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臂丛神经损伤康复方案综述

Review of rehabilitation protocols for brachial plexus injury.

作者信息

Li Haijun, Chen Jinxiu, Wang Juehan, Zhang Tianfang, Chen Zuobing

机构信息

Department of Rehabilitation Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

出版信息

Front Neurol. 2023 Apr 17;14:1084223. doi: 10.3389/fneur.2023.1084223. eCollection 2023.

Abstract

Brachial plexus injury (BPI) is one of the most serious peripheral nerve injuries, resulting in severe and persistent impairments of the upper limb and disability in adults and children alike. With the relatively mature early diagnosis and surgical technique of brachial plexus injury, the demand for rehabilitation treatment after brachial plexus injury is gradually increasing. Rehabilitation intervention can be beneficial to some extent during all stages of recovery, including the spontaneous recovery period, the postoperative period, and the sequelae period. However, due to the complex composition of the brachial plexus, location of injury, and the different causes, the treatment varies. A clear rehabilitation process has not been developed yet. Rehabilitation therapy that has been widely studied focusing on exercise therapy, sensory training, neuroelectromagnetic stimulation, neurotrophic factors, acupuncture and massage therapy, etc., while interventions like hydrotherapy, phototherapy, and neural stem cell therapy are less studied. In addition, rehabilitation methods in some special condition and group often neglected, such as postoperative edema, pain, and neonates. The purpose of this article is to explore the potential contributions of various methods to brachial plexus injury rehabilitation and to provide a concise overview of the interventions that have been shown to be beneficial. The key contribution of this article is to form relatively clear rehabilitation processes based on different periods and populations, which provides an important reference for the treatment of brachial plexus injuries.

摘要

臂丛神经损伤(BPI)是最严重的周围神经损伤之一,会导致成人和儿童上肢严重且持续的功能障碍及残疾。随着臂丛神经损伤早期诊断和手术技术相对成熟,臂丛神经损伤后康复治疗的需求逐渐增加。康复干预在恢复的各个阶段都能在一定程度上发挥作用,包括自发恢复期、术后阶段和后遗症期。然而,由于臂丛神经组成复杂、损伤部位及病因各异,治疗方法也有所不同。目前尚未形成明确的康复流程。已得到广泛研究的康复治疗方法主要集中在运动疗法、感觉训练、神经电磁刺激、神经营养因子、针灸和按摩疗法等方面,而水疗、光疗和神经干细胞疗法等干预措施的研究较少。此外,一些特殊情况和群体的康复方法常常被忽视,如术后水肿、疼痛以及新生儿。本文旨在探讨各种方法对臂丛神经损伤康复的潜在作用,并简要概述已被证明有益的干预措施。本文的关键贡献在于根据不同时期和人群形成相对明确的康复流程,为臂丛神经损伤的治疗提供重要参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c14/10150106/e54de4b3158b/fneur-14-1084223-g001.jpg

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