Occupational Therapy for Brachial Plexus Injuries or Erb’s Palsy

A brachial plexus injury or Erb’s palsy is a type of birth injury that affects the nerves of the brachial plexus that run from a newborn’s neck to his or her arms. These types of injuries often occur during a prolonged labor or difficult birth and may involve medical negligence (carelessness). A number of children who are affected by these injuries may require occupational therapy that can help protect the infant’s arm and address any weakness or tightness that persists.

This type of therapy can also protect the newborn’s arm and shoulder during feedings, clothing changes and other daily activities. Parents can also learn how to perform gentle exercises on their child’s shoulder elbow and wrist. Treatment during the first year of life can be crucial. When Erb’s palsy (brachial plexus palsy) is severe, children may need more frequent treatment and therapy – the costs of which can add up very quickly

Brachial plexus palsy (Erb’s palsy) Symptoms and Diagnosis

During a difficult vaginal delivery, the nerves of the brachial plexus may be stretched or torn. These are the nerves that control movement and sensation in the shoulder, arm and hand. When these nerves are torn, the child can become disabled for the rest of his or her life. About two out of every 1,000 babies in the United States are born with brachial plexus injuries or Erb’s palsy. Some of the common symptoms here include:

Inability to move: One of the first signs of Erb’s palsy (brachial plexus palsy) is inability to move or weakness in the affected arm. While motor control is limited in newborns, infants are able to move their arms around to some extent soon after they are born. A clear sign of Erb’s palsy is when a child is able to move one arm but not the other. The lack of movement may be severe in some cases.

Poor reflexes: Newborns have certain reflexes and a diminishment or loss of these normal reflexes in one arm may be a symptom of brachial plexus palsy. One of the common ways to test for this is to check for the Moro reflex or startle reflex where the baby’s arms are gently lifted and then let go together. When this is done, the baby should appear startled, extending the arm outward and then to the front and sides. Less movement on one side is indicative of a brachial plexus injury.

Abnormal positioning of the arm: Children with Erb’s palsy often position their affected arm in an awkward manner.

Poor grip strength: When the nerves of the brachial plexus are damaged, babies can lose the ability to grip objects properly.

How Occupational Therapy Can Help

According to Kaiser Permanente’s website, occupational therapy can help your child in a few different ways. It helps improve motor skills and arm function including strength and range of motion. It helps your child perform activities of daily living as is age appropriate. And it can also help your child regain some degree of sensation in his or her affected arm. The effectiveness of occupational therapy may depend on the location and severity of the injury. Some children may need long-term occupational therapy or possibly surgery to correct a tear in the nerve. However, early intervention is crucial. Occupational therapy can begin even before the baby leaves the hospital after delivery.

There are several stages of occupational therapy for brachial plexus palsy or Erb’s palsy depending on the severity of the injury. The first stage occurs during the first two weeks after birth where parents and caregivers are taught to properly hold and position the newborn during dressing, feeding and diaper changes. It is important to support the affected arm and shoulder. After this initial stage, occupational therapy helps improve range of motion, sensation and arm strength and helps avoid muscle tightness.

In the next stage, the therapy will focus on improving the baby’s range of motion and muscle strength. As therapy progresses, it may also help babies achieve developmental milestones such as self-feeding, sitting, crawling, standing and walking. Between the age of 1 and 4, therapy might help children gain age-appropriate skills such as playing, holding objects and motor skills.

Contacting an Experienced Lawyer

If your child has suffered a birth injury such as a brachial plexus injury or Erb’s palsy, the experienced New York personal injury attorneys at the Law Offices of Kenneth A. Wilhelm can help you better understand your legal rights and options, and also fight hard to recover just compensation for you.

One of our clients secured a $2,850,000 verdict that was reduced by the appeals court to $1,846,000 because the verdict was so large. This was the highest amount upheld by the appellate courts for many, many years. In addition we recovered $1,400,000 for a newborn who lost motion in the arm during birth due to doctors applying incorrect force on the baby’s head. Also, one of our clients obtained a verdict for $43,940,000 and another of our clients got a verdict for $23,500,000, both in medical malpractice cases.

We have seen many cases where New York City Health and Hospital Corporation facilities deliver babies who are born with cerebral palsy or Brachial plexus palsy (Erb’s palsy) stemming from negligence (carelessness), and/or medical malpractice in the labor and delivery etc. of the children.

The following list identifies some of these hospitals (operated by New York City Health and Hospital Corporation):

• Jacobi Hospital aka Bronx Municipal 1400 Pelham Parkway South Bronx, New York 10461 718-918-5000
• Lincoln Hospital 234 East 149th Street Bronx, New York 10451 718-579-5000
• North Central Bronx Hospital 3424 Kossuth Avenue Bronx, New York 10467 718-519-5000
• Coney Island Hospital 2601 Ocean Parkway Brooklyn, New York 11235 718-616-3000
• Kings County Hospital 451 Clarkson Avenue Brooklyn, New York 11203 718-245-3131
• Woodhull Hospital 760 Broadway Brooklyn, New York 11206 718-963-8000
• Bellevue Hospital 462 First Avenue New York, New York 10016 212-562-5555
• Harlem Hospital 506 Lenox Avenue New York, New York 10037 212-939-1000
• Metropolitan Hospital 1901 First Avenue New York, New York 10029 212-423-6262
• Elmhurst Hospital 79-01 Broadway Elmhurst, New York 11373 718-334-4000
• Queens Hospital Center 82-68 164th Street Jamaica, New York 11432 718-883-3000

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