MAPS Level B3 Course
Peripheral Neurological Hand
Among the nervous system injuries affecting the upper extremity, peripheral nervous system injuries play an important role.
This is one of the most complex rehabilitations due to being presented with various different facets. It is highly beneficial for therapists to understand and manage its treatment as this improves the capacity for speed and accuracy when detecting problems and deciding on the appropriate therapeutic approaches.
Rehabilitation of these hands requires an understanding of the process from start to finish, as there are various different stages. In the initial phase, we have the traumatic hand due to the mechanism of injury, followed by the stiff hand as a result of the healing process. We also have the paretic hand, the sleeping hand and the dystrophic hand as repercussions of the nerve damage. In the worst cases, we may also be faced with the painful hand. In this case, we must consider prevention and protection of the hand to offset any repercussions as far as possible.
The functional consequences of attempts to resolve the functional difficulties that develop means that a pattern of compensatory movement is established to improve the motion and make it more efficient. This modifies the central hand.
These functional changes affect the person’s motor pattern; while it can temporarily improve efficiency, it can later create difficulties in recovering the original pattern of movement. If this situation is not controlled, imbalances, instabilities and deformations will inevitably appear. At this time, the imbalance should be fully compensated and the normal pattern of movement should be maintained as far as possible.
Surgical treatment of these hands makes the healing process even more difficult. Both in the integral hand and the post-surgical hand with transposition of the tendon, if the person is unable to restore the original pattern of movement, the prognosis for recovery is very limited. Relearning is required to counteract this unpromising situation. The hand that learns gradually will carry out each and every one of the steps to achieve the best possible prognosis. Counteracting trophic functions, teaching to feel again and training the hand like a top athlete is the key to achieving the best result.
In this course we will show how to deal with conditions such as brachial plexus injuries and injuries of the main nerve trunks (median, ulnar and radial), and we will focus on how MAPS Therapy can help create a treatment with more accurate progressions and sequences that are better adapted to the specific needs of each of these situations.