Treatment of a brachial plexus injury using kinesiotape and exercise.
OBJECTIVE
This describes a child whose neonatal brachial plexus injury was treated with kinesiotape and exercise.


METHODS
The subject was a two-year-old female whose X-rays demonstrated severe inferior subluxation of the humeral head and winging of the scapula on the left. She was fitted with a shoulder brace with surgery scheduled in six months. The initial PT exam noted 80 degrees of shoulder abduction (trumpet sign), significant asymmetry, and nonuse. Mallet score was 15/25. Treatment consisted of d/c of the brace and E-stimulation, parent education on exercise and taping, and kinesiotape to facilitate rotator cuff and scapular stabilizers. Typical wear time was 2-3 days on, 1-2 days off.


RESULTS
After 2 weeks, there was prominent deltoid definition. The shoulder was in 20 degrees of abduction, shoulders level with less scapular winging. Scapular stabilizers were then taped. At 4 weeks, her arm was held to her side displaying a stable symmetrical scapula. The arm displayed increased fine motor use and initiation of activities. At 10 weeks there was a forced d/c, and a decline toward baseline levels. After 2 weeks of reinstatement, function returned to prior level. At 20 weeks (12 total visits) she displayed full ROM, symmetrical shoulders, Mallet score of 20/25, rare trumpet sign, and was hanging by arms during play. X-rays displayed significant improvement in humeral head position, rib cage rotation, angle of scapula and clavicle, and size and mineralization of humerus. Reconstructive surgery was cancelled.


CONCLUSIONS
Kinesiotape and parent education made a significant difference in this child's function.
Walsh
Sharon Fleming
SF
The University of Findlay, Physical Therapy, Findlay, Ohio, USA. walsh@findlay.edu
D055052:Athletic Tape; D001720:Birth Injuries / Q000628:therapy*; D020516:Brachial Plexus Neuropathies / Q000628:therapy*; D002675:Child, Preschool; D005081:Exercise Therapy / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D010353:Patient Education as Topic