A holistic approach to the management of Erb's palsy
A 4.5-month-old female baby was brought to Physiotherapy Department of Sri Ganapati Sachchidananda Hospital by her parents with complaints of inability to move her right upper limb and abnormal position, progressive since birth.\nArm was internally rotated, adducted, elbow extended, forearm pronated and with a closed fist of right upper limb Passive range of motion was not full and free at shoulder patient was crying on flexion and abduction beyond 150° and 130° respectively Elbow, wrist, metacarpophalangeal joints and inter phalangeal joints of right upper limb were full and free passively. There was no grasp reflex All developmental milestones were normal, except for movements of right upper limb Muscular contractions of deltoid, biceps, triceps, supinator, flexor and extensors of wrist, metaca rpophalangeal and interphalangeal were elicited suggestive of C5, C6, and C7 nerve damage[] Muscle power was assessed for all the muscle groups of right upper limb and were of grade 0.[]\nAccording to patient's mother, doctors had suggested delivery by caesarean section due to the breech presentation; however, considering personal request and financial conditions of the parents, forceps assisted vaginal delivery was performed. Both mother and baby were healthy following the delivery. Later, the parents noticed that the baby was not using her right upper limb completely, with gradual progressive deformity. It was diagnosed as Erb's palsy by a pediatrician and suggested for physiotherapy as an early measure of treatment, before electing surgical options.\nElectrical stimulation was administered by placing active electrode on skin at the nerve root, i.e. base of the neck. Pen electrode was placed on motor point and muscle mass in faradic and galvanic currents respectively.[] Patient was treated for 28 days of physiotherapy treatment, in three divided sessions [Tables and ].\nQuantity sufficient of indirectly heated ABL Taila was applied in Anuloma Gati (downward) for 15 min 25 g of Bala Mula (roots of Sida cordifolia Linn.) was processed with 500 ml of Ksheera (milk) where in milk was boiled to reduce the quantity to half and filtered. 25 g of Shastikashali was cooked very soft and made like paste with above filtrate of Ksheera Yukta Bala Mula. This paste was applied with gentle circular movements for 20 min in Anuloma Gati. Patient was treated with a total of 35 days of Ayurvedic treatment, in three divided sessions [Tables and ].