The upper brachial plexus, a network of nerves in the neck and shoulder, is affected byErb's palsy, often referred to as Erb-Duchenne palsy. This syndrome usually arises afterlabor, particularly if the baby's head and neck are pulled or stretched excessivelyduring delivery. Erb's palsy can cause the hand and arm on the afflicted side of the bodyto become paralyzed or feeble. Erb's palsy symptoms can include: restricted range ofmotion in the injured arm. weakened hand and arm in the afflicted area, loss of feelingin the hand or arm. The effected arm is in "waiter's tip" position in which the elbow isbent and the wrist is flexed. The purpose of this research is to evaluate theeffectiveness of modified constraint-induced movement therapy in children with erb'spalsy, both with and without kinesiotaping.Convenient sampling will be the method of sampling, and the study design will berandomized control trial. There will be two groups created with n = 40 subjects each.Twenty participants will be divided into two groups: twenty for each group will receivemodified constraint-induced movement therapy plus kinesiotaping, while twenty for theother group will receive modified constraint-induced movement therapy alone. Theyoungsters will be evaluated using the Active Movement Scale.Both at the program'sbaseline and after the intervention is over, data will be gathered. The course oftreatment will run for eight weeks straight, meeting three times a week for an hour eachtime. Based on inclusion criteria, subjects from Ayesha Amir Memorial Hospital andChildren Hospital Faisalabad will be chosen. Data analysis will be done using SPSS 25.00.
Group A will be applied modified constraint induced movement therapy , session will last
for one hour including following exercises such as ROM with the sling. Flexion,
extension, abduction, and rotation of the shoulder. Flexion and extension of the elbow,
Supination of forearm-Extension of wrist and finger. Stretching exercises for internal
rotators , adductors ,extensors of shoulder. This will reduce the tightness and enhance
the range of movement. Strengthening exercises also be applied to this group by throwing
a ball in different directions above head position ,by drawing on paper stuck on the wall
or window at different heights, by supinating bottles weighing <500g as tolerated by the
child by thera band exercises above, across, and below the chest. Repetitive movement
such as supinating the light bottles. Functional activities including some playful
movement will be done by this group in which children are involved in different
activities e.g playing with toys, blocks and such objects. Additionally, this group will
engaged in a kinesiotaping program which aims to obtain more stability to the scapula on
the affected side through facilitating middle and lower trapezius function. The shoulders
will be kept in downward and back- ward position, while the alignment of scapulae should
be manually maintained during the tape application. KT will set medially at the spinous
processes (T2-T3 for middle trapezius and T12 for lower trapezius) and will be applied
toward the acromion.
Group B will undergo same intervention such as group A alongwith m-CIMT but without the
application of kinesiotaping.
There will be three sessions per week for the eight consecutive weeks.
Other: m-CIMT without Kinesio taping
Baseline treatment m-CIMT will be applied includeing ROM with a sling, e.g shoulder
flexion, extension, abduction, and rotation. The elbow's flexion and extension, Forearm
supination is the extension of the wrist and fingers. Functional Training Using a tiny
toy ball, practice tossing and catching it from various angles. Play with modeling clay,
constructing towers of the toy bricks using LEGOs,Using crayons, ripping a piece of paper
towel,Grasping biscuits, Using a spoon, utilizing a glass to drink, comb hair, brush
teeth,Using a bubble blower,With a toy in hand, putting cap, putting lotion.stretching to
shoulder's extensors, adductor, and internal rotators ,wrist and elbow flexors.
strengthening exercises e.g a ball above head position in various directions,Using paper
adhered to the window or wall at varying heights for drawing. The session will go for one
hour.
Other: m-CIMT along with kinesiotaping
Modified constraint-induced movement therapy along with kinesiotaping will be applied.
m-CIMT protocol is baseline treatment and it is is same as in the other group.
This group also participated additionally in a kinesio taping program, which utilize KT
with the goal of enhancing middle and lower trapezius function to increase stability in
the scapula on the afflicted side. During the application of the tape, the shoulders were
kept in a low and backward posture, and the scapular alignment was manually maintained.
KT was administered at the acromion and positioned medially at the spinous processes
(T2-T3 for the middle trapezius and T12 for the lower trapezius). For eight weeks in a
row, there will be three sessions every week
Inclusion Criteria:
- Age of 2 years to 4 years.
- Children with Erb's palsy.
- Healthy BMI, ability to understand the command
- No previous mCIMT and kinesiotaping intervention was given
Exclusion Criteria:
- Children with visual deficits,
- Children with seizures or epilepsy,
- systemic disease or infectious disease,
- children with permanent arm deformities
Riphah international university
Lahore 1172451, Punjab Province 1167710, Pakistan
Anna Zaheer, MS, Principal Investigator
Riphah International University