Physiotherapy & Physical Rehabilitation

Background: There are 125 patients undergoing brachial plexus surgery upper region at King Faisal Specialist Hospital and Research Center from 2005-2015. 80% of them need extensive physical therapy post-surgery, which is proven to enhance the full recovery of the arm function, according to the evidence based studies. Study design: The case study was used to high light the role of physical therapy in the treatment of brachial plexus palsy post-surgery. Case description: 13 months old Saudi girl had been diagnosed with left C5-C6 brachial plexus injury (Narakas 1) patient underwent exploration and bilateral nerve grafting on the age of three months old, placed in baby holder for three weeks. Then the orthopedic physician referred her to the physical therapy clinic for OBPP protocol. Management & Outcomes: The patient received one session per month included: positioning and instructions to handle the patient in proper way, passive range of motion, active range of motion and strengthening exercises. Sensory stimulation and certain programs facilitate normal posture and motor development. At the second visit the patient started to improve gradually in ROM and MP. After six months of treatment, the patient able to pull herself to stand alone, cruising independent and get crawling position with left hand opened and in proper position on the floor, the ROM & MP almost within normal limit. Discussion: This case study showed that the early physical therapy intervention post-surgery for brachial plexus injury upper region can improve/cure the patient condition.