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Erb's palsy is an upper brachial plexus injury of the nerves. The nerves that are damaged control muscles in the shoulder, arm, or hand and can paralyze any or all of these muscles. Children with Erb's palsy are affected in different ways. Some Erb's palsy patients have no muscle control or feeling in the arm or hand. Some patients can move their arms, but have little control over the wrist and hand, while others can use their hands well but cannot use the shoulder or elbow muscles.
The child's disability depends on the degree of Erb's palsy, which nerves are injured, and how severely they have been damaged. Erb's palsy treatment can help your child gain control of their upper extremities.
Erb's palsy treatment first entails providing patient's parents with a home program of PROM (passive range of motion) sheets consisting of 2-3 daily exercises with10 repetitions of all motions. Begin gentle PROM exercises by having the child lay on their back to increase joint flexibility and muscle tone. Erb's palsy treatment with physical stimulation to the involved extremity using various textured materials will increase sensory awareness of that extremity in overall body workings.
The active use of the involved extremities with a variety of developmental activities to increase strength and coordination are an integral part of Erb's palsy treatment. These activities should be performed along with gravity in the beginning followed by advances against gravity. Bimanual and bilateral motor planning activities should always be included in Erb's palsy treatment.
Pool therapy is extremely helpful with Erb's palsy treatment because of the resistance of the pool water. A greater freedom of movement is allowed in water creating optimum range of motion.
Positioning and splinting during off times of Erb's palsy treatment is essential. To hold arm in supination (angled to the outside) and external rotation you may place pillows underneath the armpit and alongside the arm while the patient is at rest or sleeping to provide a sustained stretch. Avoid holding the arm in elbow flexion on top of chest by restraining it for long periods of time. Placing the arm while feeding or resting in this position is acceptable, but do not let arm dangle in space.
A limp hand or wrist should be assisted with a resting hand splint, and should be provided to maintain the hand in a proper functional position and for protection secondary to deficits in sensory nerves.
Erb's palsy treatment is critical in attempting to combat weakness in the affected extremities. Your child's physician can help you develop an Erb's palsy treatment program. Time is of the essence when beginning Erb's palsy treatment, so don't wait to see if it goes away on it's own.