Impact of Structured Physiotherapy on Post-Surgical Outcomes of Upper Limb Peripheral Nerve Injuries

Peripheral nerve injuries of the upper limb frequently lead to severe motor and sensory impairment, surgery restores nerve continuity, and functional recovery often remains suboptimal without structured rehabilitation. This study evaluated the impact of Structured Physiotherapy on Post-Surgical Outcomes of Upper Limb PNI.

A prospective comparative cohort design was implemented across tertiary hospitals. One hundred participants who underwent surgical repair for median, ulnar, or radial nerve injuries were consecutively recruited and followed for 6 months. Fifty patients received a structured physiotherapy program, while 50 received routine postoperative care. Functional (DASH, MHQ), motor (MRC grade), sensory (Semmes-Weinstein), pain (VAS), and work-return outcomes were evaluated at baseline, 6 weeks, 3 months, and 6 months. Data were analyzed using repeated-measures ANOVA and multivariable mixed-effects models with baseline adjustment.

Mean DASH scores improved from 65.2 ± 10.4 at baseline to 32.4 ± 11.2 at 6 months compared to 64.7 ± 11.1 to 44.7 ± 12.5 in controls (adjusted mean difference = -10.8; p < 0.001). Motor function (MRC ≥ 4.5: 37.5% vs. 16.7%; p = 0.03), sensory restoration (83.3% vs. 62.5%; p = 0.03), and pain reduction (VAS 2.9 ± 1.1 vs. 4.1 ± 1.3; p < 0.001) significantly favored physiotherapy. Return-to-work rates were higher (70.8% vs. 50%; p = 0.04).

Structured physiotherapy accelerates neurofunctional recovery and bridges the persistent gap between surgical repair and real-world functionality. These findings suggest that even within resource-limited settings, the scientific application of structured rehabilitation can transform nerve repair outcomes from anatomical success to true functional independence.