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Rehabilitation of Nerve Transfers After Brachial Plexus Injuries

presented by Jennifer T. Dodson, OTD, OTR/L, CHT

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Disclosure Statement:

Financial: Jennifer Dodson receives compensation from MedBridge for the production of this course. She has no other relevant financial relationships.

Nonfinancial: Jennifer Dodson has no competing nonfinancial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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Video Runtime: 54 Minutes, Learning Assessments: 20 Minutes

Brachial plexus injuries are devastating injuries that affect all aspects of a person's life. The complexity of these injuries requires a specialized team-based approach to address the multifaceted aspects of returning the patient to meaningful occupations. Advancements in nerve transfers restore hope and function in those who have sustained brachial plexus injuries. Just as timely surgical intervention is essential to optimal recovery, pre- and postoperative rehabilitation play a distinct and vital role in maximizing outcomes. Although there is a lack of high-level studies demonstrating the ideal postoperative management of these injuries, a few key articles are beneficial for therapists treating these injuries to become familiar with. These articles provide foundational knowledge and concepts that assist therapists in developing an individualized rehabilitation program. Synthesis of these articles will be presented along with a case study that will allow therapists to understand the importance of a comprehensive evaluation, the criteria to progress the rehabilitation program, and interventions to address the multifaceted impairments this population presents with. This course is applicable to therapists at an intermediate level in all practice settings.

Meet Your Instructor

Jennifer T. Dodson, OTD, OTR/L, CHT

Jennifer "Jen" Dodson has been an Occupational Therapist since 1998, a Certified Hand Therapist since 2004, and is fellowship trained from the Philadelphia Hand Center in 2002. She received her Post-Professional Occupational Doctorate from Jefferson University (Formerly Thomas Jefferson) in 2021 along with an Advance Practice Certificate in "Teaching in the Digital Age". Jen spent…

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Chapters & Learning Objectives

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1. Introduction to Brachial Plexus Injuries and Surgical Considerations/Concepts

This chapter will introduce indications and contraindications for nerve transfers and surgical options to restore shoulder/elbow/hand function and will provide interoperative videos of three common procedures performed. The nerve transfer procedures that will be introduced are the Somsak (increases shoulder function), Oberlin (increases elbow function), double fascicular (increases elbow function), and Bertelli (increases hand function).

2. Understanding Rehabilitation Concepts After Nerve Transfers

This chapter will present current literature on rehabilitation concepts, followed by a synthesis of the current rehabilitation approaches. Program similarities and differences will be presented along with discussion on ensuring a comprehensive evaluation, understanding of the criteria patients must meet to progress the rehabilitation program, and treatment techniques to perform throughout the continuum of care to provide an individualized treatment plan.

3. Application of Rehabilitation Concepts to a Case Study

This chapter will present a case study of the Oberlin and double fascicular transfers to restore elbow flexion. The rehabilitation concepts and evidence-informed treatment interventions will be demonstrated throughout the phases of rehabilitation.

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