joint development to maintain complete passive mobility while neurological function is being restored. Children with Erb’s palsy are more likely to have weak muscles, which can be found by ultrasonography Objective: To determine the effects of physiotherapy on strength, range and function in children with Erb’s palsy. Methods: It was a clinical trial conducted at physiotherapy department outpatient at General hospital Lahore. A sample of 46 children aged between 0-10 years, with the C5 and C6 lesion and with limited range of motion were included while children with any history of previous or recent trauma or surgery to upper limb and to the other roots of brachial plexuses was excluded. Modified Mallet scale and active movement scale was used as outcome measures. The coin toss technique of randomization was adopted, with 'Heads' assigned to strengthening exercises and 'Tails' assigned to general treatment. Independent sample test was employed to assess pre and post differences. Physiotherapy treatments included neurodevelopmental approaches to improve proprioception input, orthosis, and electrical current stimulation. Free weights, resistance bands and manual resistance were used in the strength training. The active range of motion was evaluated using goniometry, and a baseline measurement was generated using a modified mallet scale. The treatment was given every day for six months. Post-intervention measures were implemented two, four, and six months following the intervention. SPSS 25.0 was used for data analysis. Results: The finding showed that pre-interventional oxford scale muscle strength for experimental group showed the mean and standard deviation (1.434± 0.5068), control group (1.65± 0.48) while Oxford scale muscle strength post intervention showed the results with the mean and standard deviation for the experimental group 3.13±  0.54 and control group 2.65± 0.48 and showed significant p value less than 0.005. Conclusions: The study concluded that physiotherapy integrated approach improved upper limb strength, ranges and functional abilities in patients with Erb’s Palsy.