Department of Physiotherapy, Federal University of Pernambuco, Recife, Brazil.
Integrated Rehabilitation and Aquatic Therapy Center, Rio de Janeiro, Brazil.
Physiother Res Int. 2021 Jan;26(1):e1873. doi: 10.1002/pri.1873. Epub 2020 Aug 13.
Traumatic upper plexus injury affects daily living activities performance and participation of individuals. Physical therapy treatment has a fundamental role on functional recovery, but it is still an unexplored and challenging field.
To develop a protocol to evaluate the efficacy of Proprioceptive Neuromuscular Facilitation (PNF) compared to conventional physiotherapy (CPT group) on functionality and quality of life.
A committee was formed by four physical therapists to develop the treatment protocol. A Delphi study was carried out in order to quantify the level of agreement. A protocol for a randomized controlled trial was proposed to evaluate the effectiveness of the protocol in improving functionality and quality of life, according Consolidated Standards of Reporting Trials. Participants will be randomly assigned (1:1) to PNF or CPT group and two weekly sessions will be carried out for 12 months postsurgery, with a three-month follow-up. The main outcome measurements are: upper limb functionality, quality of life, range of motion, muscle strength, tactile sensitivity, and pain, which will be assessed at baseline, on the 6th, 9th, and 12th months postsurgery.
A PNF protocol was developed for traumatic upper brachial plexus injury, consisting of 11 illustrated exercises, three for immediate postoperative and eight for postoperative. Biomechanical objectives, observations, positions of patients and therapists and PNF principles, procedures and techniques have been described. An 80% agreement on all items in the first round of the Delphi study was achieved.
A protocol based on the PNF-concept was developed with the aim of improving the functionality and quality of life of individuals undergoing nerve transfer after traumatic injury to the upper plexus. The detailed description of a physical therapy treatment protocol through an appropriate method will allow its use in clinical practice and in future studies with this population.
创伤性上丛神经损伤会影响个人的日常生活活动表现和参与。物理治疗在功能恢复方面起着至关重要的作用，但这仍然是一个尚未被充分探索和具有挑战性的领域。
制定一个方案，以评估本体感觉神经肌肉促进法（PNF）与常规物理治疗（CPT 组）相比在功能和生活质量方面的疗效。
由四位物理治疗师组成一个委员会来制定治疗方案。为了量化共识水平，进行了一项德尔菲研究。根据临床试验报告的统一标准，提出了一项随机对照试验方案，以评估该方案在改善功能和生活质量方面的有效性。参与者将被随机分配（1:1）到 PNF 或 CPT 组，术后两周进行一次，共进行 12 个月，术后三个月进行随访。主要的观察指标包括：上肢功能、生活质量、运动范围、肌肉力量、触觉灵敏度和疼痛，这些指标将在基线、术后第 6、9 和 12 个月进行评估。
为创伤性上臂丛神经损伤制定了 PNF 方案，包括 11 个插图练习，其中 3 个用于术后即刻，8 个用于术后。描述了生物力学目标、观察、患者和治疗师的体位以及 PNF 原则、程序和技术。在德尔菲研究的第一轮中，所有项目的共识率达到 80%。
为了提高因创伤性上丛神经损伤而接受神经转移的个体的功能和生活质量，制定了基于 PNF 概念的方案。通过适当的方法详细描述物理治疗方案，将使其能够在临床实践和未来针对该人群的研究中使用。
