Objectives: Brachial plexus birth injuries (BPBIs) can reduce childrens’ independence and occupational performance. Examination of interventions to improve range of motion (ROM) and function in the affected upper extremity (UE) is beneficial for rehabilitation professionals. Objective is to evaluate conservative intervention methods that enhance ROM and function in the affected UE of children with BPBIs.
Methods / Approach: Data Sources: Scopus, CENTRAL, MEDLINE, and CINAHL. Data were abstracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria: Participants with BPBI, ≤ 18 years old, randomized controlled trials (RCTs) or comparative studies (cohort and case-control), PEDRO score of 4 or higher if available, sample size over 20, conservative management, published in a peer-reviewed journal, written in English. Exclusion criteria: Not intervention-based, surgical, study of additional neurological conditions, studies published before January 2009, case studies or case series design, adult population, full-text not available.
Results / Practice Implications: Interventions examined included Constraint-Induced Movement Therapy, Modified Constraint-Induced Movement Therapy, Plyometric Training, Dynamic Orthoses and Serial Casting, Kinesiotaping, Neuromuscular Electrical Stimulation, Biofeedback Therapies, and Mirror Therapy. Based on the studies reviewed, Constraint-Induced Movement Therapy, Modified Constraint-Induced Movement Therapy, Neuromuscular Electrical Stimulation, and electronic biofeedback are more effective than conventional therapy.
Conclusion / Contribution to the occupational therapy profession: Studies examining modified constraint-induced movement therapy and electronic biofeedback provide strong evidence supporting its use for improving functional outcomes in children with BPBIs. Kinesiotaping, neuromuscular electrical stimulation, and plyometric training studies provide moderate evidence, and mirror therapy, dynamic orthoses and serial casting studies provide low-level evidence.