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Obstetric Brachial Plexus Injury (OBPI): Is Functional Electrical Stimulation (FES) a Viable Intervention Option?

Gad Alon

An estimated 35,000 new-borns will acquire obstetric brachial plexus injury (OBPI) each year in the USA. Despite major advancements in early neurosurgical procedures resulting in peripheral re-innervation, the recovery process typically takes several years. The inability to activate the upper extremity (UE) muscles during this period results in severe atrophy, joints contracture, diminished peripheral blood flow, limbs length discrepancy, all contributing to impaired development of UE use during uni-and bilateral daily functions. Functional electrical stimulation (FES) augmentation of recovery after damage to the brain is document extensively in peer-reviewed rehabilitation literature. In contrast, FES is seldom considered a treatment option in OBPI. The primary reason is that in the absence of peripheral innervation, the efficacy of FES has been traditionally questioned. However, knowing that the majority of toddlers who underwent neurosurgical procedures will recover varying degrees of innervation, raise the question can FES help recover muscle strength of the re-innervated yet very weak muscles? This short communication focus on determining who is a candidate for FES training and how to utilize FES to enhance the recovery and functional use of the paretic UE of children with OBPI