Systematic Review: Non-Surgical Rehabilitation Interventions for Children With Brachial Plexus Birth Injury
Paige Koerner1, Rosie Head1, Cierra Beauvais1
1The University of Texas Medical Branch, Galveston, USA.
OTJR : Occupation, Participation and Health
|March 25, 2026
Summary
Occupational therapy interventions like modified constraint-induced movement therapy can improve range of motion and motor skills in children with brachial plexus birth injuries (BPBIs). These non-surgical methods aid recovery and enhance participation in daily activities.
Area of Science:
- Pediatric Rehabilitation
- Occupational Therapy
- Neurology
Background:
- Brachial plexus birth injuries (BPBIs) significantly impact children's upper extremity function and occupational participation.
- Non-surgical interventions are crucial as first-line or adjunctive treatments to optimize recovery and prevent secondary impairments.
Purpose of the Study:
- To review the efficacy of non-surgical occupational therapy interventions for improving range of motion (ROM) and motor skills in children with BPBIs.
- To synthesize evidence supporting conservative management strategies for pediatric brachial plexus injuries.
Main Methods:
- Systematic review of randomized controlled trials and comparative studies (cohort, case-control) published in peer-reviewed journals.
- Searches conducted across Scopus, Cochrane Trials (CENTRAL), Ovid (Medline), and CINAHL databases.
- Data abstraction followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Main Results:
- Strong evidence supports the effectiveness of modified constraint-induced movement therapy (mCIMT).
- Evidence also supports constraint-induced movement therapy (CIMT), neuromuscular electrical stimulation (NMES), and virtual reality (VR) interventions.
- These interventions demonstrated benefits in improving upper extremity (UE) range of motion and motor function.
Conclusions:
- Non-surgical occupational therapy interventions show significant promise for managing brachial plexus birth injuries in children.
- mCIMT, CIMT, NMES, and VR are evidence-based approaches for enhancing functional recovery and participation in children with BPBIs.
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