Meet 8-year-old Paris – an aspiring Pro Football Player. He lives at home with his proud parents and 3 brothers. Paris is a healthy, social, and resourceful boy who is full of character. There’s no stopping Paris! Most people see an agile child moving freely around his home, yard and school, riding his bicycle and swinging a whiffle bat. But, as Paris pauses for a moment to take a breath, an attentive eye will notice that he elevates his left shoulder and postures his left arm (bent at the elbow) as though he were about to toss a ball backwards – at waist level – with that hand. During his birth, his left arm experienced traumatic stretching over his head, which resulted in nerve damage referred to as a brachial plexus injury. The result is decreased sensation in the left arm and interruption of the brain’s communication with the muscles in the left arm and hand. Over the years, Paris has learned a number of functionally successful techniques for compensating for his weak, or unresponsive, muscles in the left upper extremity. While wonderfully adaptive, some of these strategies have led to the strengthening of some muscles and under-use of others. In addition, the posturing of the arm allows some muscles to remain in an over-lengthened state while other muscles shorten in this position.
Paris has been receiving weekly occupational therapy visits after school for the past 7 months. He was referred following a surgical procedure at Seattle Children’s Hospital that transferred stronger tendons in his left forearm to assist weaker tendons in order to increase functional reach and grasp. Therapy focuses on increasing sensory awareness and functional use of the left arm/hand, remediating the impact of the affected arm on Paris’ posture and movement, strengthening, and optimizing the surgical outcome of the tendon transfers.
When possible, Paris’s OT visits are designed to resemble a football player’s session with a trainer. There is attention to posture and symmetry, work in front of a mirror, and kinesiotaping to decrease the load on weaker muscles and increase efficiency of movement. Most recently, electrical stimulation has been introduced in order to strengthen muscles that have been weakening over the years without Paris’s awareness. Long Term goal: Pro Football ‘Walk-On’ … after a childhood stint as Bionic Boy.
