Disclosures: Hyunwoo J. Choo, MD, MPH: No financial relationships or conflicts of interest
Case Description: A healthy 6 year old girl presented to the sports medicine clinic with sudden onset right arm pain and weakness. X-ray was negative and occupational therapy (OT) was started for a presumed musculoskeletal injury. As weakness continued, the OT referred her to the multidisciplinary brachial plexus clinic. History revealed that she had a preceding viral illness. MRI demonstrated increased signal in the superior trunk of the brachial plexus. Physical exam was consistent with a clinical diagnosis of BN. Functionally, she had limitations in all areas of self-care, school skills, and importantly, horseback riding. She continued strengthening and NMES during OT, and had adjunctive robotic and pool therapy treatments. She received six months of therapies, which included treatment with the Armeo, Pablo, Wii, and Bootle Bot in the PM&R Lab.
Setting: Academic Tertiary Pediatric Clinic and PM&R Lab
Patient: 6 year old right-handed female with subacute brachial neuritis (BN) Assessment/
Results: Initial OT Evaluation showed that the rotator cuff muscles and deltoid were less than antigravity, with functional strength distally. At 6 months of conventional OT, robotic therapy, and pool therapy, she recovered full strength and range of motion, and she successfully resumed horseback riding.
Discussion: This case highlights the need for a high index of suspicion with atypical patterns of musculoskeletal injury. Additionally, integration of robotics with functional therapy for recovering BN can improve outcomes. Maximizing therapies during recovery for BN is critical for return to function and participation for the child. Recovery time for BN is highly variable, this child had a rapid and full functional recovery at six months.
Conclusion: Functional therapies are key in the treatment of BN. This case demonstrates how robotics and pool therapy offered a multimodal approach that fully engaged the child through recovery. Robotics can be safe and effective in pediatrics and can increase novelty and precision of rehabilitation.
Level of Evidence: Level V
To cite this abstract in AMA style:
Choo HJ, Deike D, Stein K, Marriott L, Gaebler-Spira D. Integration of Conventional and Robotic Therapy for Pediatric Brachial Neuritis [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/integration-of-conventional-and-robotic-therapy-for-pediatric-brachial-neuritis/. Accessed May 8, 2025.« Back to AAPM&R Annual Assembly 2020
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/integration-of-conventional-and-robotic-therapy-for-pediatric-brachial-neuritis/