Sorry this reply has taken a while. References for effectiveness of Pt
for Erb's is rather scarce.
I enclose a potted version of an article which appeared in the APCP
Journal in August 1996 (Association of Paediatric Chartered
Physiotherapists, up-to-date details of how to contact them available
through the Chartered Society of Physiotherapy, 14 Bedford Row, London
WC1R 4ED, sorry can't remember email address.)
The copy I have of this article has no references but contacting the
APCP should put you in touch with the experts.
Good luck!
Regards,
Carol David
Supt Physio
The baby needs to be seen as soon as feasible after birth. During the
first 2 weeks, sensory stimulation is vital - stroking, tapping, warm
and cold, different textures. Special attention should be given to the
areas of the triceps, scapula/humeral area, flexor surface of the
forearm and elbow joint, and the palmar surface of the hand, fingers and
thumb.
After 2 weeks passive movements can be started; take each joint through
its full range of movement, paying special attention to external
rotation, abduction and elevation of teh shoulder, supination of the
forearm, flexion of the elbow, extension of the wrist and abduction of
the thumb. When taking the scapula into flexion, ensure that the point
of the scapula is held firmly towards the spine to avoid shortening of
the tissues forming the rear wall of the axilla and internal rotators.
Continue sensory stimulation.
After 6 weeks prone lying can be encouraged, to aid weightbearing
through the shoulder girdle. *The baby must be awake and supervised if
lying prone.*
Recovery may continue over 2 years, may be step-wise with progress and
plateaux. Developmental milestones should not be ddelayed but should be
monitored. Specific activities may be used to encourage fixation of the
shoulder, eg crawling. Bilateral hand function should be encouraged.
Children with good recovery may be discharged at 1 year.
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