The Effect of Nerve Branch Stimulation in Adjunct to Conventional Treatment on C₆-C₇ Obsteric Brachial Plexus Injury: a Case Report

Obstetric brachial plexus injury (OBPI), is unfortunately a common injury in newborn children. Incidence varies between 0.15 and 3 per 1000 live births in various countries. Although spontaneous recovery is known, there is a large subset which does't recover and needs proper intervention.

This case report describes the use of adding electrical stimulation at the level of nerve branch in order to improve the motor and functional performance of a OBPI patient.

The child sustained shoulder dystocia during birth, Mother was taught to do few stretching exercise, no improvement found so parents decided to take regular Physiotherapy. During initial assessment at 5^th month, patient had major motor weakness at elbow,forearm and wrist. MRI was done which revealed C₆-C₇ nerve root avulsion injury, Neurologist advised to take Physiotherapy for 3 months. Patient received electrical stimulation(ES) for muscles such as deltoid, supraspinatus, bice ps,wrist & finger extensors and inaddition to this patient received ES at nerve branch level of brachial plexus and stretching exercises & facilitatory techniques for five days/week to activate the targeted muscle groups.

The patient was assessed every three months until the age of 2 years with Toronto active movement scale of clarke and curti & The Mallet score for motor and functional activities respectively. The patient showed good prognosis.

Nerve branch electrical simulation in adjunct to conventional treatment improves the motor and functional activity of OBPI patient. The author concludes that physical therapy may have an important role in the management of OBPI.