Early multimodal rehabilitation and functional outcomes of a left brachial plexus injury after general anesthesia: a case report.

This is one patient with no comparison group, so nothing here shows the rehabilitation caused the recovery. He received five drugs (methylcobalamin, adenosine cobalamin, nerve growth factor, ganglioside and dexamethasone) at the same time as the exercise programme, and the authors say the two cannot be separated. Incomplete upper trunk brachial plexus injuries can recover by themselves, so some of this recovery may have happened without any treatment. The nerve injury was never seen on imaging. MRI of the brachial plexus was normal and the diagnosis was inferred from the examination and nerve studies, so the exact site and severity were never confirmed directly. The strength and shoulder scores come from unblinded assessments of a single patient, and the content of the programme was adjusted during the six months, so what was actually delivered changed over time. The patient was a healthy adolescent with an incomplete injury and no other medical conditions, which says nothing about older patients, complete injuries, or people with other illnesses.

The authors declare that they received no financial support for this work or its publication. No other competing interests are described in the text provided.

Do not read this as proof that early rehabilitation restores arm function after a brachial plexus injury. The patient was also given five drugs at the same time, incomplete upper trunk injuries can recover spontaneously, and the authors themselves say the two treatments cannot be told apart. One teenager's recovery is a description of what happened, not evidence that a treatment works.