All babies born with an obstetric brachial plexus injury (OBPI) should be referred to Physiotherapy on discharge from the maternity hospital.

(OBPI is also known as obstetric brachial plexus palsy (OBPP) or Erb's palsy)

Patients living in the Glasgow area will be seen in the Therapies Department at the Royal Hospital for Children in Glasgow.

Patients living outside the Glasgow area will be seen by their local Paediatric Physiotherapy Service.

The children's specialist physiotherapist's input to clinic:-

• Attending the OBPI (Erb's Palsy) clinic held at the Royal Hospital for Children in Glasgow.
• Assessing and offering Physiotherapy advice as required.
• Arranging follow-up Physiotherapy appointments for patients within the Glasgow area.
• Arranging referral to local Paediatric Physiotherapists as appropriate.
• Liaising with local Physiotherapists regarding relevant information about patients who have attended the clinic.
• Accessing Physiotherapy reports for patients prior to their clinic appointment.

Physiotherapy input in the initial period:-

• Correcting positioning of the affected arm and sensory stimulation from birth.
• Passive elbow, forearm, wrist and finger movements from birth.
• Passive shoulder movements from 48 hours after birth.

• To prevent joint contractures and muscle tightness.
• To ensure normal sensory input.
• To emphasise maintenance of passive shoulder external rotation to prevent posterior shoulder subluxation or dislocation.
• To note timing of biceps recovery (recovery by 3 months is a good prognostic indicator).
• To facilitate normal development.