I. Overview Peripheral nerves consist of ganglia, plexuses, nerve trunks and nerve endings, which are divided into spinal nerves, cerebral nerves and visceral nerves. Peripheral nerves are mostly mixed nerves, containing sensory fibers, motor fibers and autonomic fibers. Peripheral nerve lesions can generally be divided into two categories: peripheral nerve injury and neuropathy. Peripheral nerve injury is due to the injury of nerve plexus, nerve trunk or other branches by external force, such as crush injury, pull injury, contusion, laceration, medical injury, etc. The main pathological change is the occurrence of Valerian degeneration of nerve fibers distal to the injury; neuropathy refers to the lesions of certain parts of peripheral nerves caused by inflammation, poisoning, ischemia, metabolic disorders, etc., old name is neuritis, axonal degeneration is one of the common Axonal degeneration is one of the common pathological changes, which is basically similar to Waller’s degeneration. Peripheral nerve injury can be classified according to the Seddon method: nerve loss: nerve axons and nerve membranes are intact, with temporary loss of conduction function; nerve axon disruption: nerve outer membrane, nerve bundle membrane, nerve inner membrane and Schwann cells are intact, with partial or complete disruption of nerve axons, with Waller degeneration and partial or complete loss of motor and sensory function; nerve dissection: nerve continuity is interrupted, resulting in motor and sensory complete loss of function. Nerve disuse is most often caused by crush or drug damage and usually results in complete recovery within 6 months. Axonal rupture is mostly caused by crushing or pulling and can recover on its own, but the axon needs to regenerate distally from the site of injury at a rate of about 1-2 mm/d, so it takes a longer time. Nerve rupture is mostly caused by severe strain or cutting injury, and must be repaired surgically. According to the Sunerland method, peripheral nerve injury can be divided into 5 degrees. The main clinical manifestations of peripheral nerve injury: (1) motor disorders: delayed paralysis, reduced muscle tone, muscle atrophy (2) sensory disorders: manifested as hypoesthesia or loss of sensation, sensory hypersensitivity, subjective numbness, spontaneous pain, etc. (3) Reflex disorder: weakening or disappearance of tendon reflexes. (4) Autonomic dysfunction: redness or cyanosis of the skin; low skin temperature; no sweating; little or excessive sweating; rough and brittle nails, etc. Common peripheral nerve injuries include brachial plexus nerve injury, radial nerve injury, median nerve injury, ulnar nerve injury, sciatic nerve injury, common peroneal nerve injury, carpal tunnel syndrome, diabetic peripheral neuropathy, trigeminal neuralgia, idiopathic facial nerve palsy, intercostal neuralgia, sciatica, etc. The purpose of rehabilitation treatment is to prevent and control various complications in the early stage; to promote the regeneration of damaged nerves in the late stage, so as to promote the recovery of motor and sensory functions, prevent the contracture and deformation of the limbs, and finally improve the patients’ daily life and working ability and improve the quality of life. Rehabilitation treatment should be intervened early, and the earlier the intervention, the better the effect. The earlier the intervention, the better the effect. Treatment is targeted according to the different periods of the disease. (i) Early stage The early stage is usually 5-10 days after the onset of the disease. The first step is to remove the causative factors, reduce the damage to the nerve, prevent the occurrence of joint contracture, and prepare for nerve regeneration: 1, maintain the functional position of the joints of the affected limb Apply orthoses, plaster rests, or even towels to keep the joints of the affected limb in a functional position. For example, the wrist joint should be fixed in a functional position of 20°-30° of dorsiflexion when the wrist is hanging, and the ankle joint should be fixed in a functional position of 90° when the foot is hanging. 2.Active and passive activities of the joints of the involved limb Due to factors such as swelling, pain, poor limb position and muscle imbalance, joint contracture and deformity often occur after peripheral nerve injury, so the joints of the involved limb should do full range of passive movements of each axis at least 1-2 times a day in order to maintain the normal range of motion of the involved joints. If the degree of damage is mild, active movement should be performed. 3.Treatment of swelling in the affected limb Elevation of the affected limb, elastic bandages, gentle centripetal massage and passive movement of the affected limb, ice and other measures can be used. Edema is related to the impaired blood circulation and increased tissue fluid exudation after the lesion. 4.Physical factor application Early application of ultrashort wave, microwave, infrared and other warm therapy is conducive to improving local blood circulation, promoting the absorption of edema inflammation, and promoting nerve regeneration, and hydrotherapy can be carried out when available. 5.Protection of the involved parts As the involved limbs have sensation and are prone to secondary trauma, attention should be paid to the protection of the involved parts, such as wearing gloves and socks. If trauma occurs, choose appropriate physical factors for physical factor treatment, such as ultraviolet light, to promote early wound healing. (ii) Recovery period After the early inflammatory edema subsides, the recovery period is entered, and the early therapeutic measures can still be selectively continued. The focus of this period is to promote nerve regeneration, maintain muscle mass, enhance muscle strength and promote the recovery of sensory function. 1.Neuromuscular electrical stimulation therapy After peripheral nerve damage, muscle paralysis, neuromuscular electrical stimulation therapy can be used to maintain muscle mass and meet the regeneration of nerve innervation. The first month after the loss of innervation, muscle atrophy is the fastest, it is appropriate to carry out early neuromuscular electrical stimulation, several months after the loss of nerve is still necessary to practical neuromuscular electrical stimulation. Usually a triangular current is used for electrical stimulation. In addition, direct current, modulated medium frequency, warmth, etc. can also be used for treatment. 2. muscle strength training When the muscle strength of the affected innervated muscles is 0-1, passive exercise, myoelectric biofeedback and other treatments are carried out. When the muscle strength of the affected innervated muscles is level 2-3, perform power-assisted exercise and active exercise machine instrumental exercise. However, it should be noted that the amount of exercise should not be too large to avoid muscle fatigue. As the muscle strength increases, gradually reduce the assistance, when the muscle strength of the affected innervated muscles is 3+-4, resistance exercises can be performed to strive for the maximum recovery of muscle strength. At the same time to carry out speed, endurance, sensitivity, coordination and balance of specialized training. 3, ADL training In addition to muscle strength training, attention should be paid to the combination of functional activities and activities of daily living training. For example, upper limb exercises such as washing face, combing hair, dressing, reaching for objects, etc., and lower limb exercises such as pedaling bicycle and kicking ball. The difficulty and time of training will be increased continuously to enhance the flexibility and endurance of the body. 4.Operational therapy According to the site and degree of dysfunction, muscle strength and endurance test results, the relevant operational therapy. Patients with peripheral nerve injury of the upper limbs can carry out carpentry, preparation, clay modeling, typing, repairing instruments, hoops, and other operations, and patients with peripheral nerve injury of the lower limbs can pedal bicycles, sewing machines and other exercises. 5, sensory training first tactile training, the choice of soft objects rubbing the palm side of the finger skin, and then vibration sensory training. After going to training involves the identification of multiple objects size, shape, texture and material, training principles are: from large objects to small objects, from simple objects to complex objects, from rough texture to fiber texture. 6.Promote nerve regeneration Nerve growth factor, vitamin B and other drugs, as well as ultra-short wave, microwave and other physical factors can be used to facilitate the regeneration of damaged nerves. 7.Surgical treatment Patients with peripheral nerve injury for which conservative treatment is ineffective and surgery is indicated should undergo timely surgical treatment. Such as nerve exploration, nerve relaxation, nerve grafting, etc.