Traumatic brachial plexus injury rehabilitation using neuromuscular electrical muscle stimulation in a polytrauma patient

We report a 28-year-old man admitted postmotorcycle versus car in September 2017. The patient sustained multiple injuries in both the upper and lower limbs. He sustained a complex brachial plexus injury on his left side and was transferred immediately to Stanmore Hospital to undergo specialist surgery (supraclavicular brachial plexus exploration and neurolysis) to repair his brachial plexus injury. The patient was transferred back to the specialist trauma ward for additional surgeries for his subsequent injuries. Due to the complexity of the injury and surgery the patient was not able to start rehabilitation until six weeks post operation, at which point he was referred to outpatient physiotherapy. Prior to this his left upper limb was in a sling but was instructed to move it as able. The patient commenced his comprehensive physiotherapy programme in January 2018.

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Back Pack Palsy as an Unusual Cause of Shoulder Pain and Weakness–A Case Report

Indian Journal of Physical Medicine and Rehabilitation ◽

10.5005/ijopmr-23-3-120 ◽

2012 ◽

Vol 23 (3) ◽

pp. 120-122 ◽

Cited By ~ 1

Author(s):

S.N Mansoor ◽

F.A Rathore ◽

Fahim Muhammad

Keyword(s):

Brachial Plexus ◽

Brachial Plexus Injury ◽

Axillary Nerve ◽

Electrical Muscle Stimulation ◽

Permanent Disability ◽

Strengthening Exercises ◽

Gait Abnormalities ◽

Postural Disorders ◽

Electrical Muscle ◽

Minimal Residual

Abstract Heavy back packs carried for prolonged durations can cause different musculoskeletal and neurological problems especially in the untrained and physically vulnerable individuals. They can cause postural disorders, gait abnormalities, muscular strains, pains and injuries to the brachial plexus and nerves resulting in significant morbidity and at times permanent disability. We report a case of brachial plexus injury in a young soldier wearing back pack for prolonged period. He developed weakness and pain in right shoulder which was not relieved with rest and analgesics. On examination he had weakness in deltoid, biceps and scapular muscles along with numbness in axillary nerve area. Brachial plexus injury (upper trunk) was suspected and confirmed by electrodiagnostic evaluation. His baseline investigations were normal. He was advised rest and avoidance to lift heavy weight. He was managed with electrical muscle stimulation for weak muscles, strengthening exercises and analgesics. He responded well to the treatment and had minimal residual weakness at the end of the six weeks’ treatment Back pack palsy should be suspected in people carrying back packs and presenting with pain, weakness and numbness in the upper limbs. It can be prevented by education in the use of back packs, its weight limits, physical fitness and frequent breaks with changing positions.

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Effects of Arm-cranking Training with Electrical Muscle Stimulation on Vessel Function

International Journal of Sports Medicine ◽

10.1055/a-1510-9135 ◽

2021 ◽

Author(s):

Hajime Miura ◽

Mizuki Ishikawa ◽

Ayako Murakami ◽

Yasuaki Tamura ◽

Kenichi Deguchi

Keyword(s):

Brachial Artery ◽

Training Session ◽

Lower Limbs ◽

Muscle Stimulation ◽

Electrical Muscle Stimulation ◽

Arm Cranking ◽

Adult Men ◽

The Right ◽

Flow Mediated Vasodilation ◽

Electrical Muscle

AbstractThis study aimed to determine whether arm-cranking training with electrical muscle stimulation (EMS) results in a greater improvement in vessel function than performing the same exercise without EMS. First, nine healthy young men performed two 20-min arm-cranking trials at 50% V˙O2max with and without EMS applied to the lower limbs. The flow-mediated vasodilation (FMD) of the right brachial artery was measured using a high-resolution ultrasound device. Both FMD and normalized FMD were increased significantly after the arm-cranking with EMS trial, and significant differences were observed between the two trials. Second, 16 healthy adult men were randomly assigned to either the arm-cranking exercise training (A) group or arm-cranking training with EMS (A+EMS) group. The subjects were engaged in 20 min of arm-cranking at 50% V˙O2max twice a week for 8 weeks with/without EMS applied to the lower limbs. The FMD increased significantly after A+EMS training session and the FMD in A+EMS group was significantly higher than that in the A group. These results indicate that acute/chronic endurance arm-cranking with EMS applied to the lower limbs improves the brachial artery endothelial function more markedly than the same exercise without EMS.

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