Current rehabilitation for adults with peripheral nerve injuries in the UK: An online survey

Peripheral nerve injuries can lead to paralysis, sensory loss, chronic pain, and profound psychological and vocational consequences. Recent UK guidelines recommend biopsychosocial rehabilitation, yet qualitative evidence suggest gaps in service provision. This study explored current rehabilitation and perceived barriers among therapists treating adults with peripheral nerve injuries.

A cross-sectional online survey was distributed to UK physiotherapists and occupational therapists experienced in upper and lower limb peripheral nerve injury rehabilitation. Questions captured demographics, treatment strategies before and after reinnervation, access to psychological support, and perceived organisational barriers. Descriptive analysis was undertaken.

Fifty-three respondents (60% physiotherapists, 40% occupational therapists) completed the survey; 70% had more than 10 years' experience. Ninety eight percent of respondents treated adults with upper limb nerve injuries. Motor and sensory interventions (active and passive range of motion, splinting, strength training, and functional activity) were reported as "always/frequently" used by >80% of respondents. Over a quarter of respondents (28%) occasionally/rarely used pain neuroscience education. Other specific psychological interventions including cognitive behavioural techniques and mindfulness were rarely used (<30% always/frequently). Over half respondents reported no outpatient access to clinical psychology. Organisational barriers included limited time, funding, skilled staff, and absence of local guidelines. However, 83% believed therapists could deliver more psychologically informed care.

UK rehabilitation for adults with peripheral nerve injuries remains predominantly biomedical, with limited integration of psychologically informed care and limited access to Clinical Psychology. Addressing systemic barriers and evaluating digital or hybrid models may enable more biopsychosocial, patient-centred care.