[Paralysis plexus brachialis--diagnostic and therapeutic protocol]. / Paralysis plexus brachialis--dijagnosticki i terapijski protokol.

Traction injuries of the brachial plexus, if obstetrical, are diagnosed immediately upon birth based on clinical features, while the type and the degree of injury are confirmed by neurophysiological examination. In such cases, physical therapy is promptly applied and followed up until the age of three months, when, after consultation with neurosurgeon, either physical therapy is continued or surgery is performed. In traumatic injuries, based on clinical, neurological and neurophysiological findings, necessary surgical or pre- and postoperative physiatric interventions are performed. Timely diagnostics and therapy of brachial plexus injuries, followed by recovery of paralytic muscle motor function, enable motion coordination and prevention of contractures. From 2000-2004, 181 cases of brachial plexus birth trauma and 26 cases of brachial plexus traumatic lesions were diagnosed and treated in our institution. Among patients, there were 107 boys and 74 girls with birth injury of the brachial plexus, and 16 boys and 8 girls with traction injury of the brachial plexus sustained in traffic accident. Physical treatment involved combined thermo-, electro-, and kinesitherapy, with alignment of extremities. Upon completion of any treatment session and clinical and neurophysiological examinations, doctors' consultation determined whether to continue with physical therapy or to perform surgery followed by physical therapy with rehabilitation until achieving the maximal motor recovery. The analysis of results showed that functional and motor recovery was best if therapy was initiated immediately after the obstetrical injury or following the surgery. Therapeutic approach was individualized and depended on the level and degree of lesions. Thus, maximal motor and functional recovery of the injured extremity was achieved, with work therapy and professional orientation of such patients.

[Rehabilitation in children with neuromuscular disorders]. / Aktuelnosti i rehabilitaciji dece sa neuromisicnim oboljenjima.

Physical treatment plays very important role in treatment of children with neuromuscular disorders. It is usually symptomatic and preventive, not being usual, except in children with cerebral palsy. Physical treatment of children with neuromuscular disorders is specific because good clinical knowledge as well as additional education for application of procedures is required during treatment with final evaluation of the achieved results. In fact, whole scientific philosophy is needed since natural development of child with neuromuscular disorders is in close correlation with the degree of retardation that may vary from one disease to another in relation to child's age as well as to clinical presentation of the disease. Upon neurological diagnose and medicamentous treatment, different physical procedures are applied in order to achieve the best possible results in motor development and in psychic and social reeducation as well.