The brachial plexus is a network of nerves. These nerves conduct signals from the spine to the arm and hand. These signals cause the arm and hand muscles to move. A brachial plexus injury occurs when these nerves are injured.

Injury can happen at any time but most injuries occur during birth. Many babies with brachial plexus injures are larger than average at birth but newborns of any size can have these injuries.

Symptoms depend on which nerves are affected and how severely they are affected. Some babies have little or no movement in the affected arm at birth. Some children can move their arm but not their hand and some children can move their hand but not their shoulder or elbow.

The primary goal of occupational therapy is to maintain range of motion in the affected arm and to increase strength and function of that arm. In addition, the occupational therapist will provide the family with home exercises and activities to encourage appropriate developmental skills.

The therapist will provide splinting or constraint therapy if indicated for the child. The pediatric occupational therapists at Duke are highly skilled in treating children with this condition and will work with your child’s physician to optimize movement in the affected arm.

Your child will be referred to a physical therapist if they have difficulties with neck movement (torticollis) or delays in gross motor skills.

A pediatric occupational therapist is assigned to Duke’s Brachial Plexus Clinic and works closely with the physicians in that clinic to determine the best course of treatment for the child.

Physical Therapy Treatment

• Facilitation of gross motor skills
• Therapeutic exercises to improve strength and symmetry

Occupational Therapy Treatment