Abstract
Background
This report is based on a case of ‘shaken baby syndrome,’ and clinical manifestations of this injury often include hypertonicity, spasticity and joint contracture. Shaken baby syndrome affects over 1 million children and resembles symptoms of traumatic brain injury.
Methods
The patient was a five-year-old boy who had suffered a traumatic brain injury with right spastic hemiplegia. Over the course of treatment, multiple modalities were used to manage his tone, spasticity and to reduce wrist and elbow contractures, which included Botox® (Allergan Co., Irvine, CA, USA), manual therapy and dynamic splinting as home therapy. The main outcome measured was change in maximal range of motion(s) (ROMs) in the elbow and wrist.
Results
After dynamic splinting was initiated, the child's passive ROM increased by 65° in wrist extension and 45° in elbow extension. Ulnar deviation progressed by 15–30°.
Conclusion
Dynamic splinting contributed over 900 hours of end-range, home therapy for wrist extension and 700 hours in end-range home therapy for elbow extension. It is hypothesized that this prolonged duration of passive stretching at the end-range is responsible for the substantial gains in ROM.
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