Post nerve transfer neuroplastic motor retraining program in adults with traumatic brachial plexus injury: A physiotherapist’s perspective

Physical therapeutic treatment for traumatic brachial plexus injury in adults: A scoping review

“…Only 5 23,25,27,29,45 of the 18 studies involving patients who underwent surgical treatment described their preoperative physical therapy interventions. In addition, five review articles 8,49‐52 also described the physical therapy modalities used most commonly during the preoperative phase for individuals with BPI. The main physical therapy modalities adopted for the pre‐ and postoperative rehabilitation phase in surgical cases and their respective goals are described in Table 4.…”

“…In addition to the therapeutic interventions mentioned before (Table 4), other physical therapy modalities were less frequently used postoperatively such as TENS, 31 the Cordata method, 38 the PNF concept, 40 laser therapy 22,48 and mirror therapy 16,51 . A literature review 53 addressed Traditional Chinese Medicine (TCM) interventions, such as acupuncture, fumigation therapy, moxibustion, and massage therapy, as postoperative rehabilitative strategies to treat pain after BPI surgery.…”

“…For muscle strengthening, some authors described progressive exercises initially with gravity elimination and application of manual resistance, progressing to anti‐gravity and mechanical resistance exercises, according to the patient's tolerance 16,29,30,40,41,45,47,49,51,52,55 . Other studies emphasized anti‐gravity postures for patients with MRC < 3 8,59 …”

“…Two studies mentioned the use of a home‐based rehabilitation with the use of electrical stimulation systems 21,41 . The type of current used included functional electrical stimulation (FES) current, 43 galvanic current, 29 and interrupted galvanic current with long duration progressing to faradic current with short‐term duration 51 (Table 2).…”

“…In addition, this technique was also used as part of the conservative treatment of a patient with incomplete upper trunk injury 37 (Table 2). Some reviews discussed biofeedback use in combination with donor nerve activation, 49,52 and biofeedback use to obtain greater control of the recipient contraction and dissociation of movement 51 . They also mention the importance of short sessions to avoid fatigue and the number of channels needed to activate agonist and antagonist muscles, 59 as well as portable biofeedback options for patients who undergo home‐based biofeedback training 8 (Table 3).…”