Abstract
This poster presents findings from a survey of caregivers of infants with brachial plexus birth injury regarding facilitators of and barriers to adherence to home therapy recommendations; best practices for making home recommendations are identified.
Primary Author and Speaker: Jennifer Wingrat
Additional Authors and Speakers: Shayna Gertz, Amy Mae Miller
Brachial plexus birth injury (BPBI) often results in lifelong functional impairments due to upper extremity (UE) weakness or paralysis and joint contractures, particularly at the shoulder. Occupational therapy practitioners (OTPs) often recommend that caregivers of infants with BPBI perform passive range of motion (PROM) as frequently as every diaper change each day in order to decrease the risk of shoulder contracture and improve functional UE use needed for participation in occupations. The purpose of this study was to identify facilitators and barriers to caregivers’ adherence to performing PROM. Single-stage convenience sampling was used to recruit participants from two Facebook-based BPBI support groups. Caregivers of infants 18 months or younger were invited to complete a mixed-methods survey including both open- and closed-ended questions, adapted from a questionnaire used in a pilot study by Wingrat and Elrick (2023). Seventy surveys that met the inclusion criteria were completed. Open ended responses were analyzed using thematic coding while correlation and regression analyses were used to identify relationships or differences between variables including type of PROM training, caregiver confidence, and frequency with which PROM was performed. Facilitators to PROM included building it into the daily routine and using reminders. Doing PROM while their infant was sleeping or eating was easier than during diaper changes. Barriers included lack of caregiver education, poor rapport between caregiver and healthcare professional, lack of time, and complicated instructions. Verbal training significantly facilitated adherence. Overall the results can be used to inform recommendations that facilitate adherence and maximize outcomes for caregivers and children with BPBI. OTPs should consider the impact of home recommendations on caregivers, families, and their unique context. Caregivers may benefit from repeated education and daily reminders.
Wingrat, J., & Elrick, M. J. (2023). Frequency, facilitators, and barriers for range of motion to prevent shoulder contracture in brachial plexus birth injury: A pilot study. Journal of Pediatric Rehabilitation Medicine, 10.3233/PRM-220090. Advance online publication. https://doi.org/10.3233/PRM-220090
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