Accordingto detailed studies of neurological disorders, the commonest ailmentsamong adults include stroke, spinal cord injury, amyotrophic lateralsclerosis, Parkinson disease, and epilepsy among others. Occupationaltherapists have to broaden continuously their knowledge on how tohandle the different cases. Additionally, they identify thedifficulties patients face while performing their daily dutiesthereby devising solutions. This paper will dwell on the Brachialplexus injury. It will provide the etiology, epidemiology,pathophysiology, signs and symptoms, medical treatment, and prognosisof the disorder. Apart from that, it will be linked to occupationaltherapy.
Brachialplexus cuts often lead to considerable socioeconomic hardship,psychological distress, and physical incapacity. Adult brachialplexus injuries occur due to different reasons, including falls,motor vehicle trauma, and penetrating injuries. Habitually theanalysis is delayed or even disregarded as the physician awaits therecovery. Convenient identification and testing is the preeminent wayof maximizing practical return. Assessors have to recall that muscleswill start to weaken and lose motor end plates once the proximalinjury happens. In that regard, early surgical intercession is theonly prognosticator of a favorable result [ CITATION Fah12 l 1033 ].
Ascertainingthe cases of brachial plexus injuries occurring annually is ratherdifficult. Nevertheless, since the initiation of extremely demandingsporting events as well as powerful motorized sports the rates hasbeen rising considerably. Apart from that, the heightened levels ofhigh-speed motor vehicle accident survivors continue to increase thecases of plexus injuries in a global perspective. The condition ismostly dominant among males who are between the ages of 15 and 25.Founded on his almost twenty years of study involving over 1000persons suffering from brachial plexus injuries, Narakas affirmedthat 70 percent of stressful brachial plexus injuries happensecondary to automobile accidents. 70 percent of the cases entailbicycles or motorcycles[ CITATION Sma12 l 1033 ].
Thesymptoms of the brachial plexus injury are dependent on the locationand magnitude of insult on the nerves. Also, it depends on the extentof impassiveness and weakness within the respective arm to the wholemotor paralysis of the limb. Acute neuropathic pain normally followsthe paralysis. In general, the symptoms are related to:
Swelling on the shoulder.
Shoulder and pains.
Paresthesia and weakness within the arm.
Horner`s syndrome that shows entire lesion within the lower plexus.
Theinjury to the brachial plexus nerves may be categorized into fourmain clusters:
Pre-ganglionic tear …………….Nerve root avulsion
Severe lesion in-continuity….Axonotmesis
Mild lesion in-continuity…….Neurapraxia
Theaim of the occupational therapist is to preserve ROM, strengthen, andreduce pain in a patient. Throughout occupational therapy, mucheffort is directed towards maintaining ROM within the shoulder. Also,constructing suitable orthoses to sustain the hand’s operation aswell as the arm, and elbow. The practice must also address sensorydeficits and edema control with analysis and therapy. Occupationaltherapy can address problems associated with the victim’scapability to type, write, and alternate communication means. InAddition to that, occupational therapy offers assistance withrehabilitation for actions of daily living (ADLs), such asutilization of the arm, adaptive equipment as well as strengtheningand self-ranging and exercises [ CITATION Ste15 l 1033 ].
Reorientationof the brain to direct info alongside embedded nerve tissue or newnerve pathways is the main reason patients undergo therapy. Forinstance, a person who has endured a process whereby the nerve thatoriginally aided the muscles around the ribcage has been redirectedto convey electrical info to the bicep has to be rehabilitated togrow the bicep. In that respect, deep breathing can be the priorexercise that is utilized to assist the patient in stimulating thenew link.
Anotheroccupational therapy technique entails utilization of mirrors. Thearm of the injured individual is positioned just behind the mirror ashe/she views the reflection of the unaffected one. He/she moves theunaffected arm view how it does so. This technique is utilized totrick the brain that the injured arm is actually moving. That way, itrestores the connection to the respective limb. Therapists can alsouse cardiac activities, abdominal exercise or crunches to help speedup the recovery process. The victims must exercise some level ofpatience since the nerves tend to regenerate slowly. In most cases,outcomes are rarely noticed until after six months. It is aprogressive practice that can take several years to heal completely[ CITATION Ste15 l 1033 ].
Duringthe recovery process, therapists help in adaptive mechanisms forbathing, one-handed dressing among other activities. Therapeuticmechanisms can also be utilized to train the injured harm toundertake these activities. It is also the role of occupationaltherapists to assist the patients to make realizable aims andexpectations. It helps them to remain positive and motivated [ CITATION Ste15 l 1033 ].
Occupationaltherapy interventions aim at altering the occupational performance,competencies, and performance possibilities. The changes have to bedependent on the client, physical and social environment activities.Therapists are comprehensively involved in restoring the patient’shealth. Therefore, occupational performance has to improve theskills, institute compensatory skills, and heighten the knowledgeregarding future deficiencies.
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Steven, L. S. (2015). Adult Brachial Plexus Injuries: Mechanism, Patterns of Injury, and Physical Diagnosis. 13-24.