The Muscle Shortening Maneuver: a noninvasive approach to the treatment of peroneal nerve injury. A case report

ABSTRACT

Background

The treatment of peripheral nerve injuries is a debated topic. The Muscle Shortening Maneuver (MSM), a physiotherapy approach, is noninvasive and free of side effects; it consists of a muscle shortening and a solicitation in traction applied simultaneously.

Objective

The focus of this report is to describe the effects of the MSM combined with walking retraining in a patient with incomplete injury of the peroneal nerve.

Description

The patient was a 17-year-old man, who underwent osteotomy surgery of the proximal two-thirds of the fibula, due to an Ewing sarcoma that caused a partial injury of the left peroneal nerve. Our assessment plan of the left ankle movement ability comprised range of movement, muscle strength, and surface electromyography (EMG); and a gait analysis was conducted by using an iPhone application. MSM and walking retraining were administered twice and once a week, respectively, for 4 weeks.

Outcomes

The active range of movement substantially improved in dorsiflexion (≥15°), whereas slightly decreased in plantar flexion (−5°). Aside from the tibialis anterior, an increase in muscle strength was detected. Surface EMG showed an increased activation, particularly in the peroneus longus. A decrease in gait speed and step length was recorded from the gait analysis, with a better bilateral symmetry.

Conclusions

Positive outcomes were reported without evidence of risk or adverse events for the participant.

KEYWORDS:

• Peroneal nerve
• rehabilitation
• physiotherapy

Acknowledgement

Funding was from the University of Florence, ex 60% RICATEN 2019-21 Bagni MA.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.