Article

OBJECTIVE: To investigate the impact of a video-based educational resource on
home exercise compliance among caregivers of children with neonatal brachial
plexus palsy (NBPP). DESIGN: Retrospective analysis of self-reported caregiver
home exercise habits and resultant shoulder range of motion (ROM) and biceps
power in patients with NBPP. SETTING: Home-based exercise program. PARTICIPANTS:
Adult caregivers of children with NBPP followed up through the Brachial Plexus
Program at the University of Michigan (N = 83 surveyed initially, with N = 37
completing the final survey). METHODS: Caregivers completed surveys before and
approximately 3, 6, and 12 months (times A, B, and C, respectively) after
receiving the "Home Exercise Therapy Program for Brachial Plexus Palsy" digital
video disk (DVD). A retrospective analysis of shoulder ROM and biceps power of
patients was completed as representative of arm function during the study. MAIN
OUTCOME MEASUREMENTS: Surveys assessed home exercise compliance, resources used
to guide exercises, and caregiver confidence in the correctness of exercises
being performed. Functional outcomes analyzed include biceps strength and
shoulder active and passive ROM. RESULTS: Home exercise compliance increased from
74% initially to 96% at time A (P < .001), remained at 94% at time B (P < .001),
and fell to 84% at time C (P = .016). Use of the DVD to guide home exercise
decreased from 69% at time A to 57% at time B and C (P = .026). After receiving
the DVD, exercise frequency and caregiver confidence increased. Although some
measures of shoulder active ROM and biceps power improved during the course of
the study, there was no consistent statistically significant relationship between
increased caregiver confidence and functional outcomes. No causal relationship
exists between DVD content and functional status at this time. CONCLUSIONS: As
the first formal evaluation of a video-based resource guiding exercise therapy
for children with NBPP, we suggest that this population may be receptive to
alternative media and may benefit from dynamic modeling of home exercises.
CI - Copyright A(c) 2012 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS