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Asymmetrical shoulder kinematics in children with brachial plexus birth palsy

Susan V Duff1, Sudarshan Dayanidhi, Scott H Kozin

  • 1Department of Physical Therapy, Thomas Jefferson University, 130 S. 9th Street, Suite 830, Philadelphia, PA 19107, USA. susan.duff@jefferson.edu <susan.duff@jefferson.edu>

Clinical Biomechanics (Bristol, Avon)
|April 7, 2007
PubMed

Insights

Children with brachial plexus birth palsy show altered shoulder movement. The scapulothoracic joint compensates for limited glenohumeral motion in less affected limbs, impacting arm elevation and scapulohumeral rhythm.

Area of Science:

  • Orthopedics
  • Pediatric Rehabilitation
  • Biomechanics

Background:

  • Unilateral brachial plexus birth palsy (BPBP) causes distinct shoulder movement patterns between affected and unaffected limbs.
  • Understanding interlimb differences in glenohumeral and scapulothoracic joint contributions is crucial for BPBP management.

Purpose of the Study:

  • To analyze and compare the 3D kinematic contributions of the glenohumeral and scapulothoracic joints during arm elevation in children with BPBP.

Main Methods:

  • Sixteen children (4-12 years) with BPBP underwent 3D shoulder kinematic analysis during arm elevation.
  • Participants were grouped based on maximum arm elevation in the involved limb (<75° or >75°).
  • Kinematic data were collected using a magnetic tracking device for involved and non-involved limbs.

Main Results:

  • The involved limb in the <75° group showed reduced glenohumeral joint excursion and an altered glenohumeral:scapulothoracic ratio compared to the non-involved limb and the >75° group.
  • Increased scapular upward rotation was observed in the involved limb across both groups.
  • The glenohumeral:scapulothoracic ratio became more similar between limbs in the >75° group during higher degrees of arm elevation.

Conclusions:

  • The scapulothoracic joint plays a compensatory role in arm elevation for children with more severe BPBP, disrupting normal scapulohumeral rhythm.
  • Potential contributing factors include musculoskeletal and neural impairments.
  • 3D kinematic analysis offers a valuable tool for treatment planning and outcome quantification in pediatric BPBP.
Abstract

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