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Updated: Apr 13, 2026
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Published on: March 27, 2026
Coordination and balance in children with birth-related brachial plexus injury: a preliminary study
Doria Bellows1, Marija Bucevska2, Cynthia Verchere2
1Physiotherapy Department, British Columbia Children's Hospital.
Insights
Children with birth-related brachial plexus injury (BRBPI) often show impaired coordination and balance. Most participants in this study scored at risk for balance issues, suggesting balance rehabilitation could be beneficial.
Area of Science:
- Pediatric neurology
- Developmental pediatrics
- Rehabilitation medicine
Background:
- Birth-related brachial plexus injury (BRBPI) is a significant cause of functional impairment in children.
- Limited data exists on the specific impact of BRBPI on motor coordination and balance in pediatric populations.
Purpose of the Study:
- To investigate motor coordination and balance deficits in children with BRBPI.
- To quantify the prevalence of these deficits using standardized assessments.
Main Methods:
- A prospective cohort study of 39 children (aged 5-15 years) with BRBPI.
- Utilized the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2) and Movement Assessment Battery for Children (MABC-2) for motor skills assessment.
- Included the Activities Scale for Kids (ASKp) to evaluate physical disability.
Main Results:
- 28.2% of participants scored below average on the BOT-2 Body Coordination subtest.
- 66.7% of participants scored below average on the MABC-2 Balance subtest.
- A significant correlation was found between self-reported disability and poorer balance scores (p=0.007).
Conclusions:
- The majority of children with BRBPI demonstrated balance difficulties, categorized as at risk or significant difficulty.
- Balance-focused rehabilitation interventions may be a valuable addition to the treatment of BRBPI in children.
Purpose:
Most children with severe birth-related brachial plexus injury (BRBPI) have some functional impairment, but information on the impact of BRBPI on coordination and balance is limited. The study's purpose was to determine whether children with BRBPI exhibit deficits in body coordination and balance.
Method:
A prospective cohort study involving 39 children with BRBPI aged 5-15 years was conducted. Range of motion, strength, active movement, and balance and coordination motor skills were assessed using the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2), and the Movement Assessment Battery for Children-Second Edition (MABC-2). A self-report measure of physical disability, the Activities Scale for Kids-Performance Version (ASKp), was also administered.
Results:
Participants scored a mean of 44.72 on the BOT-2 Body Coordination composite subtest; scores can range from 20 to 80. Eleven participants (28.2%) scored below average on this test. Participants scored a mean of 7.3 on the Balance subtest of the MABC-2; scores can range from 1 to 19. Twenty-six participants (66.7%) scored below average on this test. Of 38 participants, 25 (65.8%) had an ASKp score indicating some level of disability (<95/100); we found a statistically significant difference in balance (p=0.007) between these 25 participants and those without disability (ASKp score 95-100).
Conclusions:
The majority of our study population scored in the categories of at risk or significant difficulty for balance on the MABC-2. Balance rehabilitation may be a valuable treatment adjunct for children with BRBPI.
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