Effects of Exercise Training With Proprioceptive Equipment on Proprioceptive and Functional Status of Children with Obstetrical Brachial Plexus Injury

Yıl 2017, Cilt: 8 Sayı: 1, 1 - 7, 01.03.2017

Deran Oskay , Edibe Ünal , Gürsel Leblebicioğlu Zeynep Tuna

https://doi.org/10.5799/jcei.328708

Öz

Objective: Decreased proprioception in Obstetric Brachial Plexus Injury (OBPI) reduces the quality of functional
movement. Hence, the aim of our study was to evaluate the effects of exercise training with additional proprioceptive
equipments on the functional status and proprioceptive sense in children with OBPI.
Methods: Forty children with OBPI were randomly divided into two groups. Passive, active and active-assisted range
of motion and stretching exercises were included in home-based program (HP) group while additional exercises with
proprioceptive equipments were also added in the proprioceptive training (PT) group. After 6 weeks, proprioceptive
perception and functional level were compared to pre-treatment results.
Results: Proprioceptive perception at the beginning and at the end of the movement increased in both groups (p<0,05).
The Active Movement Scale (AMS) scores increased significantly only in some movements in both groups (p<0,05).
AMS scores of shoulder abduction and external rotation in PT group were better than HP group (p<0,05).
Conclusion: Home exercise program and proprioceptive exercise training both improve proprioceptive sense and
functional status in children with OBPI. The proprioceptive exercise training seems to be more beneficial in improving
functional movements of shoulder.  

Anahtar Kelimeler

Exercise training, obstetrical brachial plexus injuries, proprioception

Kaynakça

• 1. Jennet RJ, Tarby TJ, Kraus RL. Erb’s palsy constracted with Klumpke’s and total palsy:different mechanism are involved. Am J Obstet Gynecol 2002;186:1215-20．
• 2. Gilbert A. Long term evaluation of brachial plexus surgery in obstetrical palsy. Hand Clins 1995;11:583-94.
• 3. Kirkos JM, Papadopoulos IA. Late treatment of brachial plexus palsy secondary to birth injuries: rotational osteotomy of the proximal part of the humerus. J Bone Joint Surg 1998; 80A:1477-83．
• 4. Magarey ME, Jones MA. Dynamic evaluation and early management of altered motor control around the shoulder complex. Man Ther 2003;8(4):195- 206.
• 5. Oskay D, Ünal E, Çetinkaya Ş. Do obstetrical brachial plexus injuries affect proprioceptive sense? Neurosciences 2010;15:268-71.
• 6. Clarke HM, Curtis CG. Examination and Prognosis. In Gilbert A, ed. Brachial Plexus Injuries. London:Martin Dunitz, 2001:59-172.
• 7. Ulkar B, Kunduracıoğlu B, Çetin C, et al. Effect of positioning and bracing on passive position sense of shoulder. Br J Sports Med 2004;38:549-52．
• 8. Cuomo F, Birdzell MG, Zuckerman JD. The effect of degenerative arthritis and prosthetic arthroplasty on shoulder proprioception. J Shoulder Elbow Surg 2005;14:345-48．
• 9. Birch R, Bonney G, Wynn Parry CB. Birth lesions of the brachial plexus. In Livingstone C, ed. Surgical Disorders of the Peripheral Nerves (209- 233) Edinburgh: Churchill Livingstone, 1998:209- 33.
• 10. Eng G, Binder H, Getson P, et al. OBPP outcome with conservative management．Muscle Nerve 1996;16:884-91．
• 11. Benjamin K. Part 2. Distinguishing physical characteristics and management of brachial plexus injuries. Adv Neonatal Care 2005;5:240-51 ．
• 12. Muhlig RS, Blaauw G, Sloof ACJ, et al. Conservative treatment of obstetrical brachial plexus palsy and rehabilitation．In Gilbert A, ed. Brachial Plexus Injuries. London:Martin Dunitz, 2001:173-187.
• 13. Grigg P. Peripheral neural mechanism in proprioception. J Sport Rehabil 1994;3:2-17.
• 14. Cordo P, Carlton L, Bevan L, et al. Proprioceptive coordination of movement sequence: Role of velocity and position information. J Neurophysiol 1994;71:1848-61
• 15. Johansson H, Sjölender P. Neurophysiology of joints. In Wright VEL, ed. Mechanics of Human Joint Physiology, Pathopyhsiology and Treatment. New York, 1993:243-90.
• 16. Grubb BD, Birrellm GJ, McQueen DS, Iggo A. The role of PGE in the sensitization of mechanoreceptors in normal and inflamated ankle joints of the rat. Exp Brain Res 1991;184:383-92.
• 17. Swanik KA, Lephart SM, Swanik B, et al. The effect of shoulder plyometric training on proprioception and selected muscle performance characteristics. J Shoulder Elbow Surg 2002;11:579-86．
• 18. Rogol IM, Ernst G, Perrin D. Open and closed kinetic chain exercises improve shoulder joint reposition sense equally in healthy subjects. J Athletic Train 1998;33:315-18．
• 19. Hilberg T, Herbsleb M, Puta C, et al. Physical training increase muscular strength and proprioceptive performance in haemophilic subjects. Haemophilia 2003;9:86-93.
• 20. Jerosch JG. Effects of shoulder instability on joint proprioception. In Lephart SM, Fu FH, ed. Proprioception and neuromuscular control on joint instability. Pittsburg, 2002:247-64．
• 21. Waters P, Bae D. Effect of tendon transfers and extra articular soft tissue balancing on glenohumeral development in brachial plexus birth palsy. J Bone Joint Surg 2005;87:320-25.
• 22. Benjamin K. Part 1. Injuries to the brachial plexus: mechanism of injury and identification of risk factors. Adv Neonatal Care 2005;5:181-89．
• 23. Sunmire HF, DeMott RK. Erb's palsy without shoulder dystocia. Int J Gynaecol Obstet 2000;78:253-56．
• 24. Shenaq SM, Berzin E, Lee R, et al. Brachial plexus birth injuries and current management. Clin Plast Surg. 1998;25:527-36．
• 25. Sainburg RL, Poizner H, Ghez C. Loss of proprioception produces deficits in interjoint coordination. J Neurophysiol 1993;70:2136-47.
• 26. Cordo P, Carlton L, Bevan L, et al. Proprioceptive coordination of movement sequence: Role of velocity and position information. J Neurophysiol 1994;71:1848-61．
• 27. Bairstow PJ, Lazslo JI. Kinestetic sensitivity to passive movements and its relation to motor development and motor control. Dev Med Child Neurol 1981;23:606-16．
• 28. Hay L, Bard C, Ferrel C. Role of proprioceptive information in movement programing and control in 5 to 11-year-old children. Hum Mov Sci 2005;24:139-54．