Het NPi organiseert geregeld zgn. 'masterclasses'. Onder een masterclass verstaan we: een scholingsactiviteit, gegeven door een (inter-)nationaal gerenommeerde expert, die qua inhoud vernieuwend is voor paramedici die zich in een bepaalde richting hebben gespecialiseerd, en waarvoor een duidelijk omschreven ingangsniveau geldt.
Deze masterclass richt zich specifiek op fysio- en ergotherapeuten die een opleiding Handtherapie volgen of hebben afgerond.

Hand and brain - an evidence-based rehabilitation approach to peripheral nerve injuries

This masterclass presents an evidence-based management of peripheral nerve injuries (PNI) based on neuroscientific research on the interaction between the hand and the brain from day one after an injury. Knowledge about the effect of a peripheral nerve injury on the CNS opens new perspectives to treatment by guided plasticity where rapid as well as slow plasticity mechanisms can be used therapeutically to support and improve function.

The brain has a tremendous capacity to undergo plastic reorganization and adapt, i.e. plasticity, due to environmental changes or injury. The plastic capacity decreases with age but is never lost. Following a peripheral nerve injury there is a within minutes-hours reorganization. Due to misdirection of regenerating axons the signalling from the hand to the brain is changed, resulting in a second line of reorganization in the brain. With the early and later reorganization in mind, the rehabilitation should also be divided in an initial period, phase 1, where no afferent signals are sent from the injured nerve to the brain. Phase 2 starts when axons have re-innervated their mechanoreceptors and muscles. The goal of relearning is to improve sensory and motor function by using the dynamic capacity of the brain, and it is thus our belief that the relearning should start immediately after nerve repair – in phase 1.

Birgitta Rosén, Associate Professor, OT is an experienced occupational therapist. She graduated 1977 and started working with hand therapy1981, and has a special interest in outcome after nerve injuries and in rehabilitation after nerve injuries – sensory re-learning using guided plasticity or extrinsic modulation of brain plasticity mechanisms, and sensory feedback in hand prostheses. She has 83 original scientific articles and 6 book chapters in the field. Her PhD thesis (2000) was entitled ”The Sensational Hand: clinical assessment after nerve repair”. She is course leader and organizer of a commissioned education 15 ECTS at Lund University “Rehabilitation in Hand Surgery” since 2000. She is an experienced speaker nationally and internationally since 20 years back. Since 2009 she has a position at Lund University, with a combination of clinical work at Dpt of Hand Surgery Malmö, Lecturing at Dpt of Health Science Lund University and Research.