Erb's Palsy

[prem]

i'll definetely follow ur suggestion and thank u so much for guiding me.i've observed the patient's forearm bulk is more than the normal one and the affected upperlimb is also short by 4 cm. the effected side elbow is in slight flexion.can we get the limb length to normal by stretching and strengthening the elbow extensors?

[sdkashif]

Yeah you should try to release the contractures at elbow by stretching and strengthening the weak muscles. Once the contracture is released, the upper limb affected will look normal in length.

[emad]

Personally , i see the issue of stretching and strenghtening can NOT provide the good outcome expected .
The key point is NOT the muscle ,but the behavior of the child regarding that limb ,Cortical attention toward that upper limb seems to be lost , sometimes they do NOT like that limb ....reach the level of hating it , usually they prefer using the non-affected .
Encourging them to use that limb is a social matter primarily .I begin to apply Induced constraint therapy early as possible ,i noticed great progress from the first 3 months of age .

Cheers
Emad

[sdkashif]

It is Ok with to induce the movement in the weak limb but where there is contracture, stretching has a definite role to play. By inducing the active movements in a limb is actually the way of strengthening the weak limb in other words.

[emad]

Stretching needs to be reviewed within physiotherapy and rehabilitation concepts ,because it fires protective mechanisms ( reflexes) leading more contractures . Just observe this child manner /pattern of activity ,you will find them move in pattern leads to that flexed contracture . This type of contracture was mysterous for me with one of those childern .Just non-cooperative child .

Cheers
Emad

[sdkashif]

Is there any evidence based study that verifies that stretching leads to more contractures? If there is any studies regarding that, kindly provide some links regarding that.

[emad]

Unfortunately , NO evidence .

Cheers
Emad

[ramywhite]

I don't know either if there is any evidence that stretching contracture tissue may lead to more contractures . But if the muscle is good innervated you can use Active Inhibition to overcome the patient active resistance to stretching.
Cheers

[emad]

Nice ,Why are we standing still believers in Stretching ? Is there evidence supports stretching efficacy in contractures .

Further behind step , anyone has experience that stretching could work in contractures .What is the cause of this contracture with that Erb,s girl ?

Cheers
Emad