Facilitação Neuromuscular Proprioceptiva na Lesão do Nervo Radial: Um relato de caso: Proprioceptive Neuromuscular Facilitation in Radial Nerve Injury: A case report

Poliana Candido  Vasconcelos; Paulo José Moté  Barbosa; Marcelo Moraes  Valença; Silvya Nery  Bernardino; Alessandra Carolina de Santana  Chagas; Daniella Araújo de  Oliveira

doi:10.17765/2176-9206.2025v18e13025

Authors

Poliana Candido Vasconcelos Federal University of Pernambuco https://orcid.org/0000-0002-3217-9557
Paulo José Moté Barbosa Integrated Aquatic Therapy and Rehabilitation Center https://orcid.org/0000-0002-0112-8933
Marcelo Moraes Valença Federal University of Pernambuco https://orcid.org/0000-0003-0678-3782
Silvya Nery Bernardino Getulio Vargas Hospital https://orcid.org/0000-0002-3054-5576
Alessandra Carolina de Santana Chagas Federal University of Pernambuco https://orcid.org/0000-0002-1248-2452
Daniella Araújo de Oliveira Federal University of Pernambuco https://orcid.org/0000-0002-6013-978X

DOI:

https://doi.org/10.17765/2176-9206.2025v18e13025

Keywords:

Case report, Physiotherapy, Radial neuropathy, Rehabilitation

Abstract

Objective: To report the physiotherapeutic treatment using Proprioceptive Neuromuscular Facilitation (PNF) in a patient with radial nerve neuropraxia. Method: Case report of a patient with wrist drop following alcohol consumption. Upper limb function was assessed using the DASH scale, muscle strength with the MRC, wrist range of motion with goniometry, grip strength with a dynamometer, and tactile sensitivity of dermatomes C5 to C8. Results: The DASH score decreased, indicating improved upper limb functionality. Muscle strength increased from grade 0 to 3 in wrist extension and from 0 to 4 in finger extension, with normalization of sensitivity and complete recovery of range of motion. Conclusion: The PNF protocol resulted in significant improvements in muscle strength, sensitivity, range of motion, and upper limb functionality after three months of treatment. Keywords: Radial neuropathy. Rehabilitation. Physical therapy modalities. Case report.

Downloads

Download data is not yet available.

Author Biographies

Poliana Candido Vasconcelos, Federal University of Pernambuco

Bachelor's degree in Physiotherapy from the Federal University of Pernambuco (UFPE). Master's degree in Physiotherapy from the Department of Physiotherapy at the Federal University of Pernambuco (UFPE); Postgraduate degree in Neurofunctional Physiotherapy.

Paulo José Moté Barbosa, Integrated Aquatic Therapy and Rehabilitation Center

Master in Rehabilitation Sciences from Universidade Nove de Julho and Physiotherapist at CIRTA - Integrated Center for Rehabilitation and Aquatic Therapy.

Marcelo Moraes Valença, Federal University of Pernambuco

Professor of Neurosurgery at the Federal University of Pernambuco.

Silvya Nery Bernardino, Getulio Vargas Hospital

PhD in Neurology from the University of Pernambuco.

Alessandra Carolina de Santana Chagas, Federal University of Pernambuco

Master in Physiotherapy from the Federal University of Pernambuco

Daniella Araújo de Oliveira, Federal University of Pernambuco

Professor of the Department of Physiotherapy at the Federal University of Pernambuco.

References

Duz B, Solmaz I, Civelek E, Onal MB, Pusat S, Daneyemez M. Analysis of proximal radial nerve injury in the arm. Neurol India. 2010;58(2):230. doi:10.4103/0028-3886.63802.

Gragossian A, Varacallo M. Radial nerve injury. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. PMID: 30725989. Disponível em: https://www.ncbi.nlm.nih.gov/books/NBK537304/.

Kerasnoudis A, Ntasiou P, Ntasiou E. Prognostic value of nerve ultrasound and electrophysiological findings in Saturday night palsy. J Neuroimaging. 2017;27(4):428-32. doi:10.1111/jon.12414.

Alencar R, Cordeiro T, Anjos P, Cavalcanti P. Neuromuscular facilitation proprioceptive on the mat repurchase of functions in spinal cord injury. Rev Neurocienc. 2011;19:512-8. Disponível em: https://www.researchgate.net/publication/307936651_Neuromuscular_facilitation_proprioceptive_on_the_mat_repurchase_of_functions_in_Spinal_Cord_injury.

Queiroz MLdS, Wanderley D, Coriolano MdGWdS, Belo LR, Martins JV, Barboza PJM, et al. Efeitos da irradiação de força contralateral na extensão de punho de pacientes após acidente vascular cerebral. Rev bras neurol. 2016:5-11. doi:10.46979/rbn.v52i2.4187.

Orfale AG. Tradução e validação do Disabilities of the Arm, Shoulder and Hand (DASH) para a língua portuguesa. 2003. Disponível em: https://repositorio.unifesp.br/handle/11600/19992.

Marques AP. Manual de goniometria. Barueri: Editora Manole; 1997. Disponível em: https://www.manole.com.br/manual-de-goniometria-3-edicao/p?srsltid=AfmBOoqDrfKFhsVdycUP.

No MM. Aids to the examination of the peripheral nervous system. London: HMSO; 1976. Disponível em: https://www.ukri.org/publications/aids-to-the-examination-of-the-peripheral-nervous-system/.

NHS Scotland. Serviço escocês de lesões do plexo braquial adulto informações para fisioterapeutas, p. 30, 2016. Disponível em: https://www.brachialplexus.scot.nhs.uk/documents/Info%20for%20Physios.pdf.

Moreira D. Estudo sobre a realização da preensão palmar com a utilização do dinamômetro: considerações anatômicas e cinesiológicas. Fisioter Bras. 2001;2(5):295-300. doi:10.33233/fb.v2i5.651.

Nocera G, Jacob C. Mechanisms of Schwann cell plasticity involved in peripheral nerve repair after injury. Cell Mol Life Sci. 2020;77:3977-3989. doi:10.1007/s00018-020-03516-9.

Bosch-Queralt M, Fledrich R, Stassart R. Schwann cell functions in peripheral nerve development and repair. Neurobiol Dis. 2023;176:105952. doi:10.1016/j.nbd.2022.105952.

Cassilhas R, Tufik S, Mello M. Physical exercise, neuroplasticity, spatial learning and memory. Cell Mol Life Sci. 2016;73:975-983. doi:10.1007/s00018-015-2102-0.

Adler SS, Beckers D, Buck M. PNF in practice. 4th ed. Berlin: Springer-Verlag; 2014. Disponível em: https://www.academia.edu/36669442/An_Illustrated_Guide_PNF_in_Practice_Fourth_Edition.

Moreira R, Lial L, Monteiro MGT, Aragão A, David LS, Coertjens M, et al. Diagonal movement of the upper limb produces greater adaptive plasticity than sagittal plane flexion in the shoulder. Neurosci Lett. 2017;643:8-15. doi:10.1016/j.neulet.2017.02.022.

Shumway-Cook A, Woollacott MH, Rachwani J, Santamaria V. Motor control: translating research into clinical practice. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2023. Disponível em: https://www.researchgate.net/publication/228118305_Motor_Control_Translating_Research_Into_Clinical_Practice.