Case report: Physical findings, physical therapy practice, and characteristics of disability of activities of daily living caused by obturator nerve palsy after neurotmesis
The obturator nerve originates from the lumbar plexus and innervates sensation in the thigh and movement of the adductor muscle group of the hip. Reports on physical therapy for patients with obturator nerve injuries have been limited due to insufficient injuries, and there have been no reports on r...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1062018/full |
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| author | Daichi Shima Daichi Shima Tokio Kinoshita Tokio Kinoshita Yasunori Umemoto Yoshinori Yasuoka Yoshinori Yasuoka Takamasa Hashizaki Takamasa Hashizaki Makoto Asaeda Yukihide Nishimura Tamaki Yahata Takashi Shimoe Fumihiro Tajima |
| author_facet | Daichi Shima Daichi Shima Tokio Kinoshita Tokio Kinoshita Yasunori Umemoto Yoshinori Yasuoka Yoshinori Yasuoka Takamasa Hashizaki Takamasa Hashizaki Makoto Asaeda Yukihide Nishimura Tamaki Yahata Takashi Shimoe Fumihiro Tajima |
| author_sort | Daichi Shima |
| collection | DOAJ |
| description | The obturator nerve originates from the lumbar plexus and innervates sensation in the thigh and movement of the adductor muscle group of the hip. Reports on physical therapy for patients with obturator nerve injuries have been limited due to insufficient injuries, and there have been no reports on rehabilitation after neurotmesis. Furthermore, there are no reports on the status of activities of daily living (ADL) and details of physical therapy in patients with paralysis of the adductor muscle group. In this study, we reported on a patient with adductor paralysis due to obturator neurotmesis, including the clinical symptoms, characteristics of ADL impairment, and effective movement instruction. The patient is a woman in her 40's who underwent laparoscopic total hysterectomy, bilateral adnexectomy, and pelvic lymph node dissection for uterine cancer (grade-2 endometrial carcinoma). During pelvic lymph node dissection, she developed an obturator nerve injury. She underwent nerve grafting during the same surgery by the microsurgeon. Donor nerve was the ipsilateral sural nerve with a 3-cm graft length. Due to obturator nerve palsy, postoperative manual muscle test results were as follows: adductor magnus muscle, 1; pectineus muscle, 1; adductor longs muscle, 0; adductor brevis muscle, 0; and gracilis muscle, 0. On postoperative day 6, the patient could independently perform ADL; however, she was at risk of falling toward the affected side when putting on and taking off her shoes while standing on the affected leg. The patient was discharged on postoperative day 8. Through this case, we clarified the ADL impairment of a patient with adductor muscle palsy following obturator neurotmesis, and motion instruction was effective as physical therapy for this disability. This case suggests that movement instruction is important for acute rehabilitation therapy for patients with hip adductor muscle group with obturator neurotmesis. |
| first_indexed | 2024-04-10T20:46:47Z |
| format | Article |
| id | doaj.art-3f57feef4e114cfd998269a315ca1b6c |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-10T20:46:47Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-3f57feef4e114cfd998269a315ca1b6c2023-01-24T06:55:05ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-01-011410.3389/fneur.2023.10620181062018Case report: Physical findings, physical therapy practice, and characteristics of disability of activities of daily living caused by obturator nerve palsy after neurotmesisDaichi Shima0Daichi Shima1Tokio Kinoshita2Tokio Kinoshita3Yasunori Umemoto4Yoshinori Yasuoka5Yoshinori Yasuoka6Takamasa Hashizaki7Takamasa Hashizaki8Makoto Asaeda9Yukihide Nishimura10Tamaki Yahata11Takashi Shimoe12Fumihiro Tajima13Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, JapanDivision of Rehabilitation, Wakayama Medical University Hospital, Wakayama, JapanDepartment of Rehabilitation Medicine, Wakayama Medical University, Wakayama, JapanDivision of Rehabilitation, Wakayama Medical University Hospital, Wakayama, JapanDepartment of Rehabilitation Medicine, Wakayama Medical University, Wakayama, JapanDepartment of Rehabilitation Medicine, Wakayama Medical University, Wakayama, JapanDivision of Rehabilitation, Wakayama Medical University Hospital, Wakayama, JapanDepartment of Rehabilitation Medicine, Wakayama Medical University, Wakayama, JapanDivision of Rehabilitation, Wakayama Medical University Hospital, Wakayama, JapanFaculty of Wakayama Health Care Sciences, Takarazuka University of Medical and Health Care, Wakayama, JapanDepartment of Rehabilitation Medicine, Iwate Medical University, Shiwa-gun, JapanDepartment of Obstetrics and Gynecology, Wakayama Medical University, Wakayama, JapanDepartment of Orthopaedic Surgery, Wakayama Medical University, Wakayama, JapanDepartment of Rehabilitation Medicine, Wakayama Medical University, Wakayama, JapanThe obturator nerve originates from the lumbar plexus and innervates sensation in the thigh and movement of the adductor muscle group of the hip. Reports on physical therapy for patients with obturator nerve injuries have been limited due to insufficient injuries, and there have been no reports on rehabilitation after neurotmesis. Furthermore, there are no reports on the status of activities of daily living (ADL) and details of physical therapy in patients with paralysis of the adductor muscle group. In this study, we reported on a patient with adductor paralysis due to obturator neurotmesis, including the clinical symptoms, characteristics of ADL impairment, and effective movement instruction. The patient is a woman in her 40's who underwent laparoscopic total hysterectomy, bilateral adnexectomy, and pelvic lymph node dissection for uterine cancer (grade-2 endometrial carcinoma). During pelvic lymph node dissection, she developed an obturator nerve injury. She underwent nerve grafting during the same surgery by the microsurgeon. Donor nerve was the ipsilateral sural nerve with a 3-cm graft length. Due to obturator nerve palsy, postoperative manual muscle test results were as follows: adductor magnus muscle, 1; pectineus muscle, 1; adductor longs muscle, 0; adductor brevis muscle, 0; and gracilis muscle, 0. On postoperative day 6, the patient could independently perform ADL; however, she was at risk of falling toward the affected side when putting on and taking off her shoes while standing on the affected leg. The patient was discharged on postoperative day 8. Through this case, we clarified the ADL impairment of a patient with adductor muscle palsy following obturator neurotmesis, and motion instruction was effective as physical therapy for this disability. This case suggests that movement instruction is important for acute rehabilitation therapy for patients with hip adductor muscle group with obturator neurotmesis.https://www.frontiersin.org/articles/10.3389/fneur.2023.1062018/fullobturator nerveperipheral nerve injuryactivities of daily livingrehabilitationcase report |
| spellingShingle | Daichi Shima Daichi Shima Tokio Kinoshita Tokio Kinoshita Yasunori Umemoto Yoshinori Yasuoka Yoshinori Yasuoka Takamasa Hashizaki Takamasa Hashizaki Makoto Asaeda Yukihide Nishimura Tamaki Yahata Takashi Shimoe Fumihiro Tajima Case report: Physical findings, physical therapy practice, and characteristics of disability of activities of daily living caused by obturator nerve palsy after neurotmesis Frontiers in Neurology obturator nerve peripheral nerve injury activities of daily living rehabilitation case report |
| title | Case report: Physical findings, physical therapy practice, and characteristics of disability of activities of daily living caused by obturator nerve palsy after neurotmesis |
| title_full | Case report: Physical findings, physical therapy practice, and characteristics of disability of activities of daily living caused by obturator nerve palsy after neurotmesis |
| title_fullStr | Case report: Physical findings, physical therapy practice, and characteristics of disability of activities of daily living caused by obturator nerve palsy after neurotmesis |
| title_full_unstemmed | Case report: Physical findings, physical therapy practice, and characteristics of disability of activities of daily living caused by obturator nerve palsy after neurotmesis |
| title_short | Case report: Physical findings, physical therapy practice, and characteristics of disability of activities of daily living caused by obturator nerve palsy after neurotmesis |
| title_sort | case report physical findings physical therapy practice and characteristics of disability of activities of daily living caused by obturator nerve palsy after neurotmesis |
| topic | obturator nerve peripheral nerve injury activities of daily living rehabilitation case report |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1062018/full |
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