The aim of this study was to evaluate the impacts of BFR combined with swimming on functional recovery and nerve degeneration in a rat model of brachial plexus stretch injury.
Thirty adult male Sprague-Dawley (SD) rats, 8 weeks old and weighing 200-250g, were randomly divided into three groups: BFR with swimming group (BS, n=10), swimming alone group (S, n=10), and sham-intervention control group (C, n=10). All rats underwent unilateral brachial plexus stretch and crush surgery (BPSI) by applying a pulling force with forceps. Ten days post-surgery, interventions consisting of BFR-combined swimming, swimming alone, and a sham intervention were administered to each group for 20 minutes per session over a 10-day period. Outcome measures, including acetone, von Frey filament, grooming, and walking track tests, were conducted to assess sensory and motor function pre-operatively, post-operatively, and post-treatment. Morphological studies of the nerve in injured and uninjured sides were performed using hematoxylin and eosin (H&E) staining.
There were no significant differences in functional tests among the three groups at timepoints of pre-operation and post-operation (p > 0.05). Significant improvements were found in the mechanical thresholds and index of walking tract analysis in BS group when compared to those of S group. These results were also no significant differences in BS group between time points of pre-surgery and post-treatment (p > 0.05), whereas the S group showed significant differences (p 0.05). Following BPSI, the BS, S, and C groups exhibited significantly more vacuole formation and increased inflammatory cell nuclei compared to their contralateral uninjured sides (p 0.05). Additionally, a significant increase in both vacuole formation and inflammatory cell nuclei was observed in the C group compared to the BS and S groups (p 0.05). Furthermore, BPSI-induced vacuole formation was significantly decreased in the BS group compared to the S group (p 0.05), while no marked differences were observed in inflammatory cells between the BS and S groups (p > 0.05).
The primary goals of peripheral nerve injury treatment are to promote nerve repair, minimize nerve degeneration, and restore functional capabilities. This study demonstrated that combined BFR and swimming therapy can effectively delay nerve degeneration and improve functional outcomes following BPSI. Future studies could explore the underlying mechanisms of BFR's neuroprotective effects and investigate the optimal duration and intensity of BFR combined with swimming therapy.
These results suggest that BFR combined with swimming is a promising therapeutic approach for improving functional outcomes and reducing nerve damage following BPSI.
brachial plexus injury
functional recovery
