Effect of modified constrained induced movement therapy on improving arm function in children with obstetric brachial plexus injury

Abstract

Many children who sustain birth injuries to the brachial plexus suffer significant functional limitations due to various sequelae affecting the shoulder and elbow or forearm. The aim of this study was to test the feasibility of a treatment program based on the elements of the modified constraint induced movement therapy (MCIMT) to encourage use of the affected arm of a child with obstetric brachial plexus injury (OBPI). Thirty children with OBPI from both sexes ranging in age from three to five years were assigned into two groups of equal number. The control group (group A) who received the exercise program which focused on improving the arm function as well as shoulder abduction and external rotation and the study group (group B) received MCIMT in addition to the same exercise program given to the control group. The arm function was evaluated by the Mallet score system, while active abduction and external rotation range of motion were measured by a standard universal goniometer. The results revealed no significant difference when comparing the pretreatment mean values of the two groups (study and control), while a significant improvement was observed in measuring variables of the two groups when comparing their pre and post treatment mean values. A significant difference was also observed when comparing the post treatment results of the two groups in favor of the study group (group B). The modified constraint movement therapy is an effective method on improving the arm function in children with OBPI.