Rehabilitation of brachial plexus injuries in adults and children.

Management of brachial plexus injury sequelae is a challenging issue in neurorehabilitation. In the last decades great strides have been made in the areas of early diagnosis and surgical techniques. Conversely, rehabilitation of brachial plexus injury is a relatively unexplored field. Some critical aspects regarding brachial plexus injury rehabilitation have to be acknowledged. First, brachial plexus injury may result in severe and chronic impairments in both adults and children, thus requiring an early and long-lasting treatment. Second, nerve damage causes a multifaceted clinical picture consisting of sensorimotor disturbances (pain, muscle atrophy, muscle weakness, secondary deformities) as well as reorganization of the Central Nervous System that may be associated with upper limb underuse, even in case of peripheral injured nerves repair. Finally, psychological problems and a lack of cooperation by the patient may limit rehabilitation effects and increase disability. In the present paper the literature concerning brachial plexus injury deficits and rehabilitation in both adults and children was reviewed and discussed. Although further research in this field is recommended, current evidence supports the potential role of rehabilitation in reducing both early and long-lasting disability. Furthermore, the complexity of the functional impairment necessitates an interdisciplinary approach incorporating various health professionals in order to optimizing outcomes.