Chordata method combined with electrotherapy in functional recovery after brachial plexus injury: report of three clinical cases

Authors

  • Régis Gemerasca Mestriner Pontifical Catholic University of Rio Grande do Sul (PUCRS) http://orcid.org/0000-0001-9837-1691
  • Charlene Brito de Oliveira Pontifical Catholic University of Rio Grande do Sul
  • Denizar Alberto da Silva Melo Pontifical Catholic University of Rio Grande do Sul
  • Mayara Ferraz de Menezes Pontifical Catholic University of Rio Grande do Sul
  • Irenio Gomes da Silva Filho Pontifical Catholic University of Rio Grande do Sul
  • Jefferson Luis Braga da Silva Pontifical Catholic University of Rio Grande do Sul
  • Verônica Baptista Frison Pontifical Catholic University of Rio Grande do Sul

DOI:

https://doi.org/10.15448/1980-6108.2016.2.22425

Keywords:

brachial plexus neuropathies, physical therapy modalities, peripheral nerve injuries.

Abstract

Aims: To report three clinical cases of complex brachial plexus injury treated with an innovative physical therapy program, the Chordata Method, combined with electrotherapy.

Case description: Three patients suffered a complex brachial plexus injury. They were submitted to surgery and to long-term rehabilitation with the Chordata method (including suspension and tilting exercises) combined with electrotherapy. All patients exhibited significant signs of recovery in post-treatment electroneuromyography. Moreover, improvements in muscle strength and in the range of motion of the injured upper limb were also observed, leading to better posture and gains in activities of daily living (e.g., driving a modified car, holding objects, performing household chores, and doing leisure activities).

Conclusions: There was great functional recovery after the physical therapy program with the Chordata Method combined with electrotherapy, with an impact on patients’ daily lives as well as on electroneuromyography findings. Randomized clinical trials are needed to confirm or refute this new non-pharmacological strategy for the treatment of brachial plexus injuries.

Downloads

Download data is not yet available.

Author Biographies

Régis Gemerasca Mestriner, Pontifical Catholic University of Rio Grande do Sul (PUCRS)

College of Nursing, Nutrition and Physiotherapy and Professor.

Charlene Brito de Oliveira, Pontifical Catholic University of Rio Grande do Sul

Biomedical Gerontology PhD student.

Denizar Alberto da Silva Melo, Pontifical Catholic University of Rio Grande do Sul

College of Nursing, Nutrition and Physiotherapy and Professor.

Mayara Ferraz de Menezes, Pontifical Catholic University of Rio Grande do Sul

Celular and Molecular Biology Post Graduation Program (PUCRS). Master Student.

Irenio Gomes da Silva Filho, Pontifical Catholic University of Rio Grande do Sul

Geriatrics and Gerontology Institute (PUCRS) and Professor.

Jefferson Luis Braga da Silva, Pontifical Catholic University of Rio Grande do Sul

College of Medicine. Director and Professor.

Verônica Baptista Frison, Pontifical Catholic University of Rio Grande do Sul

College of Nursing, Nutrition and Physiotherapy and Professor.

References

Galanakos SP, Zoubos AB, Mourouzis I, Ignatiadis I, Bot AG, Soucacos PN. Prognostic scoring system for peripheral nerve repair in the upper extremity. Micros. 2013;33(2):105-11. http://dx.doi.org/10.1002/micr.22000

Scott KR, Ahmed A, Scott L, Kothari MJ. Rehabilitation of brachial plexus and peripheral nerve disorders. Hand clin neurol. 2013;110:499-514. http://dx.doi.org/10.1016/B978-0-444-52901-5.00042-3

Smania N, Berto G, La Marchina E, Melotti C, Midiri A, Roncari L, Zenorini A, Ianes P, Picelli A, Waldner A, Faccioli S, Gandolfi M. Rehabilitation of brachial plexus injuries in adults and children. Eur J Phys Rehab Med. 2012;48(3):483-506.

Limthongthang R, Bachoura A, Songcharoen P, Osterman AL. Adult brachial plexus injury: evaluation and management. Orthop Nor Am. 2013;44(4):591-603. http://dx.doi.org/10.1016/j.ocl.2013.06.011

Midha R. Epidemiology of brachial plexus injuries in a multitrauma population. Neurosur. 1997;40(6):1182-8. http://dx.doi.org/10.1097/00006123-199706000-00014

Rosen B, Lundborg G, Dahlin LB, Holmberg J, Karlson B. Nerve repair: correlation of restitution of functional sensibility with specific cognitive capacities. J Hand Sur. 1994;19(4):452-8. http://dx.doi.org/10.1016/0266-7681(94)90209-7

Kretschmer T, Ihle S, Antoniadis G, Seidel JA, Heinen C, Borm W, et al. Patient satisfaction and disability after brachial plexus surgery. Neurosur. 2009;65(4 Suppl):A189-96. http://dx.doi.org/10.1227/01.NEU.0000335646.31980.33

Aszmann OC, Roche AD, Salminger S, Paternostro-Sluga T, Herceg M, Sturma A, Hofer C, Farina D. Bionic reconstruction to restore hand function after brachial plexus injury: a case series of three patients. Lancet. 2015;385(9983):2183-9. http://dx.doi.org/10.1016/S0140-6736(14)61776-1

Deschenes MR, Maresh CM, Crivello JF, Armstrong LE, Kraemer WJ, Covault J. The effects of exercise training of different intensities on neuromuscular junction morphology. J Neuroc. 1993;22(8):603-15. http://dx.doi.org/10.1007/BF01181487

Klimaschewski L, Hausott B, Angelov DN. The pros and cons of growth factors and cytokines in peripheral axon regeneration. Inter Ver Neur. 2013;108:137-71. http://dx.doi.org/10.1016/b978-0-12-410499-0.00006-x

Allodi I, Udina E, Navarro X. Specificity of peripheral nerve regeneration: interactions at the axon level. Prog Neur. 2012;98(1):16-37. http://dx.doi.org/10.1016/j.pneurobio.2012.05.005

Okafor UA, Akinbo SR, Sokunbi OG, Okanlawon AO, Noronha CC. Comparison of electrical stimulation and conventional physiotherapy in functional rehabilitation in Erb's palsy. Nig J Hosp Med. 2008;18(4):202-5.

Merzenich MM, Jenkins WM. Reorganization of cortical representations of the hand following alterations of skin inputs induced by nerve injury, skin island transfers, and experience. J Hand Ther. 1993;6(2):89-104. http://dx.doi.org/10.1016/S0894-1130(12)80290-0

Published

2016-05-13

How to Cite

Mestriner, R. G., de Oliveira, C. B., Melo, D. A. da S., de Menezes, M. F., Filho, I. G. da S., da Silva, J. L. B., & Frison, V. B. (2016). Chordata method combined with electrotherapy in functional recovery after brachial plexus injury: report of three clinical cases. Scientia Medica, 26(2), ID22425. https://doi.org/10.15448/1980-6108.2016.2.22425

Issue

Section

Case Reports

Most read articles by the same author(s)