Congenital Limb Abnormalities

1. What causes Congenital Limb Abnormalities and how to prevent? Congenital limb abnormalities are a result of incomplete or abnormal formation of the limbs as the baby grows inside the mother’s uterus. Hence, either a portion or the complete upper limb (arms) or lower limb (legs) fails to form in the growing foetus during pregnancy. Subsequently, the infant is born with the defect at birth itself. These abnormalities may manifest in various forms including-  Total absence of limb  Abnormal linkages as part of limbs do not separate like joint fingers or toes  Duplication of parts as extra toes or fingers  Overgrowth where the limb assumes a larger size than normal  Undergrowth where the limb size is smaller than usual Congenital abnormalities impact the normal life of children and affect their daily living. It also curtails normal development, especially in motor activities. This may, in turn, cause limitations in movements, physical activities and sports. Additionally, it triggers emotional problems and societal acceptance issues due to physical deformities and abnormalities. Causes of Congenital Limb Abnormalities  Conditions that deter the normal development of the baby in the uterus like genetic abnormalities, restrictions for proper growth and mechanical forces  Exposure of the mother to dangerous viruses and pollutants like chemicals during the pregnancy phase  Side-effects of certain medications  Smoking during pregnancy or exposure to secondary smoking(passive smoking) Treatment Approaches While there is no standard treatment available for congenital defects, the following approaches and choices may be recommended-  Prosthetics or use of artificial limbs  Orthotics or usage of assistive and supportive devices like splints and braces  Surgical intervention  Rehabilitation

2. Let us focus on the types of rehabilitation available as entailed below. Rehabilitation Approach The rehabilitation process is primarily targeted at overcoming the congenital defects to maximize the abilities of young infants and children. This children’s rehabilitation would enable better participation in various activities at their homes, schools and also at the community at large. It is also called Paediatric Rehabilitation. Some types of rehabilitation include  Down’s syndrome rehabilitation-A variety of therapies may be used for children with Down’s syndrome. It involves a multi-disciplinary approach and may include  Physical therapy to overcome low-muscle tone, increase mobility and also overcome physical challenges.  Speech-Language therapy to initiate speech, understand language, improve comprehension and conversation skills or use sign language as an alternate means of communication  Occupational therapy for making adjustments to match the child’s wants and abilities to do daily living activities as independently as possible.  Behavioural therapies to minimize negative and compulsive behaviours, enhance coping and interpersonal skills, deal with aggression and intense emotions.  Upper limb rehabilitation -The goal of this rehabilitation is to strengthen the muscles and joints of the arms and hands to the maximum extent possible so that it is capable of performing skilled movements needed for everyday activities. Physiotherapy plays a vital role here to restore functionality. It adopts a ‘hands-on’ approach and is tailored around the child’s individual needs. Electric stimulation, constraint-induced movement therapy and robotic guided systems may also be used in the rehabilitation process for maximizing clinical outcomes.   Lower limb rehabilitation-This rehabilitation primarily focuses on balancing and co-ordination skills to improve the child’s ability to stand and walk independently and even climb stairs. Physical therapy is administered after doing adequate movement analysis and assessment to identify the problems in the foot, legs and pelvis. Gait training may also be given. This rehabilitation also supports children in using splints, orthotics and latest biofeedback devices to aid movement. Prevention of Congenital Limb Abnormalities Prevention is largely done by proper genetic counselling, which involves recurrence risk estimation and proper prenatal screening, diagnosis and treatment. There are other preventative measures that mothers can proactively take before and during pregnancy. That includes increasing intake of folic acid, decreasing sugar consumption, avoiding exposure to smoke, alcohol, certain medications with side-effects and other harmful and toxic environmental pollutants

3. There are many renowned paediatric physiotherapists in Chennai who deal with congenital limb abnormalities to improve the quality of children’s life. For more information, please contact us.