Enter your Email address:
Wolters Kluwer Health may email you for journal alerts and information, but is committed
to maintaining your privacy and will not share your personal information without
Walsh, Sharon F.1
1Physical Therapy, The University of Findlay, Findlay, OH, USA (Walsh)
2Neurology, Rocky Mountain University of Health Professions, Provo, UT, USA
Brachial plexus injuries are frequently seen in the physical therapy department with treatment most often beginning soon after birth. Many treatments such as surgery, bracing, and E-stim meet with very poor compliance. The purpose of this case study will be to describe the treatment and subsequent progress of a 2 year old child whose brachial plexus injury was treated successfully with kineseotape and exercise.
The subject was a 2 year old female with a diagnosis of brachial plexus injury. She had been treated by a previous therapist until 1 1/2 years of age and was discontinued from therapy when she plateaued. A followup at a large urban center was successful until x-rays demonstrated severe inferior subluxation of the humeral head and severe winging of the scapula. The subject was fitted with a night time brace to stretch shoulder internal rotators. E-stim was recommended. Reconstructive surgery was also scheduled in six months. At the initial physical therapy examination she was observed to hold the involved shoulder in approximately 80 degrees of abduction, displayed significant asymmetry between sides, used the arm only as an assist, and always transferred objects to the noninvolved hand for manipulation. Treatment at the outpatient clinic consisted of discontinuing use of the night resting brace as it was impossible for the child to sleep, discontinuing E-stim as not feasible for a child of her young age, beginning patient education, and initiating kinesotape to facilitate rotator cuff and scapular stabilizer function. The parent typically left the tape on for 2–3 days before reapplying, with the average weekly wear time of 4–5 days/week.
After only 2 weeks of taping (4 visits), there was significant progress. The deltoid muscle definition was prominent. The subject typically held her shoulder in approximately 20 degrees of abduction. Her shoulders were level and her scapula was displaying less winging. Tape was then added for scapular stabilizers. At the end of 4 weeks of taping (6 visits), her involved arm was held to her side similar to her uninvolved arm. She used the involved arm to initiate activities, no longer transferred objects to the uninvolved arm, and displayed increased fine motor use with the involved hand. The subject's involved arm also displayed a very stable scapula on the thoracic spine with negligible asymmetry. Treatment continued for 3 months. X-rays of the involved shoulder displayed an intact shoulder with good position of the humeral head in the socket.
Treatment of shoulder dislocation began quite late for this child, almost 2 years after her diagnosis. Many of the treatments suggested were inappropriate for a child of her age. With the use of simple kinesotape and parent education for follow through, weekly therapy visits made a significant difference in the functional use of the involved upper extremity. Research needs to follow in this area so that unnecessary surgery and expensive treatments for children of this age do not occur.
brachial plexus; kineseotape; children
© 2006 Lippincott Williams & Wilkins, Inc.
Colleague's E-mail is Invalid
Your Name: (optional)
Separate multiple e-mails with a (;).
Thought you might appreciate this item(s) I saw at Pediatric Physical Therapy.
Send a copy to your email
Your message has been successfully sent to your colleague.
Some error has occurred while processing your request. Please try after some time.
An Existing Folder
A New Folder
The item(s) has been successfully added to "".
Login with your LWW Journals username and password.
Username or Email:
Enter and submit the email address you registered with. An email with instructions to reset your password will be sent to that address.
Link to reset your password has been sent to specified email address.
What does "Remember me" mean?
By checking this box, you'll stay logged in until you logout. You'll get easier access to your articles, collections,
media, and all your other content, even if you close your browser or shut down your
To protect your most sensitive data and activities (like changing your password),
we'll ask you to re-enter your password when you access these services.
What if I'm on a computer that I share with others?
If you're using a public computer or you share this computer with others, we recommend
that you uncheck the "Remember me" box.
Save my selection
Article Level Metrics
Highlight selected keywords in the article text.
Search for Similar Articles
You may search for similar articles that contain these same keywords or you may
modify the keyword list to augment your search.