ABSTRACT
Background: The loss of mobility and functional activities of the upper limbs are the main longstanding complications of obstetric brachial plexus injury. OBPI is one of the challenges associated with maternal delivery, with varying prevalence across countries.
Objective: To identify the existing non-pharmacological interventions for children with obstetric brachial plexus injury
Methods: Pubmed, Cochrane Library, Google scholar and PEDro databases were searched for eligible studies, hand search was also done. Included in this review were randomized controlled trials (RCTs), quasi experimental and case-control studies that used non-pharmacological interventions for obstetric brachial plexus injury. Only papers written and published in English Language were used. In this review, we employed qualitative and quantitative syntheses. Data were selected and extracted according to predesigned eligibility criteria using a standardized data extraction table. Where appropriate, the PeDro risk of bias assessment tool was used to assess the study quality.
Result: 13 articles met the inclusion criteria for this review, 12 out of the 13 were used for meta-analysis. The non-pharmacological interventions were constraint induced movement therapy, virtual reality, neuromuscular electrical stimulation, kinesiotaping, exercises, leap motion controller, augumented biofeedback, and bimanual intensive therapy. The outcomes assessed include active range of motion, muscle strength, functional potential; though hand function with and muscle strength (61.6%) and AROM (30.8%) were the most assessed outcome. Most of the included studies had moderate quality (61.5%), with sample sizes that were less than 35 (53.8%). Most of the studies (61.56%) therefore provided a level III evidence. A significant change was observed in all the outcomes in favor of non-pharmacological interventions (p<0.05)
Conclusion: From the review, all the NPIs showed beneficial effects on upper limb functionality in children with OBPI, the pooled analysis of the combined effects of these interventions were significantly in favor of NPIs with constraint induced movement therapy being the most utilized and effective intervention. From the results of the meta-analysis, we can draw a conclusion that these interventions are beneficial. Thus, clinicians can seek guidance from evidence regarding the effect of these interventions.
Keywords: Non-pharmacological, children, brachial plexus injury
