Rehabilitation of Neuropathies

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Abstract
Polyneuropathies can be classified according to etiology, symptoms, time course, and prognosis. Peripheral nerves contain motor, sensory, and autonomic fibers. Composite functions depend on their integrity. The evaluation of individual functions is often difficult, because different types of neuropathies require measurement with different scales and scores. Even for similar types of neuropathies, a variety of scales are used. Contrary to mononeuropathies, where the steps of recovery and the influence of rehabilitation have been well studied, concepts for neurorehabilitation of neuropathies are vague. Analogous to the concepts used in mononeuropathies, (1) reversibility similar to neurapraxia, (2) reinnervation after complete or partial lesions, or (3) permanent loss of peripheral nerve function, with or without progression, are seen. Prior to rehabilitation, a careful analysis of motor, sensory, autonomic, and composite functions, as well as additional features such as pain, gait, and posture and secondary effects such as ulcers or bone deformity, quality of life, psychological aspects, communication, fatigue, and social context, is essential. Recent years have shown increasing awareness of neuroplasticity as a central mechanism to compensate for peripheral deficits. Injury to peripheral nerves triggers an acute mechanism that alters maps at multiple subcortical and cortical levels. Selective amplification of neuroplasticity could be a future aspect of neurorehabilitation.

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