Intensive Therapy of Shoulder External Rotators in Erb's Palsy

Riphah International University

Status: Completed

Conditions: Erbs Palsy

Treatments: Other: Non intensive physical therapy; Other: Intensive physical therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT04979689

REC/Lhr/21/0204 Qurat

Details and patient eligibility

About

Erb's palsy is a common neurological injury occurs at the time of birth. It causes injury to the upper trunk nerve root c5-c6, i.e., supply is around shoulder and muscles of forearm and these nerves network from the spine and pass through the cervicoaxillary canal in the neck and the ribs and emerge into the axilla. Restoring external rotation in erb's palsy is quite difficult and mostly surgery is recommended but if physiotherapy sessions are given with extended time up to 2 hours and latest techniques are applied to strengthen external rotators then range of external rotation can be improved.

Full description

Erb's palsy is form of brachial plexus palsy which involves injury to cervical nerve roots c5 c6 causing loss of movements and deformities i.e., internally rotated shoulder, hanging arm and waiter's tip hand deformity. Most common risk factors are shoulder dystocia, maternal obesity, breech presentation and high birth weight of child. Its incidence is 0.42 per 1000 live births in which 25% experience permanent impairment and injury.

Both Conservative and non-conservative treatment protocols are applied in erb's palsy but key interventions are positioning in early infancy, passive range of motions and gentle stretching. Another latest treatment approach is intensive physical therapy in which single session duration is extended to three to four hours with combination of treatments. This study will be randomized control trial, used to check effectiveness of intensive physical therapy to restore shoulder external rotation in erb's palsy. Subjects with erb's palsy meeting the predetermined inclusion and exclusion criteria will be divided into two groups by using lottery method. Pre assessment will be done by using AROM on goniometer as objective measurement. Subject in one group will be treated with intensive physical therapy and the other with conventional treatment. Each subject will receive 5 Treatment sessions per week for 6 months.

Recorded values will be analyzed by using SPSS version 25

Enrollment: 20 patients

Sex: All

Ages: 9 to 12 months old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Children (male and female)
• Ages ranged from 9 months to 12 months
• Unilateral involvement of c5, c6 and c7
• patients did not undergo surgery of the nerves or plexus

Exclusion criteria

• Musculoskeletal or neuro-muscular abnormalities other than Erb's palsy
• Contractures or fixed limitations in the affected upper extremity
• Hypersensitivity to latex and adhesive tapes

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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20 participants in 2 patient groups

Intensive physical therapy

Experimental group

Description:

Intensive session

Treatment:

Other: Intensive physical therapy

Non intensive physical therapy

Other group

Description:

Non intensive session

Treatment:

Other: Non intensive physical therapy