Subscribe to RSS
DOI: 10.1055/s-0038-1642068
The Use of Dynamic Assist Orthosis for Muscle Reeducation following Brachial Plexus Injury and Reconstruction
Publication History
Received: 14 June 2017
Accepted after revision: 07 March 2018
Publication Date:
25 April 2018 (online)
Abstract
Therapeutic management of brachial plexus injuries remains complex. The impact of brachial plexus injuries on everyday human functioning should not be underestimated. Early active-assisted range of motion following such injuries may prevent myostatic contractures, minimize muscle atrophy, facilitate muscle fiber recruitment, and enable a faster return to baseline strength levels. The dynamic assist elbow flexion orthosis proposed is designed to provide patients with a graded system for muscle reeducation and function. No clinical data are currently available on the use of this orthosis design; however, this article presents a treatment option based on sound clinical reasoning to facilitate rehabilitation following this devastating injury.
-
References
- 1 Kinlaw D. Pre-/postoperative therapy for adult plexus injury. Hand Clin 2005; 21 (01) 103-108
- 2 Kohlmeyer KM, Weber CG, Yarkony GM. A new orthosis for central cord syndrome and brachial plexus injuries. Arch Phys Med Rehabil 1990; 71 (12) 1006-1009
- 3 Ogce F, Ozyalçin H. A myoelectrically controlled shoulderelbow orthosis for unrecovered brachial plexus injury. Prosthet Orthot Int 2000; 24 (03) 252-255
- 4 Perry J, Hsu J, Barber L, Holler MM. Orthoses in patients with brachial plexus injuries. Arch Phys Med Rehabil 1974; 55 (03) 134-137
- 5 Figueiredo RdeM, Grechi G, Gepp Rd. Oberlin’s procedure in children with obstetric brachial plexus palsy. Childs Nerv Syst 2016; 32 (06) 1085-1091
- 6 Bulstra LF, Shin AY. Nerve Transfers to Restore Elbow Function. Hand Clin 2016; 32 (02) 165-174
- 7 Kahn LC, Moore AM. Donor activation focused rehabilitation approach: maximizing outcomes after nerve transfers. Hand Clin 2016; 32 (02) 263-277
- 8 Marieb EN, Mallatt J, Wilhelm PB. Human Anatomy. San Francisco, NC: Pearson Education; 2008
- 9 Spinner RJ, Shin AY, Ethassan BT. et al. Traumatic brachial plexus injury. In: Wolfe S, Pederson W, Hotchkiss R. et al eds. Green’s Operative Hand Surgery. Philadelphia, PA: Elsevier; 2011: 1235-1292
- 10 Alnot JY. Traumatic brachial plexus lesions in the adult. Indications and results. Hand Clin 1995; 11 (04) 623-631
- 11 Dubuisson AS, Kline DG. Brachial plexus injury: a survey of 100 consecutive cases from a single service. Neurosurgery 2002; 51 (03) 673-682
- 12 Midha R. Epidemiology of brachial plexus injuries in a multitrauma population. Neurosurgery 1997; 40 (06) 1182-1188
- 13 Shin AY, Spinner RJ, Steinmann SP, Bishop AT. Adult traumatic brachial plexus injuries. J Am Acad Orthop Surg 2005; 13 (06) 382-396
- 14 Giuffre JL, Kakar S, Bishop AT, Spinner RJ, Shin AY. Current concepts of the treatment of adult brachial plexus injuries. J Hand Surg Am 2010; 35 (04) 678-688
- 15 Bayer AS. M.S., Waters PM. Brachial plexus injuries. In: Trumble TE, Budoff JE, Slutcky DJ. eds. Principles of Hand Surgery and Therapy. Philadelphia, PA: Saunders; 2016: 322-338
- 16 Alfonso I, Alfonso DT, Papazian O. Focal upper extremity neuropathy in neonates. Semin Pediatr Neurol 2000; 7 (01) 4-14
- 17 Bayer AS, Morehouse S, Waters PM. Brachial plexus injuries. In: Trumble TE, Rayan G, Baratz M. et al eds. Principles of Hand Surgery and Therapy. Philadelphia, PA: Saunders; 2016: 322-338
- 18 Pondaag W, Malessy MJ, van Dijk JG, Thomeer RT. Natural history of obstetric brachial plexus palsy: a systematic review. Dev Med Child Neurol 2004; 46 (02) 138-144
- 19 Buterbaugh KL, Shah AS. The natural history and management of brachial plexus birth palsy. Curr Rev Musculoskelet Med 2016; 9 (04) 418-426
- 20 Waters PM. Update on management of pediatric brachial plexus palsy. J Pediatr Orthop B 2005; 14 (04) 233-244
- 21 Ashworth S, Kozin S. Brachial plexus reconstruction: tendon transfers, osteotomies, capsular release, and arthrodesis. In: Skirven T, Osterman L, Fedorczyk J. et al eds. Rehabilitation of the Hand and Upper Extremity. Philadelphia, PA: Elsevier; 2011: 792-811
- 22 Rankine JJ. Adult traumatic brachial plexus injury. Clin Radiol 2004; 59 (09) 767-774
- 23 Quick TJ, Singh AK, Fox M, Sinisi M, MacQuillan A. A quantitative assessment of the functional recovery of flexion of the elbow after nerve transfer in patients with a brachial plexus injury. Bone Joint J 2016; 98-B (11) 1517-1520
- 24 Maldonado AA, Romero-Brufau S, Kircher MF, Spinner RJ, Bishop AT, Shin AY. Free functioning gracilis muscle transfer for elbow flexion reconstruction after traumatic adult brachial pan-plexus injury: where is the optimal distal tendon attachment for elbow flexion?. Plast Reconstr Surg 2017; 139 (01) 128-136
- 25 Dahlin LB, Andersson G, Backman C, Svensson H, Björkman A. Rehabilitation, using guided cerebral plasticity, of a brachial plexus injury treated with intercostal and phrenic nerve transfers. Front Neurol 2017; 8: 72
- 26 Bonnard C, Narakas A. Restoration of hand function after brachial plexus injury. Hand Clin 1995; 11 (04) 647-656
- 27 Kwok IH, Silk ZM, Quick TJ, Sinisi M, MacQuillan A, Fox M. Nerve injuries associated with supracondylar fractures of the humerus in children: our experience in a specialist peripheral nerve injury unit. Bone Joint J 2016; 98-B (06) 851-856
- 28 Parry CBW. Rehabilitation of the Hand. 2nd ed.. London, UK: Butterworths & Co.; 1966
- 29 Parry CB. Thoughts on the rehabilitation of patients with brachial plexus lesions. Hand Clin 1995; 11 (04) 657-675
- 30 Gordon T, English AW. Strategies to promote peripheral nerve regeneration: electrical stimulation and/or exercise. Eur J Neurosci 2016; 43 (03) 336-350
- 31 Novak CB, von der Heyde RL. Rehabilitation of the upper extremity following nerve and tendon reconstruction: when and how. Semin Plast Surg 2015; 29 (01) 73-80
- 32 Cooper C. Fundamentals: hand therapy concepts and treatment techniques. In: Cooper C. ed. Fundamentals of Hand Therapy. Elsevier Mosby: St. Louis, MO: Elsevier Mosby; 2014: 1-14
- 33 Bhardwaj P, Bhardwaj N. Motor grading of elbow flexion—is Medical Research Council grading good enough?. J Brachial Plex Peripher Nerve Inj 2009; 4: 3
- 34 Bhat DI, Indira DeviB, Bharti K, Panda R. Cortical plasticity after brachial plexus injury and repair: a resting-state functional MRI study. Neurosurg Focus 2017; 42 (03) E14
- 35 Socolovsky M, Malessy M, Lopez D, Guedes F, Flores L. Current concepts in plasticity and nerve transfers: relationship between surgical techniques and outcomes. Neurosurg Focus 2017; 42 (03) E13