United Brachial Plexus Network, Inc.

We've started taking our son to see a new therapist and she has recommended using an e-stim machine on his arm. He had primary surgery at 11 wks old and is now 23 months. He has feeling down to his fingers now but is still not using or able to really move his fingers. He cannot lift his arm at all but does bend it after doing botox to the triceps last Dec. Would e-stim be beneficial to getting more movement?

Any suggestions, pros or cons, would be helpful.

Thanks!
Carly

Hi Carly,
Our daughter has a total ROBPI, had surgery/nerve grafts at 4.5 months and just had botox to her shoulder and tricep on Monday. She is now 15 months old.
Her therapist has been doing e-stim on her hand and bicep for the last couple of months and it seems to be helping. The therapist put the e-stim on both my husband and me first so we could feel it. For her, she puts it at the lowest setting which is mostly sensory. She is still under a year out from the surgery, so I think the progress has something to do with that as well, but the e-stim seems to make a difference and possibly increase the speed of progress. They say sensation is the first thing to return for the nerves, so vibration, electricity, brushing and other tactile things have been a big part of her therapy.
I don't know if the above helps you, but I will say I was very skeptical at first and I am much more sold now.

I should also say that her finger function is starting to be much more active and her bicep has gotten a lot stronger and more active since doing the e-stim. For the hand it's hard to tell how much is e-stim and how much is natural healing since hand is last to come usually, but I think it could be doing something.
For the bicep, the therapist usually does the e-stim during hi-chair or eating time, so we will put food in her right hand and help her bend it up to her mouth while buzzing at the same time to alert the bicep - this is when you should be working. Hope that helps!

We have been using e-stim (Empi-300PV TENS machine) with my son (ROPBI) for about 6 months. He had primary nerve transfer at 3 months (Oct. 2011) and another surgery (Sept 2012) to clean up scar tissue that was interfering with the bicep transfer. We can get great extension of the wrist and fingers with our unit. I have found that his hand function has improved. He still just uses it as a "helper" hand on his own but if we direct him to try and use it as primary he will. His grasp is weak but getting stronger so most tasks we have him do with "righty" are with light and easy to grasp objects. He has no bicep function at all and, while we still use the unit to try and stimulate this muscle, we are getting no contracture. So our experience using e-stim has been a little good and a little disappointing. But in my opinion its is definitely worth a try. Just make sure your therapist has been trained to use the unit and had used it on kids before. He/she should put the unit on you first to let you feel what your child will be feeling. Hope this helps!