Sonography of Common Peripheral Nerve Disorders With Clinical Correlation

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135210/1/jum2016354683.pd

Posterior Interosseus Nerve Palsy Resulting From Inflammatory Myofibroblastic Pseudotumor: Case Presentation

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147197/1/pmrj659.pd

Poster 285 High Prevalence of Cranial Asymmetry May Exist in Infants with Neonatal Brachial Plexus Palsy (NBPP)

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147206/1/pmr2s184b.pd

Poster 285 High Prevalence of Cranial Asymmetry May Exist in Infants with Neonatal Brachial Plexus Palsy (NBPP)

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147206/1/pmr2s184b.pd

Neuromuscular Electrical Stimulation for Infants with Neonatal Brachial Plexus Palsy: A Pilot Study

Background: Biceps recovery is a critical determinant for treatment decision-making in patients with neonatal brachial plexus palsy (NBPP). One treatment intervention used by therapists is neuromuscular electrical stimulation (NMES), but its use remains controversial. This study’s aim was to determine the effect and safety of NMES on biceps function in infants with NBPP compared to standard therapy. Methods: In this pilot, randomized controlled study, patients were randomized to the NMES treatment or control/sham group. Inclusion criteria were infants 3 to 9 months of age with a confirmed diagnosis of NBPP and biceps weakness, without other comorbidities. The parents administered the NMES (treatment or control) 30 min daily. Outcomes of active range of motion (AROM), muscle strength, and morphometric measurements were assessed by one of two blinded therapists at enrollment and 1-, 2-, and 3-month follow-up intervals. Results: Seventeen patients (10 NMES, seven control) participated in the study. Despite equal group demographics, the treatment group demonstrated significant improvement in elbow flexion AROM after the first month of NMES compared to the control group (improvement 31° vs. -3°, P = .047). No adverse effects were reported. Conclusion: Use of NMES can be beneficial and should be considered in the early rehabilitation protocol for infants with NBPP

Assessment of Selfâ Determination in Adolescents with Neonatal Brachial Plexus Palsy

BackgroundThe term selfâ determination refers to decisionâ making, goal setting, and perseverance to achieve those goals. Numerous studies have established the importance of selfâ determination to enhance learning and improve postschool outcomes. However, most studies evaluate students with learning disabilities, cognitive impairment, or behavioral disabilities. There is an absence of research on selfâ determination for adolescents with physical disabilities.ObjectiveTo assess selfâ determination of adolescents with neonatal brachial plexus palsy (NBPP) compared with their typically developing peers via selfâ reported measures of function.DesignCaseâ control study.SettingBrachial plexus clinic.ParticipantsTwenty adolescents with NBPP (aged 10â 17 years) and their parents and 20 age/genderâ matched typically developing adolescents and their parents were recruited. Nonâ Englishâ speaking participants and those with other physical impairments were excluded from study.MethodsParticipants completed demographic and American Institutes for Research (AIR) selfâ determination surveys. One of two designated occupational therapists evaluated participant physical function.Main Outcome MeasurementsA demographic survey and AIR selfâ determination assessment were administered, and active range of motion measurements in shoulder forward flexion, elbow flexion, elbow extension, forearm pronation, and supination were obtained. Grip/pinch strength, MRC muscle strength, 9â Hole Peg Test, and Mallet scale scores also were evaluated.ResultsDespite physical differences, adolescents with NBPP presented similar selfâ determination levels as their typically developing peers. Adolescents with NBPP rated their opportunities to engage in selfâ determined behaviors at school significantly lower than at home. Both adolescents with NBPP and those in the control group rated their opportunities to engage in selfâ determined behaviors at school significantly lower than at home.ConclusionsAdolescents with NBPP presented similar selfâ determination scores as their age/genderâ matched typically developing peers. These results could be a reflection of our program’s patientâ and familyâ centered care approach. Therefore, caregivers and providers should encourage personal development and fulfillment in adolescents with NBPP. Teachers and schools should be aware that opportunities for acquiring selfâ determination skills might be more limited at school than at home in this age group.Level of EvidenceIIIPeer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146984/1/pmr264.pd

Home Exercise DVD Promotes Exercise Accuracy by Caregivers of Children and Adolescents With Brachial Plexus Palsy

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147221/1/pmr2924.pd

Delayed Sciatic Nerve Injury Resulting From Myositis Ossificans Traumatica

A motorcyclist sustained multipleâ system trauma, including a left buttock hematoma requiring decompression and evacuation. Presentation for severe hip pain and lower extremity weakness was delayed. Imaging revealed myositis ossificans traumatica compressing the sciatic nerve in the buttock. The patient underwent sciatic nerve decompression with resection of heterotopic calcification, resulting in improvement in pain and left lower extremity function. This case illustrates the contrast in differential diagnosis of peripheral nerve injury immediately posttrauma and that occurring in a slow, delayed fashion posttrauma. Myositis ossificans may be an underrecognized complication of trauma but should be considered in cases of delayed peripheral nerve injury after trauma.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147088/1/pmrj484.pd

Use of Neuromuscular Electrical Stimulation in the Treatment of Neonatal Brachial Plexus Palsy: A Literature Review

Background: The purpose of this study was to conduct a review of current literature on the effectiveness of neuromuscular electrical stimulation (NMES) for restoring motion and function in neonatal brachial plexus palsy (NBPP). Method: A database search was conducted for NMES articles published between 1947 and 2015. Pre and posttreatment data were extracted for muscle power, active range of motion (AROM), and morphometric measurements. Results: An initial search yielded 2,721 articles. A further title/abstract review produced 27 articles; of these, four met the inclusion criteria. Treatment protocols varied. There were no changes in average Medical Research Council (MRC) scores following treatment for elbow flexion, shoulder abduction, or wrist extension. Shoulder flexion increased from MRC 1 to 4. AROM improved following treatment. Conclusions: Evidence for improved muscle strength after NMES is mixed. Improvement in AROM is more consistent. Due to variations in treatment modalities, patient profiles, and adjunct treatment, a clinical trial to isolate the effects of NMES in NBPP is required. Since improved motion and function has been reported, NMES in NBPP therapy remains reasonable

An Assessment of the Compliance and Utility of a Home Exercise DVD for Caregivers of Children and Adolescents With Brachial Plexus Palsy: A Pilot Study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146875/1/pmr2190.pd