Focal muscle vibration and neurocognitive exercise improve function and reduce neuropathic pain after sciatic nerve injury. A case report assessment through gait analysis

Filippo Camerota¹Naomi Francesca Pocino^2*Federico Zangrando¹Alessia Lucani²Marco Paoloni²Massimiliano Mangone²Claudia Celletti³

• ¹Physical Medicine and Rehabilitation Division, Umberto I University Hospital, Rome, Italy
• ²Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, Rome, Italy
• ³Department of Life Sciences, Health, and Health Professions, Link Campus University, Rome, Italy

Sciatic nerve may be injured during total hip arthroplasty (THA). This complication can lead to severe neuropatic pain syndrome. The aim of this case report is to investigate the effect of a combined treatment approach involving neurocognitive rehabilitation and focal mechanical vibrations in a patient affected by iatrogenic sciatic nerve injury and neuropathic pain following total hip arthroplasty (THA). Patient was followed over a total period of one year, during which she underwent three cycles of twelve weeks of neurocognitive physiotherapy, with weekly one-hour sessions, interspersed with two cycle of one week of therapy involving only focal mechanical vibrations (fMV). She was also evaluated with clinical scale and gait analysis. We have observed a significant reduction in the pain perceived by the patient, although not complete, but interestingly the patient reported resolution of allodynia right after first fMV session. Furthermore, the duration of the gait cycle approached more normal values. Overall, the combined treatment of neurocognitive rehabilitation and focal mechanical vibrations yielded positive results and contributed significantly to the reduction of chronic neuropathic pain in the patient. Simultaneously, the focal mechanical vibrations seem to provide crucial proprioceptive stimulation, promoting better motor control and further aiding in neuropathic pain reduction.