COMPARISON OF EFFECTIVENESS OF HOME-BASED DONOR ACTIVATION FOCUSED REHABILITATION APPROACH (DAFRA) AND INSTITUTIONAL BASED REHABILITATION FOLLOWING UPPER LIMB NERVE TRANSFERS IN REGAINING FUNCTION

Authors

  • Nousheen Saleem Department of Plastic Surgery, Fauji Foundation Hospital, Rawalpindi, Foundation University Islamabad-Pakistan https://orcid.org/0009-0004-2070-5590
  • Ahmed Ali Department of Plastic Surgery, Fauji Foundation Hospital, Rawalpindi, Foundation University Islamabad-Pakistan
  • Ayesha Aslam Department of Plastic Surgery, Fauji Foundation Hospital, Rawalpindi, Foundation University Islamabad-Pakistan https://orcid.org/0000-0001-8780-8990
  • Sameena Aman Department of Plastic Surgery, Fauji Foundation Hospital, Rawalpindi, Foundation University Islamabad-Pakistan
  • Mehwish Mehmood Department of Plastic Surgery, Fauji Foundation Hospital, Rawalpindi, Foundation University Islamabad-Pakistan https://orcid.org/0000-0001-5891-4073
  • Hira Feroz Department of Plastic Surgery, Fauji Foundation Hospital, Rawalpindi, Foundation University Islamabad-Pakistan https://orcid.org/0000-0001-7036-3024
  • Samia Rizwan Department of Plastic Surgery, Fauji Foundation Hospital, Rawalpindi, Foundation University Islamabad-Pakistan
  • Nadiya Tariq Department of Plastic Surgery, Fauji Foundation Hospital, Rawalpindi, Foundation University Islamabad-Pakistan
  • Anum Ikram Department of Plastic Surgery, Fauji Foundation Hospital, Rawalpindi, Foundation University Islamabad-Pakistan
  • Shanzay Hummayoun Department of Plastic Surgery, Fauji Foundation Hospital, Rawalpindi, Foundation University Islamabad-Pakistan

DOI:

https://doi.org/10.55519/JAMC-01-12823

Keywords:

Keywords: Brachial Plexus injury, nerve transfer, rehabilitation, DAFRA, sensorimotor function, Muscle strength, MCR grading.

Abstract

Introduction: Brachial Plexus injuries cause devastating impact on quality of life. Management of these injuries include surgical intervention of nerve transfer and then rehabilitation post surgically to maximize the functional outcome. Rehabilitation can be institutional-based or donor activation focused rehabilitation approach. (DAFRA). Purpose of the study was to evaluate and compare the results of home-based donor activation focused rehabilitation approach and institutional-based rehabilitation following nerve transfers in upper limb. Methods: It is a comparative study which was conducted from January 2015 to December 2022. Patients were divided into two groups, Group A included patients who had a home-based exercise program that is DAFRA and Group B consisted of patients who underwent institutional based rehabilitation. After 3 weeks of surgery rehabilitation was started and the gain in muscle strength was recorded using Medical Research Council’s (MCR) grading for muscle strength at 18 months was compared in both groups. Results:  Total 23 patients under went 41 nerve transfers. Group A had 16 patients with 27 nerve transfers and group B had 7 patients with 14 nerve transfers. Mean age of the patients was 35.13±18.6 years in Group A while 36.57±15.62 years in the Group B. Mean gain in muscle strength in home-based DAFRA was 3.96±0.922 (out of 5) and that in institutional based rehabilitation was 3.71±0.726 (out of 5). Conclusion: It can be concluded that significant improvements can be gained by vigorous rehabilitation regimens either in institutions or at home targeting donor nerves. Home based DAFRA exercises are equally effective as institutional based rehabilitation.

Author Biography

Ahmed Ali, Department of Plastic Surgery, Fauji Foundation Hospital, Rawalpindi, Foundation University Islamabad-Pakistan

Correspondence:

Department of Plastic Surgery, Fauji foundation Hospital, Jehlum Road, Defence Chowk Rawalpindi-Pakistan

Email: royal_drali@yahoo.com

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Published

2025-03-15

How to Cite

1.
Saleem N, Ali A, Aslam A, Aman S, Mehmood M, Feroz H, et al. COMPARISON OF EFFECTIVENESS OF HOME-BASED DONOR ACTIVATION FOCUSED REHABILITATION APPROACH (DAFRA) AND INSTITUTIONAL BASED REHABILITATION FOLLOWING UPPER LIMB NERVE TRANSFERS IN REGAINING FUNCTION. J Ayub Med Coll Abbottabad [Internet]. 2025 Mar. 15 [cited 2025 Jul. 19];37(1). Available from: https://www.jamc.ayubmed.edu.pk/index.php/jamc/article/view/12823

Issue

Vol. 37 No. 1 (2025): JOURNAL OF AYUB MEDICAL COLLEGE ABBOTTABAD

Section

ORIGINAL ARTICLE

License

Copyright (c) 2025 Nousheen Saleem, Ahmed Ali, Ayesha Aslam, Sameena Aman, Mehwish Mehmood , Hira Feroz, Samia Rizwan, Nadiya Tariq, Anum Ikram, Shanzay Hummayoun

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