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

NCT05411731 | Completed

• 1 other identifier: REC/RCR&AHS/22/0701
• Study Type: interventional
• Target: 16
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Obstetric; Injury

Keywords

birth injuries therapy; arm function; constraint induced movement therapy; brachial plexus neuropathies

Outcome Measures

Primary Outcomes (1)

• 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 Outcomes (2)

• goniometer

  4th week

• Upper extremity function index

  4th week

Study Arms (2)

Conventional physical therapy treatment

ACTIVE COMPARATOR

Patients in this group will receive conventional physical therapy i.e. stretching, strengthening exercises, Aeroplan positioning

Other: Conventional physical therapy treatment

Constraint induced movement therapy

EXPERIMENTAL

patients of this group will receive the same treatment along with constraint induced movement therapy

Other: Constraint induced movement therapy

Interventions

Conventional physical therapy treatment OTHER

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

Conventional physical therapy treatment

Constraint induced movement therapy OTHER

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.

Constraint induced movement therapy

Eligibility Criteria

• Age: 3 Years - 10 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• to 10 years
• Both genders will be included
• Deficiency of shoulder abduction and external rotation
• Who can follows command

You may not qualify if:

• uncontrolled seizures
• Orthopedic and/or neurological surgery.
• A visual impairment interfering with treatment/testing.
• Unable to actively engage in assessment process

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Bakhtawar Amin Trust Teaching Hospital

Multan Khurd, Punjab Province, 59300, Pakistan

Location

Related Publications (11)

• Pejkova S, Filipce V, Peev I, Nikolovska B, Jovanoski T, Georgieva G, Srbov B. Brachial Plexus Injuries - Review of the Anatomy and the Treatment Options. Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2021 Apr 23;42(1):91-103. doi: 10.2478/prilozi-2021-0008.

  PMID: 33894122 BACKGROUND

• Souza L, Lustosa L, Silva AEL, Martins JV, Pozzo T, Vargas CD. Kinematic Changes in the Uninjured Limb After a Traumatic Brachial Plexus Injury. Front Hum Neurosci. 2021 Dec 9;15:777776. doi: 10.3389/fnhum.2021.777776. eCollection 2021.

  PMID: 34955793 BACKGROUND

• Adler JB, Patterson RL Jr. Erb's palsy. Long-term results of treatment in eighty-eight cases. J Bone Joint Surg Am. 1967 Sep;49(6):1052-64. No abstract available.

  PMID: 6038856 BACKGROUND

• Sparrow J, Zhu L, Gajjar A, Mandrell BN, Ness KK. Constraint-Induced Movement Therapy for Children With Brain Tumors. Pediatr Phys Ther. 2017 Jan;29(1):55-61. doi: 10.1097/PEP.0000000000000331.

  PMID: 27984470 BACKGROUND

• Eren B, Karadag Saygi E, Tokgoz D, Akdeniz Leblebicier M. Modified constraint-induced movement therapy during hospitalization in children with perinatal brachial plexus palsy: A randomized controlled trial. J Hand Ther. 2020 Jul-Sep;33(3):418-425. doi: 10.1016/j.jht.2019.12.008. Epub 2020 Mar 7.

  PMID: 32151503 BACKGROUND

• Berggren J, Baker LL. Therapeutic application of electrical stimulation and constraint induced movement therapy in perinatal brachial plexus injury: A case report. J Hand Ther. 2015 Apr-Jun;28(2):217-20; quiz 221. doi: 10.1016/j.jht.2014.12.006. Epub 2014 Dec 17.

  PMID: 25841560 BACKGROUND

• Wang Q, Zhao JL, Zhu QX, Li J, Meng PP. Comparison of conventional therapy, intensive therapy and modified constraint-induced movement therapy to improve upper extremity function after stroke. J Rehabil Med. 2011 Jun;43(7):619-25. doi: 10.2340/16501977-0819.

  PMID: 21603848 BACKGROUND

• El-Shamy S, Alsharif R. Effect of virtual reality versus conventional physiotherapy on upper extremity function in children with obstetric brachial plexus injury. J Musculoskelet Neuronal Interact. 2017 Dec 1;17(4):319-326.

  PMID: 29199193 BACKGROUND

• Zielinski IM, van Delft R, Voorman JM, Geurts ACH, Steenbergen B, Aarts PBM. The effects of modified constraint-induced movement therapy combined with intensive bimanual training in children with brachial plexus birth injury: a retrospective data base study. Disabil Rehabil. 2021 Aug;43(16):2275-2284. doi: 10.1080/09638288.2019.1697381. Epub 2019 Dec 8.

  PMID: 31814455 BACKGROUND

• Ramey SL, DeLuca SC, Stevenson RD, Conaway M, Darragh AR, Lo W; CHAMP. Constraint-Induced Movement Therapy for Cerebral Palsy: A Randomized Trial. Pediatrics. 2021 Nov;148(5):e2020033878. doi: 10.1542/peds.2020-033878. Epub 2021 Oct 14.

  PMID: 34649982 BACKGROUND

• Werner JM, Berggren J, Loiselle J, Lee GK. Constraint-induced movement therapy for children with neonatal brachial plexus palsy: a randomized crossover trial. Dev Med Child Neurol. 2021 May;63(5):545-551. doi: 10.1111/dmcn.14741. Epub 2020 Nov 21.

  PMID: 33219706 BACKGROUND

MeSH Terms

Conditions

Wounds and Injuries; Brachial Plexus Neuropathies

Interventions

Constraint Induced Movement Therapy

Condition Hierarchy (Ancestors)

Peripheral Nervous System Diseases; Neuromuscular Diseases; Nervous System Diseases

Intervention Hierarchy (Ancestors)

Exercise Therapy; Physical Therapy Modalities; Therapeutics; Rehabilitation

Study Officials

• Hafiza Mehjabeen, ppdpt

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 6, 2022
• First Posted: June 9, 2022
• Study Start: April 30, 2022
• Primary Completion: September 1, 2022
• Study Completion: September 1, 2022
• Last Updated: March 17, 2023

Record last verified: 2023-03

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)