Brachial plexus birth injury (BPBI) is a condition that occurs when the nerves controlling the arm are injured during birth, leading to weakness, limited movement, and sensory problems. These motor difficulties may also affect cognitive processes related to movement. BPBI requires long-term follow-up and rehabilitation. This study will compare two treatment approaches in children with BPBI: * virtual reality (VR)-based exercises, and * motor-cognitive dual-task exercises. We will examine their effects on brain adaptation (cortical activation), muscle strength, joint motion, proprioception, and upper-limb function. Fourteen children aged 7-14 years will be randomly assigned to one of the two programs, each delivered for 12 weeks. Afterward, participants will continue a 9-month home program. Assessments will be conducted at baseline, after treatment, and at 12 months, including functional MRI (fMRI). This study will be the first to evaluate long-term brain changes and functional outcomes after these two rehabilitation approaches in children with BPBI.
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Change in Motor Cortex Activation (BOLD Signal) Measured by fMRI
Timeframe: From baseline (pre-treatment) to 12 weeks of intervention and 9-month follow-up after baseline.
Range of Motion (ROM)
Timeframe: From baseline (pre-treatment) to 12 weeks of intervention and 9 months follow-up after baseline.
Brachial Plexus Outcome Measure (BPOM)
Timeframe: From baseline (pre-treatment) to 12 weeks of intervention and 9 months follow-up after baseline.
Muscle Strength
Timeframe: From baseline (pre-treatment) to 12 weeks of intervention and 9 months follow-up after baseline.