Modified Constraint Induced Movement Therapy in Children With Obstetric Brachial Plexus Injury

Study Overview
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Brief Summary
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The aim of this study was to increase and improve the use of affected extremity in obstetric brachial plexus palsy children while restricting the use of less affected arm and the purpose was to improve the function, Range of motion and disability in affected arm of children with brachial plexus injury.

Official Title
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Effect of Modified Constraint Induced Movement Therapy on Range of Motion, Function and Disability in Children With Obstetric Brachial Plexus Injury

Conditions
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Obstetric; Injury

Intervention / Treatment
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* Other: Conventional physical therapy treatment
* Other: Constraint induced movement therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 3 to 10 years Both genders will be included Deficiency of shoulder abduction and external rotation Who can follows command Exclusion Criteria: uncontrolled seizures Orthopedic and/or neurological surgery. A visual impairment interfering with treatment/testing. Unable to actively engage in assessment process

Ages Eligible for Study
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Minimum Age: 3 Years
Maximum Age: 10 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Conventional physical therapy treatment<br>Patients in this group will receive conventional physical therapy i.e. stretching, strengthening exercises, Aeroplan positioning | Other: Conventional physical therapy treatment<br>* The control group (group A) will receive the exercise program which focused on improving the arm function as well as shoulder abduction and external rotation for 10 week. stretching Aeroplan positioning<br>|
| Experimental: Constraint induced movement therapy<br>patients of this group will receive the same treatment along with constraint induced movement therapy | Other: Constraint induced movement therapy<br>* The study group (group B) who will receive Modified constraint induced movement therapy for 3 hrs. a day 12 hrs. a week in addition to the same exercise program given to the control group for 10 weeks.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mallet grading system | The Mallet grading system is a commonly used functional scoring system to assess shoulder abduction/external rotation deficits in children with obstetric brachial plexus palsy. One feature of the Mallet score is that each grade is translated in to certain degree of deficiencies in both shoulder abduction and external rotation. A scale of 1 to 5 is used to evaluate shoulder abduction, global external rotation, and hand to neck, hand to back, and hand to mouth positions. | 4 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| goniometer | changes from the baseline ROM of shoulder abduction and external rotation as well as elbow ranges was measured by goniometer was measured by can evaluate both active as well as passive range of motion. | 4th week | 
| Upper extremity function index | It is a self-administered questionnaire which measures disability in people with upper extremity orthopaedic conditions. The questionnaire lists 20 activities and the patient gives a score to each based on the difficulty they have completing that activity. It is evaluated on a 5-point scale that refers to the perceived difficulty in performing the mentioned action: Extreme difficulty or unable to perform activity (0 points); Quite a bit of difficulty (1 point); Moderate difficulty (2 points); A little bit of difficulty (3 points); No difficulty (4 points). The overall Upper extremity function index (UEFI) result ranges between 0 and 80, where 0 indicates most severe limitation and 80 suggests least limitation. Changes from baseline function of affected extremity was given by this tool. | 4th week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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birth injuries therapy, arm function, constraint induced movement therapy, brachial plexus neuropathies