Efficacy of combined physical and occupational therapy treatment of patients with sub acute neuralgic amyotrophy: a proof of principle pilot-study

Abstract

Introduction Currently no evidence is available for a multidisciplinary intervention helping people with upper extremity complaints who are recovering from neuralgic amyotrophy (NA). These patients encounter numerous difficulties in daily life and are often not able to resume work activities. We have developed a multidisciplinary treatment program for these patients, combining physical therapy and occupational therapy. We have tried to establish a proof of principle for this treatment program Design Proof of principle pilot study Methods Eight patients recovering >6 months after NA, recruited from our outpatient clinic, have been structurally measured 3 months before and during the treatment period. All patients received eight sessions of occupational- and physical therapy over a period of 16 weeks. Including proprioceptive shoulder training, strength training, behavioral therapy and teaching of energy conservation techniques. Results Patients showed no significant change in patients, three months prior to entering the program. At the end of program, patients show large and statistically significant improvements (p<0.025) on the canadian occupational performance measure (COPM) (+2.0 points) and shoulder rating questionnaire (SRQ) (+46%) measurements. The majority of patients also show large improvements in disability of arm shoulder and hand (DASH) scores and increase of serratus anterior muscle strength (6 of 8 patients). Checklist individual strength (CIS)-fatique scores did not change significantly. Conclusion Results clearly show that therapy has not damaged or disadvantaged participants. They show a big improvement in efficacy in our patients. Patients learn to adapt to their complaints and limitations, are able to function better and reach higher satisfaction. Further research into a multidisciplinary approach for people recovering from NA is advised.