频率、促进因素和运动范围障碍，以预防臂丛神经出生损伤所致的肩部挛缩：一项初步研究。
Frequency, facilitators, and barriers for range of motion to prevent shoulder contracture in brachial plexus birth injury: A pilot study.
机构信息
Department of Occupational Therapy and Occupational Science, Towson University, Towson, MD, USA.
Department of Occupational Therapy, Kennedy Krieger Institute, Baltimore, MD, USA.
出版信息
J Pediatr Rehabil Med. 2023;16(2):331-336. doi: 10.3233/PRM-220090.
PURPOSE
This pilot study investigated the efficacy of passive range of motion (PROM) during the first year of life to prevent development of shoulder contractures in children with brachial plexus birth injury (BPBI) and identified facilitators and barriers to caregiver adherence with daily PROM.
METHODS
Five caregivers of children with upper trunk BPBI participated in retrospective interviews about the frequency with which they performed PROM during their child's first year of life including facilitators and barriers to daily adherence. Medical records were reviewed for documentation of caregiver-reported adherence and documented evidence of shoulder contracture by age one.
RESULTS
Three of the five children had documented shoulder contractures; all three had delayed initiation or inconsistent PROM in the first year of life. Two without shoulder contractures received consistent PROM throughout the first year of life. Making PROM part of the daily routine was a facilitator to adherence while family contextual factors were barriers.
CONCLUSION
Absence of shoulder contracture may be related to consistent PROM throughout the first year of life; decreased frequency of PROM after the first month of life did not increase the risk of shoulder contracture. Consideration of family routines and context may facilitate adherence with PROM.
目的
本初步研究旨在探讨在生命的第一年中被动关节活动度（PROM）对预防臂丛神经损伤（BPBI）患儿发生肩部挛缩的疗效，并确定影响患儿家长日常 PROM 依从性的促进因素和障碍因素。
方法
5 名上肢 BPBI 患儿的家长参与了回顾性访谈，内容涉及他们在孩子生命的第一年中进行 PROM 的频率，包括日常依从性的促进因素和障碍因素。回顾了病历，以记录患儿家长报告的依从性和一岁时记录的肩部挛缩的证据。
结果
5 名患儿中有 3 名有记录的肩部挛缩；这 3 名患儿在生命的第一年中均有 PROM 开始延迟或不规律。2 名无肩部挛缩的患儿在生命的第一年中接受了持续的 PROM。将 PROM 纳入日常活动是依从性的促进因素，而家庭背景因素则是障碍因素。
结论
无肩部挛缩可能与生命的第一年中持续进行 PROM 有关；在生命的第一个月后 PROM 频率降低不会增加肩部挛缩的风险。考虑家庭常规和背景可能有助于 PROM 的依从性。
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