Proprioceptive neuromuscular facilitation compared to conventional physiotherapy for adults with traumatic upper brachial plexus injury: A protocol for a randomized clinical trial

• Published in: Physiotherapy research international : the journal for researchers and clinicians in physical therapy Vol. 26; no. 1; pp. e1873 - n/a
• Main Authors: Chagas, Alessandra Carolina de Santana, Wanderley, Débora, Barboza, Paulo José Moté, Martins, José Vicente Pereira, de Moraes, Alexa Alves, de Souza, Fernando Henrique Morais, Oliveira, Daniella Araújo
• Format: Journal Article
• Language: English
• Published: United States 01.01.2021
• Subjects: Adult; Brachial Plexus; brachial plexus injury; Humans; Muscle Stretching Exercises; nerve transfer; Physical Therapy Modalities; Quality of Life; Randomized Controlled Trials as Topic; rehabilitation; Treatment Outcome; rehabilitation; brachial plexus injury; physical therapy modalities; nerve transfer
• ISSN: 1358-2267; 1471-2865
• DOI: 10.1002/pri.1873

Background 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. Aim 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. Methods 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. Result 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. Conclusion 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.