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Yefet LS, Bellows D, Bucevska M, Courtemanche R, Durlacher K, Hynes S, Verchere C. Shoulder Rotation Function Following the Sup-ER Protocol in Children with Brachial Plexus Injuries. Hand (N Y) 2022; 17:549-557. [PMID: 32674626 PMCID: PMC9112750 DOI: 10.1177/1558944720937365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Our group previously developed an upper extremity repositioning (Sup-ER) protocol for brachial plexus birth injuries (BPBIs) that may improve supination and external rotation (ER) at 2 years of age. Questions were raised about the potential for the protocol to cause internal rotation (IR) deficits. The goal of this study was to explore the longer-term outcomes of the Sup-ER protocol and investigate IR/ER function. Methods: This prospective cross-sectional cohort study examined 16 children older than 4 years of age with significant enough BPBI to be treated with the Sup-ER protocol. Total shoulder and elbow function were assessed, including passive and active ranges of motion and strength of IR and ER. Results: Range of motion (ROM) for most active movements was decreased in the affected compared to unaffected arm. Notably, IR passive ROM was similar in the affected (78.7°) and unaffected arm (82.8°). External rotation strength of the affected arm was weaker (42.8 N) compared to the unaffected arm (57.9 N). IR strength had a greater deficit in the affected (43.2 N) arm compared to the unaffected arm (72.2 N), but both ER and IR showed less deficit than described in the literature. Conclusions: Despite differences in ranges of motion between the affected and unaffected arms, ROMs for the affected arm were comparable to the functional limits as reported in the literature. The Sup-ER protocol shows potential to optimize long-term shoulder rotation function in children with BPBI without compromising IR.
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Affiliation(s)
- Leeor S. Yefet
- University of British Columbia, Vancouver, Canada,British Columbia Children’s Hospital, Vancouver, Canada
| | - Doria Bellows
- University of British Columbia, Vancouver, Canada,British Columbia Children’s Hospital, Vancouver, Canada
| | - Marija Bucevska
- University of British Columbia, Vancouver, Canada,British Columbia Children’s Hospital, Vancouver, Canada
| | - Rebecca Courtemanche
- University of British Columbia, Vancouver, Canada,British Columbia Children’s Hospital, Vancouver, Canada
| | - Kim Durlacher
- University of British Columbia, Vancouver, Canada,British Columbia Children’s Hospital, Vancouver, Canada
| | - Sally Hynes
- University of British Columbia, Vancouver, Canada,British Columbia Children’s Hospital, Vancouver, Canada
| | - Cynthia Verchere
- University of British Columbia, Vancouver, Canada,British Columbia Children’s Hospital, Vancouver, Canada,Cynthia Verchere, Division of Paediatric Plastic Surgery, British Columbia Children’s Hospital, 4480 Oak Street, Rm. K3-131, ACB, Vancouver, British Columbia V6H 3V4, Canada.
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