Occupational Therapy for Children with Arthrogryposis
ROBIN MERCER, O.T.R., MOTT O.T., F4454, AND VIRGINIA SIMSON NELSON, M.D.
Eleven children from birth to six years of age with arthrogryposis from a variety of conditions are currently being followed through the department of Physical Medicine and Rehabilitation. Ten of the eleven children have all extremities involved. Occupational therapy services are initiated as soon as possible with the primary goals being family education and increasing range of motion. This is achieved through passive range, splinting and/or casting depending on the severity of the contractures. Maintaining elbow and hand range of motion is essential for later independence. As the children progress, goals also encompass attainment of developmental milestones. The entire rehab team plays a role as the focus is on head/trunk control, balance, weight bearing and maximizing performance of activities of daily living. Surgery is an option when gains are no longer achieved through non-surgical techniques. Young children are adept at creatively overcoming their limitations. A videotape of a three year old with upper extremity involvement shows how she uses her legs as a prop for her arms, and controls her movements through lower extremity and trunk movements. Her self-released elbow extension contractures, through a fall and fracture, has further increased her independence. Occupational therapy intervention addressed maximal performance in all activities of daily living in this challenging population.
University of Michigan Medical Center, Ann Arbor, MI 48109-0224