Shoulder external rotation tendon transfers for brachial plexus birth palsy.

Children with brachial plexus birth palsy may have permanent loss of shoulder external rotation strength. This impairment may result to a difficulty in reaching the face and head with the affected hand for grooming activities, and in reaching overhead for participation in sports or work-related tasks. In addition, the contracture that results from unopposed internal rotation may further restrict range of motion and cause glenohumeral joint deformity and subluxation.A combination of muscle release and transfers reliably improves the child's ability to position the hand, and may halt the development of joint deformity. Postoperative rehabilitation is necessary to maximize the strength and range of motion obtained from this operation.

Timed motor test for wheelchair users: initial development and application in children with spinal cord injury.

OBJECTIVE: The objective of this study was to describe the development and preliminary results of reliability testing of the timed motor test (TMT), a performance-based measure of functional status for children with a spinal cord injury (SCI) who use a manual wheelchair. This study will also provide pilot data using the TMT to examine the impact of thoracolumbosacral orthoses (TLSO) on function in children with a SCI. STUDY DESIGN: Cross-sectional observational study. METHODS/PARTICIPANTS: This study enrolled 11 subjects with SCI. The TMT consisted of donning a shirt, donning pants, even transfers, uneven transfers, and propelling a wheelchair 80 feet and up a ramp of 45 feet. Nine subjects completed the TMT with and without a TLSO, and 6 subjects (4 of whom also completed the TMT with and without a TLSO) completed the reliability testing. RESULTS: Except for donning pants, the intertester and intratester reliability of the TMT was fair-to-good with intraclass correlation coefficients (ICCs) of 0.60 or greater. When wearing a TLSO, participants were slower at donning a shirt, donning pants, performing even and uneven transfers, and hallway propulsion (P < 0.05). There was a preference for not wearing a TLSO for dressing and transfer skills. CONCLUSION: In general, the TMT for wheelchair users had fair-to-good intertester and intratester reliability. Based on these pilot data, there was an increase in time to complete several functional tasks because of the use of a TLSO as measured by the TMT in children with a SCI.