Effects of Electrical Stimulation Combined with Functional Activity in Children with Erb’s Palsy: A Quasi-Experimental Study

Abstract

Background: Erb’s palsy, a common brachial plexus birth injury, leads to weakness or paralysis of the upper limb, particularly limiting shoulder movements. Electrical stimulation promotes muscle activation, while functional activities enhance motor learning and strength. Objective: To determine the effects of electrical stimulation combined with functional activity in children with Erb’s palsy. Methodology: This quasi-experimental study was approved in December 2021 by the Research and Ethics Committee of Riphah International University (Ref No. REC/RCR & AHS/21/0701). The study was conducted at the physiotherapy outpatient department at a public and a private hospital in Lahore city. A sample of 18 children was collected using convenient non-probability sampling, aged 1 to 3 years with a diagnosis of Erb’s palsy and no history of surgery; children with hemiplegic cerebral palsy or with upper limb deformity or fracture were excluded. Informed consent was taken from the parents, and they were educated about the procedure. The intervention applied was electrical stimulation for 5 days per week for 2 weeks, then on alternate days. Electrical stimulation was set at a frequency of 20 Hz with a pulse width of 300 msec for 30 minutes. Pre-intervention data for shoulder range of motion were measured using a goniometer and functional activities were measured on a modified mallet scale. Using the Shapiro-Wilk test, the data were found to be normally distributed. The repeated measure ANOVA was used for within-group analysis with p≤0.05 as significant. Results: The mean age of children was 2.72±1.07 years. Among 18 participants, there were 13 males and 5 females, of whom 12 (66.67%) had right-sided and 6 (33.33%) had left-sided Erb’s palsy. Mallet Score increased over time from 10.22±0.42 to 18.22±0.68, which differed significantly across three time points (p=0.00). Shoulder abduction improved from 31.67°±2.43 to 101.11°±3.23 (p=0.00), flexion 91.38°±2.304 to 130.83°±1.91 (p=0.00) and lateral rotation from 5.16°±0.38 to 15.00°±0.00 (p=0.00). Conclusion: The study concluded that electrical stimulation combined with functional activities has a significant and positive effect in the rehabilitation of patients with Erb’s palsy.