Department of Neurological, Neuropsychological, Morphological and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Centre, University of Verona, Verona, Italy.
Eur J Phys Rehabil Med. 2012 Sep;48(3):483-506.
Management of brachial plexus injury sequelae is a challenging issue in neurorehabilitation. In the last decades great strides have been made in the areas of early diagnosis and surgical techniques. Conversely, rehabilitation of brachial plexus injury is a relatively unexplored field. Some critical aspects regarding brachial plexus injury rehabilitation have to be acknowledged. First, brachial plexus injury may result in severe and chronic impairments in both adults and children, thus requiring an early and long-lasting treatment. Second, nerve damage causes a multifaceted clinical picture consisting of sensorimotor disturbances (pain, muscle atrophy, muscle weakness, secondary deformities) as well as reorganization of the Central Nervous System that may be associated with upper limb underuse, even in case of peripheral injured nerves repair. Finally, psychological problems and a lack of cooperation by the patient may limit rehabilitation effects and increase disability. In the present paper the literature concerning brachial plexus injury deficits and rehabilitation in both adults and children was reviewed and discussed. Although further research in this field is recommended, current evidence supports the potential role of rehabilitation in reducing both early and long-lasting disability. Furthermore, the complexity of the functional impairment necessitates an interdisciplinary approach incorporating various health professionals in order to optimizing outcomes.
臂丛神经损伤后遗症的管理是神经康复中的一个难题。在过去的几十年中，在早期诊断和手术技术领域取得了重大进展。相反，臂丛神经损伤的康复是一个相对未被探索的领域。臂丛神经损伤康复有一些关键方面需要注意。首先，臂丛神经损伤可导致成人和儿童严重和慢性的损伤，因此需要早期和长期的治疗。其次，神经损伤导致多方面的临床表现，包括感觉运动障碍（疼痛、肌肉萎缩、肌肉无力、继发性畸形）以及中枢神经系统的重组，这可能与上肢失用有关，即使在外周损伤神经修复的情况下也是如此。最后，心理问题和患者的配合不足可能会限制康复效果并增加残疾。本文综述和讨论了成人和儿童臂丛神经损伤缺陷和康复的文献。尽管建议在这一领域进行进一步的研究，但现有证据支持康复在减少早期和长期残疾方面的潜在作用。此外，功能障碍的复杂性需要多学科的方法，包括各种卫生专业人员，以优化结果。
