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A Case Report of an Infant With Arthrogryposis
Kristy Azbell1, Lisa Dannemiller
1Rehabilitation Services Department, Rocky Mountain Hospital for Children at Presbyterian St Luke's Medical Center, Denver, Colorado (Dr Azbell); and Physical Therapy Program, University of Colorado Anschutz Medical Campus, Aurora (Dr Dannemiller).
Insights
This case report details an infant with arthrogryposis multiplex congenita, showing functional improvements with consistent occupational and physical therapy. Interventions improved range of motion and participation, despite some motor skill decreases.
Area of Science:
- Pediatric Rehabilitation
- Developmental Pediatrics
- Orthopedic Surgery
Background:
- Arthrogryposis multiplex congenita (AMC) presents significant challenges in infant development, impacting motor function and participation.
- Early and consistent intervention is crucial for managing the complex needs of infants with AMC.
- This case report focuses on a single infant to illustrate the effects of a multidisciplinary approach.
Observation:
- The infant received alternating occupational and physical therapy from 11 days to 9 months of age.
- Lower extremity serial casting and orthopedic visits were part of the intervention plan.
- The infant experienced passive range of motion improvements and decreased pain scores.
Findings:
- Despite improvements in passive range of motion and decreased pain, the Peabody Developmental Motor Scales, 2nd edition, showed a decrease in locomotion and stationary skills.
- The Patient Specific Functional Scale score increased, indicating improved functional capacity.
- Outcomes suggest a positive response to a comprehensive intervention program.
Implications:
- Multidisciplinary interventions including stretching, strengthening, splinting, casting, and surgical procedures like Achilles tenotomies can yield positive outcomes in AMC.
- While some functional gains were observed, ongoing monitoring of gross motor skills is warranted.
- This case highlights the importance of tailored, intensive therapy for infants with arthrogryposis multiplex congenita.
Purpose:
This case report documents limitations of body structures and function, activity, and participation for an infant with arthrogryposis multiplex congenita and reports frequency and timing of interventions for this child.
Summary Of Key Points:
The infant was followed from 11 days to 9 months of age while receiving occupational therapy and physical therapy on alternating weeks, with orthopedic visits for lower extremity serial casting. Passive range of motion improved and pain scores decreased during passive range of motion. The Patient Specific Functional Scale score increased; The Peabody Developmental Motor Scales, 2nd edition, standard score decreased from 9 in locomotion and stationary skills to 3 in locomotion and 8 in stationary skills.
Recommendations For Clinical Practice:
Outcomes demonstrate improvement in impairments of body structures and functions, participation, and some activities, through a program of stretching, strengthening, splinting, casting, and bilateral Achilles tenotomies for this infant with arthrogryposis multiplex congenita.
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