General Topics

Current therapy treatments successfully address the needs of the infant and school aged child with brachial plexus birth injury. Once they have met their developmental milestones, age appropriate self care skills, school readiness skills and independence in home exercise programs, they are often reduced to a consultation basis or discharged from our programs. 

This session will increase awareness and identify long-term complications in teenagers and young adults with brachial plexus birth injury.

In addition to the obvious physical appearances of arm/hand size and length differences, the posturing caused by muscle imbalances of shoulder internal rotation/adduction, elbow flexion, forearm and possibly hand contractures, the less obvious anatomical changes of glenohumeral joint dysplasia and elbow incongruity will be explored. The areas of pain, emotional, mental, social, academic and work domains will be addressed. 

Discussion of possible barriers to bridging the gap may include the time constraints of the changing healthcare climate for more productivity and billable hours, high caseloads, shortage of staff, lack of functional goals, and limited skill sets for manual therapy and modalities. Families may have limited resources for transportation and insurance coverage to continue care.

We will identify possible strategies to bridge the gap through early ongoing education to increase patient and caregiver awareness of potential long- term complications, use of a multidisciplinary team, incorporating an education day, mental health group, and a transitional aging-out process. 

Participants will have an opportunity to share their ideas and experiences on how to bridge the gap to meet the needs of teenagers and young adults with Brachial Plexus Birth Palsy.

What happens when a pediatric patient with a congenital hand difference turns 18? Who is the best provider for a 30-year-old with a history of cerebral palsy affecting upper extremity function? What is considered best practice for a young adult with a complex medical history including JIA or EDS? This presentation will focus on bridging the gap between pediatric and adult upper extremity care. We will cover various conditions that typically start at birth or in childhood but continue to impact patients’ lives and require follow up as the patients age. Case studies will be used to illustrate examples of how the pediatric hand surgeon and hand therapist work together with the patient and their families to help make sure their needs are met. This may involve surgical procedures, orthosis fabrication, ADL training, school and jobsite accommodation, and referral to adult upper extremity providers with the knowledge and skill set necessary to serve these individuals.

This session reports on a survey of caregivers of infants with brachial plexus birth injury (BPBI) regarding their experiences, perceptions, and preferences for the education and training they received for performing home-based therapy recommendations. The session will provide a brief background about BPBI and the importance of home-based therapy programs for this population, describe the methods for surveying the sample of caregivers, and present the results and a discussion of the implications of the findings. In addition to a PowerPoint presentation, Kahoot (or similar platform) will be used to survey attendees about the home-based therapy recommendations they make and the methods/strategies they use to teach and support caregivers in carrying-out the recommendations.