[Physiotherapy applied to the upper extremity in 0 to 10-year-old children with obstetric brachial palsy: a systematic review]. / Fisioterapia aplicada en la extremidad superior a niños de 0 a 10 años con parálisis braquial obstétrica: revisión sistemática.

INTRODUCTION: Obstetric brachial palsy is involved with affected upper limb, resulting in permanent structural and function sequelae that limit the motion articular range and reduce independence in daily activities, as well as the children participation in their natural environment. AIM: To describe the physiotherapy treatments currently used to increase the affected upper limb functionality in children from 0 to 10 years diagnosed with obstetric brachial palsy. PATIENTS AND METHODS: A bibliographic search of published studies between 2009 and 2018 was carried out in the PubMed, PEDro, ScienceDirect and The Cochrane Library databases. RESULTS: After applying the inclusion/exclusion criteria, ten studies were obtained with favorable results for the affected upper limb functionality and bone mineralization density, regardless of the technique of choice used during the intervention. The used physiotherapy programs in the different studies such as Constraint Induced movement therapy, kinesiotape, electrotherapy, virtual reality and use of splints or orthotics were analyzed. CONCLUSION: All the described techniques suggest favorable results for the affected upper limb functionality in obstetric brachial palsy from 0 to 10 years.

TITLE: Fisioterapia aplicada en la extremidad superior a niños de 0 a 10 años con parálisis braquial obstétrica: revisión sistemática.Introducción. La parálisis braquial obstétrica cursa con afectación del miembro superior y da lugar a secuelas estructurales y de la función permanentes que limitan el rango articular de movimiento y reducen la independencia en las actividades cotidianas, así como la participación del niño dentro de su entorno natural. Objetivo. Describir los tratamientos de fisioterapia empleados en la actualidad para incrementar la funcionalidad de la extremidad superior afectada en niños de 0 a 10 años diagnosticados de parálisis braquial obstétrica. Pacientes y métodos. Se realizó una búsqueda bibliográfica de los trabajos publicados entre 2009 y 2018 en las bases de datos PubMed, PEDro, ScienceDirect y Cochrane Library. Resultados. Tras aplicar los criterios de inclusión/exclusión, se obtuvieron diez estudios con resultados favorables para la funcionalidad de la extremidad superior afectada y la densidad de mineralización ósea, independientemente de la técnica de elección utilizada durante la intervención. Se analizaron los programas de fisioterapia empleados en los diferentes estudios, como la terapia de movimiento inducido por restricción, el kinesiotape, la electroterapia, la realidad virtual y el uso de férulas u ortesis. Conclusión. Todas las técnicas descritas sugieren resultados favorables para la funcionalidad del miembro superior en niños de 0 a 10 años con parálisis braquial obstétrica.

[Treatment of early and late obstetric brachial plexus palsy]. / Vaiku peties nervinio rezginio pazeidimo ir jo sukeltu padariniu gydymas.

The aim of this study was to review and to analyze treatment patterns of early and late obstetric brachial plexus palsy. Eighty-one children with early and late obstetric brachial plexus palsy were treated in the Department of Pediatric Orthopedics and in the Postintensive Care Unit within the period 1988-2002. Children were classified into 2 groups according to age: Ist group (67 newborns) was treated conservatively, and IInd group (14 children with late obstetric brachial plexus palsy with deformity) underwent operative treatment. Active hand movements and innervation were evaluated before and after treatment. Thirty newborns had full recovery, 32 newborns had incomplete recovery, and in 5 cases no improvement was seen. Fourteen children with late obstetric brachial plexus palsy underwent the following operations: rotation osteotomy of the humerus was performed in 10 cases, lengthening of biceps and brachialis muscle tendons--in 6 cases, transposition of triceps muscle tendon--in 1 case, transposition of pectoralis major tendon--in 3 cases and flexor carpi transposition--in 1 case. There was an improvement in active hand movements after operative treatment and rehabilitation. According to our experience, in most cases newborns recover spontaneously or after conservative treatment. Secondary reconstructive surgery of late brachial plexus palsy can improve the condition of these patients.