Brachial Plexus Birth Injury: The First Year
Presented by Tymar Fields
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The first year of life for infants with a brachial plexus birth injury (BPBI) is a critical time for nonsurgical and surgical interventions. Brachial plexus birth injuries are relatively uncommon, and most pediatric clinicians will infrequently provide care for this population. Many pediatric clinicians need additional resources to provide optimal interventions for this unique population. After completing this course, clinicians will be confident in evaluation, therapeutic interventions, and home programming for infants with a BPBI. Clinicians will understand critical timelines for therapy and surgical interventions to optimize development and upper extremity function. This is an introductory-level course for occupational and physical therapists and early intervention providers.
Meet your instructor
Tymar Fields
Tymar is a pediatric occupational therapist and certified hand therapist. Professionally, she is inspired by new ideas and creative problem-solving and has a passion for learning. She began her occupational therapy career in 2008 at a nonprofit level 1 trauma hospital. In this role, she worked with children and adults in the…
Chapters & learning objectives
1. Brachial Plexus Birth Injury
Chapter 1 introduces anatomy of the brachial plexus, peripheral nerves, and shoulder muscles. It includes descriptions of typical clinical presentations and associated critical timelines that require a referral to a BPBI specialty clinic and/or provider. Lastly, this chapter describes differential diagnoses to monitor for and indications for referral to specialty clinic.
2. Evaluating an Infant With a Brachial Plexus Birth Injury
Chapter 2 describes a comprehensive evaluation of an infant with a BPBI, including specific instruction on therapeutic use of self, handling of an infant, and the importance of caregiver and baby emotional health. This chapter includes a review of a typical clinical presentation and the impact of the BPBI on the development of the glenohumeral joint. Lastly, the chapter includes instruction on obtaining pertinent history, occupational and developmental assessment, range of motion, and use of the Active Movement Scale and goal attainment scaling.
3. Interventions for Infants With a Brachial Plexus Birth Injury
Chapter 3 is an instructional review of interventions to facilitate infant development and functional arm use. Interventions include range of motion, positioning for play and strengthening, facilitation techniques, and bimanual skills. Special attention is given to therapeutic use of self, specialized care of the infant, parent coaching, and home program design.
4. Surgery, Orthoses, and Care of the Family
Chapter 4 reviews the most common surgical interventions for infants with a BPBI, including postoperative care after nerve grafting, nerve transfer, and Botox injections. A comprehensive review of common orthoses used during the first year, including indications for use and basic design principles, is given. The chapter concludes with special considerations and care for the family.
