Neonatal Brachial Plexus Palsy Case Study

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Questions and Answers

What type of delivery method was used for the child in the case study?

  • Vacuum extraction
  • Forceps delivery (correct)
  • Natural childbirth
  • Cesarean section

What was the child's Apgar score at 10 minutes after birth?

  • 10 (correct)
  • 8
  • 7
  • 9

What is the primary focus of the case study?

  • The role of parents in the recovery process of children with NBPP
  • The use of conservative treatment strategies in rehabilitating a child with NBPP (correct)
  • The effectiveness of bimanual stimulation in treating NBPP
  • The long-term impact of shoulder dystocia on child development

Which of the following is NOT a therapeutic intervention mentioned in the case study?

<p>Occupational therapy (C)</p> Signup and view all the answers

What is the age of the child in the case study at the time of the report?

<p>5 years old (B)</p> Signup and view all the answers

What condition did the child present with?

<p>Brachial plexus injury (D)</p> Signup and view all the answers

Which of the following is NOT a typical compensation seen in children with NBPP?

<p>Scoliosis (D)</p> Signup and view all the answers

What is the primary goal of the rehabilitation process in the case study?

<p>To restore the child's functional and sensory abilities of the affected arm. (B)</p> Signup and view all the answers

What was the frequency of physical therapy sessions for the patients?

<p>Once a week (B)</p> Signup and view all the answers

How long did the intensive therapeutic intervention program last?

<p>18 months (B)</p> Signup and view all the answers

Which therapy was provided two days a week?

<p>Occupational therapy (B)</p> Signup and view all the answers

What is the likely diagnosis for the patients who underwent these therapeutic interventions?

<p>Traumatic brain injury (A)</p> Signup and view all the answers

Which of the following therapeutic interventions were NOT mentioned in the text?

<p>Art therapy (A)</p> Signup and view all the answers

What is a possible reason for the extended duration of the therapy program?

<p>To promote long-term recovery and rehabilitation (B)</p> Signup and view all the answers

What is the likely age range of the patients who underwent these interventions?

<p>Children (D)</p> Signup and view all the answers

What aspect of the treatment plan is characterized as 'intensive'?

<p>The frequency of therapy sessions (C)</p> Signup and view all the answers

The mention of “therapeutic interventions for recovery” suggests that the objective of the treatment was to?

<p>Promote physical and functional independence (B)</p> Signup and view all the answers

What is a potential benefit of including both physical and occupational therapy in this intervention program?

<p>To address different aspects of impairments (C)</p> Signup and view all the answers

What is the frequency of the occupational therapy sessions in the described intervention?

<p>2 days a week (B)</p> Signup and view all the answers

What is the maximum duration of each session?

<p>60 minutes (A)</p> Signup and view all the answers

What was the intervention approach like?

<p>Intensive (A)</p> Signup and view all the answers

What does the phrase 'taken into account' likely refer to?

<p>The patient's tolerance and abilities (B)</p> Signup and view all the answers

What was the primary goal of the intervention?

<p>To teach parents how to help their child (B)</p> Signup and view all the answers

What type of intervention is described in the passage?

<p>Occupational therapy (D)</p> Signup and view all the answers

How many months did the intervention last?

<p>18 (D)</p> Signup and view all the answers

The intervention was likely designed to improve which aspect of the child's functioning?

<p>Motor skills (C)</p> Signup and view all the answers

What is a plausible reason for the intensive nature of the intervention?

<p>To quickly address a complex medical condition (D)</p> Signup and view all the answers

What is a potential limitation of this case study?

<p>All of the above (D)</p> Signup and view all the answers

Flashcards

Intervention Strategies

Methods used in rehabilitation, including various mobilization and stimulation techniques.

NBPP

Neonatal Brachial Plexus Palsy, a condition affecting arm movement in newborns.

Functional Recovery

Restoration of normal arm movements and activities after therapy.

Kinesio Tape

A supportive tape used in therapy to promote movement and reduce pain.

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Parental Involvement

Engagement of parents in the rehabilitation process to support the child.

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Botulinum Toxin

A treatment used to reduce muscle stiffness in rehabilitation.

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Conservative Treatment

Non-surgical approaches to manage and rehabilitate conditions.

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CARE Guidelines

A framework for reporting case studies in clinical settings.

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Therapeutic Interventions

Therapies designed to aid in physical or mental recovery.

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Recovery from NBPP

The process of healing from Neurogenic Bladder and Pelvic Pain.

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Physical Therapy Sessions

Regular appointments focused on improving physical function.

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Occupational Therapy Sessions

Therapy aimed at improving daily living skills.

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Frequency of Therapy

The number of therapy sessions per week.

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Intensive Therapy Approach

A concentrated method involving frequent sessions.

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Duration of Recovery

The length of time prescribed for therapeutic interventions.

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Holistic Recovery

Considering both physical and mental aspects in healing.

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Recovery Goals

Objectives set for progress during therapy.

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Therapeutic Environment

A supportive setting for conducting therapy sessions.

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Collaborative Approach

Working together with parents in therapy to enhance outcomes.

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Session Duration

Length of therapy sessions, which was around 45 minutes.

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Intensive Therapy

Frequent sessions aimed at achieving significant progress.

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Child's Tolerance

The child's ability to handle the duration and intensity of therapy.

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Frequency of Sessions

Therapy was structured with specific days a week for sessions.

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Reproducibility

Ability for parents to replicate therapy techniques at home.

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Assessment at 18 Months

Evaluation of progress after intensive sessions over time.

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Study Notes

Neonatal Brachial Plexus Palsy (NBPP)

  • NBPP is a partial or total peripheral nerve injury, occurring during birth.
  • The injury occurs due to stretching, rupture, or avulsion of nerve fibres.
  • Classified by affected nerve(s): upper trunk (C5-C6), middle trunk (C7), lower trunk (C8-T1), and complete injury (C5-T1).
  • Classified by severity, as avulsion, neurotmesis, axonotmesis, stretching, etc.

Case Report Summary

  • A 5-year-old girl with right-arm NBPP, with C5, C6, and C7 nerve injuries.
  • Symptoms at birth and diagnosis: absence of right arm movement, but finger movement, internal rotation, elbow extension, active wrist and finger flexion, ulnar hand deviation.
  • Conservative rehabilitation plan: passive and active mobilization, kinesio tape, splints, bimanual stimulation.
  • Rehabilitation benefited the child to function the limb for daily activities, with integrated bimanual motor skills and coordination; active and passive range of motion (except for pronation and sensibility).
  • Early intervention, parental involvement, and continuous follow-up were vital for a positive prognosis and functional limb maintenance.

NBPP Treatment

  • Conservative treatment: intensive physiotherapy, occupational therapy.
  • Non-conservative/surgical treatment: primary and secondary surgery, botulinum toxin injection.
  • Initial physical assessments: arm asymmetry observation, pregnancy/delivery history, physical examination.
  • Essential follow-up in multidisciplinary clinics, with therapists and neurologists.

Diagnostic Assessment

  • Primarily physical observation of the child is conducted to diagnose, assess progression of motor and sensory function.
  • Supplementary diagnostic tests: electromyography (EMG), MRI, neurodevelopmental, musculoskeletal, and individualised muscle strengthening techniques.

Therapeutic Interventions

  • Focus on neurodevelopmental techniques, musculoskeletal restoration, and individual muscle strengthening strategies.
  • Passive mobilization and active mobilization – these are important in the first three months of life.
  • Activities focused on increasing the functionality of the joint.
  • Use of tactile and proprioceptive stimulation (with various materials).
  • Use of splints, kinesio tape, and constraint-induced movement therapy for targeted muscle strengthening.
  • Interventions tailored to the child's development.

Follow-Up and Outcomes

  • Successful conservative treatment resulted in functional recovery and limb integration for daily activities.
  • The child demonstrated functional limb, with some limitations in pronation and sensibility.
  • Parental involvement and continuous follow-up are crucial for positive outcomes.

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