Effective long-term management of brachial plexus injury following surgery: What is needed from hand therapists' perspectives

Abstract

Introduction: Traumatic, brachial plexus injuries (BPI) result represent a significant cost to the individual and society. Recovery involves multiple surgeries, takes years, and often results in permanent physical dysfunction. While the last couple of decades have seen advancements in surgical management, the BPI rehabilitation literature has not kept pace with these developments.

Purpose: We aim to explore the experience of public and privately employed hand therapists' in delivering effective long-term rehabilitation services to inviduals with BPI in Australia.

Methods: An interpretative qualitative study. Two focus groups were conducted with Australian hand therapists' (n = 10). Data were analyzed using an inductive thematic approach.

Results: Three key themes were generated from the data. The first theme 'Falling through the gaps: overlooked components of therapy for BPI' captures participants' thoughts on postinjury health care and rehabilitation services. The second 'Developing a therapeutic alliance: underpinned by time and trust' relates to the relationship building challenges and opportunities following trauma that will withstand the long-term recovery of individuals following BPI. The last theme, 'Factors required for professional development: knowledge and support,' considers the variation seen with these clients in relation to therapy needs and outcomes.

Conclusions: The findings of this study highlight the need to better equip hand therapists' skills and knowledge in responding to pain and psychological management post BPI. Our results reinforce the benefit of interdisciplinary models of care in the management of individuals with BPI.

Keywords: Adult; Brachial plexus injuries; Occupational therapy; Rehabilitation.