Systematic Review: Non-Surgical Rehabilitation Interventions for Children With Brachial Plexus Birth Injury

Brachial plexus birth injuries (BPBIs) can affect children's occupational participation. This review examined the efficacy of non-surgical interventions used by occupational therapy for increasing the range of motion (ROM) and improving motor skills of the affected upper extremities (UEs) of children with BPBIs. Non-surgical interventions are typically used as first-line treatment or in adjunct to surgery with the aim of optimizing recovery, decreasing risk of secondary impairment, and promoting occupational participation. Sources were Scopus, Cochrane Trials (CENTRAL), Ovid (Medline), and CINAHL. Data were abstracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria: Participants with BPBI, not older than 18 years, randomized controlled trials or comparative studies (cohort and case-control), sample size over 20, conservative management, published in a peer-reviewed journal, written in English. Strong evidence supported modified constraint-induced movement therapy, constraint-induced movement therapy, neuromuscular electrical stimulation, and virtual reality.