Local Physiotherapy

Patients who live outside the Glasgow area who require follow-up treatment are usually referred on to their local hospital or health centre. This is the responsibility of the CSP.

Physiotherapy Protocols

The CSP will ensure that the physiotherapist treating the patient has all the relevant information e.g. operation notes, post-operative instructions etc. They will need to manage the patient along with treatment guidelines which are described in the Information for Physios* booklet and Physiotherapy Protocols as compiled by Jane Green, Clinical Specialist Physiotherapist.

*Contact details and telephone numbers may be out of date.

Clinical Assessment and Treatment

All BPI patients who have been referred to the SNBPIS or have undergone surgery are assessed and instructed in appropriate exercise programmes, either in hospital as an inpatient or at the BPI Clinic as an outpatient. Follow-up appointments with the CSP are arranged at an outpatient Physiotherapy clinic.

If the patient requires input from any other team member then this will be arranged. Where patients are attending for different appointments we shall endeavour to coordinate appointment times to ensure the minimum number of hospital visits for the patient.

Advice Regarding Patient Management

The principle of patient management is based on an holistic approach with particular emphasis on the patient's ability to reintegrate.

This is a crucial part of the service as patients come from all over Scotland, Northern Ireland and northern England and are therefore treated by a large number of physiotherapists.

The CSP is available to answer any questions or queries regarding the management of BPI patients during normal working hours. Queries about patient management can also be made via email.

Enquiries regarding adult physiotherapy for adult brachial plexus injury fall into 6 main areas:

• Referral.
• Advice regarding the management of patients.
• Splinting.
• Protocols.
• Available research.
• Joint treatment sessions.

Joint Treatment Sessions:

The physiotherapist is available for joint treatment sessions if warranted. This can be arranged by contacting the CSP by email or telephone. Similarly if a review physiotherapy session would be helpful before the patient’s return appointment at the Brachial Plexus Clinic this can be arranged.

The Physiotherapy Service accepts referrals from therapists and consultants throughout Scotland.

Patients are accepted by referral from anywhere in Scotland. Although the majority of patients are referred from the BPI Clinic not all are referred this way, e.g. patients with progressive irradiation neuritis, brachial neuritis or those with longstanding injuries. In most of these instances further surgical intervention is not indicated and it is therefore up to the discretion of the CSP whether or not an onward referral to the clinic is appropriate.

Help with splinting for BPI patients is available. Requests should be made by telephone or email to ensure the type of splint required is appropriate and can be supplied. Please see the Splinting guide document for more information.

Journals

1. Birch R. Traction Lesions of the Brachial Plexus. British Journal of Hospital Medicine September 1984


2. Frampton V. Management of Brachial Plexus Lesions. Physiotherapy 1984; vol 70 no 10,


3. Frampton V. Management of Pain in Brachial Plexus Lesions. Journal of Hand Therapy 1996; 9:339-343


4. Holtsag H, Post, M, van der Werken, C, Lideman, E. Return to work after major trauma. Clinical Rehabilitation 2007; 21:373-383


5. Jivan S, Kumar N, Wiberg M, Kay S. The influence of pre-surgical delay on the functional outcome after reconstruction of brachial plexus injuries. Journal of Plastic, Reconstruction and Aesthetic Surgery 2009; 62:472-479


6. Moseley, L. Graded motor imagery for pathologic pain. Neurology 2006; 67: 2129-2134


7. Moseley L, Gallace A, Spence C. Is mirror therapy all it is cracked up to be? Current evidence and future directions. Pain 2008; 138: 7-10


8. Ramachandran, V, Altschuler. The use of visual feedback, in particular mirror visual feedback in restoring brain function. Brain 2009; 132: 1693-1710


9. Spinner R, Shin A, Bishop A. Update on brachial plexus surgery in adults. Current Opinion in Orthopaedics 2004; 15: 203-214


10. Vekris M, Beris A, Lykissas M, Korompilias , Vekris A, Soucacos P. Restoration of elbow function in severe paralysis via muscle transfer. Injury, International Journal of the Care of the Injured 2008; 395: 15-22

Books

1. Examination of the Hand and Wrist. Tibiana. Thomine, Mackin. Published by Martin Dunitz. Chapter 4 ISBN 1 -85317- 544-77


2. Surgical Disorders of the Peripheral Nerves. Birch, Bonney, Parry 1998. Published by Churchill Livingstone. Chapter 9, ISBN 0443-04443-0


3. Rehabilitation of the Hand. Hunter, Mackin, Callahan. Published by Mosby. Chapter 35, 36 ISBN0-8016-7125-6


4. Nerve injury and repair. Regeneration, Reconstruction and Cortical Remodelling. Lundborg, G (2004). Published by Elsevier Churchill Livingstone. Salter. M, Cheshire. L (2000)


5. Hand Therapy: Principles and Practice: Maureen Salter, Lynn Cheshire (Eds.). Butterworth-Heinemann, Oxford, 2000. ISBN 0-7506-1686-5