Manejo Fisioterapêutico Após Neurólise Cirúrgica por Lesão do Nervo Fibular: Relato de Caso
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Resumo
O nervo fibular torna-se superficial próximo à cabeça da fíbula, o que aumenta sua exposição a mecanismos de lesão. Há uma necessidade de aprimorar o conhecimento sobre a influência da fisioterapia na reabilitação de lesões de nervos periféricos. O caso envolve uma mulher de 47 anos que sofreu um corte na região terço distal do nervo fibular comum direito. Essa lesão resultou em perda de sensibilidade, força, queda do pé e dor neuropática após a sutura. Esses sintomas persistiram por seis semanas, sendo necessário realizar uma cirurgia seis semanas após o acidente. A fisioterapia foi iniciada um mês após a intervenção cirúrgica, incorporando terapia manual, estimulação elétrica, exercícios funcionais e aeróbicos, além de educação da paciente. A paciente apresentou alterações sensoriais, eliminação da dor e recuperação funcional da marcha e da corrida. No entanto, permaneceram fraquezas residuais no extensor do hálux e nos dorsiflexores. Este estudo de caso contribui para o desenvolvimento de intervenções de reabilitação do nervo fibular.
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Referências
Aman M, Zimmermann KS, Thielen M, et al. An Epidemiological and Etiological Analysis of 5026 Peripheral Nerve Lesions from a European Level I Trauma Center. J Pers Med. 2022;12(10). doi:10.3390/jpm12101673
Menorca RMG, Fussell TS, Elfar JC. Nerve physiology. Mechanisms of injury and recovery. Hand Clin. 2013;29(3):317-330. doi:10.1016/j.hcl.2013.04.002.
Campbell WW. Evaluation and management of peripheral nerve injury. Clinical Neurophysiology. 2008;119(9):1951-1965. doi:10.1016/j.clinph.2008.03.018.
Hussain G, Wang J, Rasul A, et al. Current status of therapeutic approaches against peripheral nerve injuries: A detailed story from injury to recovery. Int J Biol Sci.Ivyspring International Publisher. 2020;16(1):116-134. doi:10.7150/ijbs.35653.
Osborne NR, Anastakis DJ, Davis KD. Peripheral nerve injuries, pain, and neuroplasticity. Journal of Hand Therapy. 2018;31(2):184-194. doi:10.1016/j.jht.2018.01.011.
Lundy-Ekman. Neuroscience - Fundamentals for Rehabilitation. 3rd ed. Aunders Elsevier; 2007.
Armada-da-Silva PAS, Pereira C, Amado S, Veloso AP. Role of physical exercise for improving posttraumatic nerve regen-eration. In: International Review of Neurobiology. Vol 109. Academic Press Inc.; 2013:125-149. doi:10.1016/B978-0-12-420045-6.00006-7.
Pang Z, Zhu S, Shen YD, et al. Functional outcomes of different surgical treatments for common peroneal nerve injuries: a retrospective comparative study. BMC Surg. 2024;24(1). doi:10.1186/s12893-024-02354-x.
Gordon T, English AW. Strategies to promote peripheral nerve regeneration: Electrical stimulation and/or exercise. Euro-pean Journal of Neuroscience. 2016;43(3):336-350. doi:10.1111/ejn.13005.
English AW, Wilhelm JC, Ward PJ. Exercise, Neurotrophins, and Axon Regeneration in the PNS Enhanced Reader. Physiol-ogy. 2014;29:437-445. doi:10.1152/physiol.00028.2014.
Chiaramonte R, Pavone V, Testa G, et al. The Role of Physical Exercise and Rehabilitative Implications in the Process of Nerve Repair in Peripheral Neuropathies: A Systematic Review. Diagnostics.Multidisciplinary Digital Publishing Institute (MDPI). 2023;13(3). doi:10.3390/diagnostics13030364.
Cebola PA, Rainho MF, Teixeira AA. Um exemplo de neuropatia periférica que pode ser gerida pelo médico de família: neuropraxia do nervo peroneal. Revista Portuguesa de Clínica Geral. 2021;37(5):462-467. doi:10.32385/rpmgf.v37i5.13069
English AW, Wilhelm JC, Ward PJ. Exercise, Neurotrophins, and Axon Regeneration in the PNS Enhanced Reader. Physiol-ogy. 2014;(29):437-445. doi:10.1152/physiol.00028.2014.
Fortier LM, Markel M, Thomas BG, Sherman WF, Thomas BH, Kaye AD. An Update on Peroneal Nerve Entrapment and Neuropathy. Orthop Rev (Pavia). 2021;13(2). doi:10.52965/001C.24937.
Dale Avers, Marybeth Brown. Daniels and Worthingham’s Muscle Testing Techniques of Manual Examination and Perfor-mance Testing. 10th ed. Elsevier; 2019.
Rodríguez-Fuentes G, Romero Rodríguez T. Physiotherapy in scars. Review of current state. Cirugia Plastica Ibero-Latinoamericana.Sociedad Espanola de Cirugia Plastica Reparadora y Estetica (SECPRE). 2022;48(1):69-80. doi:10.4321/S0376-78922022000100009.
Shacklock M. Clinical Neurodynamics: A New System of Musculoskeletal. Elsevier; 2005.
Bordoloi K. Scientific Reconciliation of the Concepts and Principles of Rood Approach.; 2018. www.ijhsr.org.
Chiaramonte R, Pavone V, Testa G, et al. The Role of Physical Exercise and Rehabilitative Implications in the Process of Nerve Repair in Peripheral Neuropathies: A Systematic Review. Diagnostics.Multidisciplinary Digital Publishing Institute (MDPI). 2023;13(3). doi:10.3390/diagnostics13030364.
Cameron MH, Ocelnik M. Electrical Currents for Muscle Contraction. In: Cameron MH, ed. Physical Agents in Rehabilita-tion. An Evidence-Based Approach to Practice. 6th ed. Elsevier; 2023:244-263.
Pop NL, Mitrea DR, Urdă-Cîmpean AE, Filip A, Clichici S, Orăsan R. Peripheral nerve injury rehabilitation. Health, Sports & Rehabilitation Medicine. 2020;21(4):244-251. doi:10.26659/pm3.2020.21.4.244.
Moore GE, Durstine JL, Painter PL, Kinetics H. ACSM’s Exercise Management for Persons With Chronic Diseases and Disa-bilities Healthy Living and Exercise Medicine Associates FOURTH EDITION. Preprint posted online 2016.
Diana Victoria G, Carmen E voiculescu, Alexandru S, Antoanela O, Florin C, Daniel D. The PNF (Proprioceptive Neuro-muscular Facilitation) Streching Technique - a Brief Review. Vol XIII.; 2013. http://web.mit.edu/tkd/stretch/stretching_4.htm.
Huber J, Leszczyńska K, Wincek A, et al. The role of peripheral nerve electrotherapy in functional recovery of muscle mo-tor units in patients after incomplete spinal cord injury. Applied Sciences (Switzerland). 2021;11(20). doi:10.3390/app11209764.
Takakusaki K. Functional Neuroanatomy for Posture and Gait Control. Journal of Movement disord. 2017;10(1):1-17. doi:10.14802/jmd.16062/J.