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Journal Review: Sensory nerve regeneration and reinnervation in muscle following peripheral nerve injury
Journal Review: Sensory nerve regeneration and reinnervation in muscle following peripheral nerve injury

Sensory afferent fibers are an important component of motor nerves and com-pose the majority of axons in many nerves traditionally thought of as “pure” motor nerves. These sensory afferent fibers innervate special sensory end organs in muscle, including muscle spindles that respond to changes in muscle length and Golgi tendons that detect muscle tension. Both play a major role in proprioception, sensorimotor extremity control feedback, and force regulation. After peripheral nerve injury, there is histological and electrophysiological evi-dence that sensory afferents can reinnervate muscle, including muscle that was not the nerve's original target. Reinnervation can occur after different nerve injury and muscle models, including muscle graft, crush, and tran-section injuries, and occurs in a nonspecific manner, allowing for cross-innervation to occur. Evidence of cross-innervation includes the following: mus-cle spindle and Golgi tendon afferent-receptor mismatch, vagal sensory fiber reinnervation of muscle, and cutaneous afferent reinnervation of muscle spindle or Golgi tendons. There are several notable clinical applications of sensory rein-nervation and cross-reinnervation of muscle, including restoration of optimal motor control after peripheral nerve repair, flap sensation, sensory protection of denervated muscle, neuroma treatment and prevention, and facilitation of prosthetic sensorimotor control. This review focuses on sensory nerve regener-ation and reinnervation in muscle, and the clinical applications of this phenomena. Understanding the physiology and limitations of sensory nerve regeneration and reinnervation in muscle may ultimately facilitate improvement of its clinical applications.

1)Develop an understanding of the muscle sensory system and apply it to the care of patients with peripheral nerve injury;
2) Understand how muscle afferent regeneration and reinnervation after peripheral nerve transection occurs, and be able to apply it to assessment and care in clinical practice;
3)Understand the implications of sensory nerve regeneration and end-organ reinnervation for neuroma surgery and prosthetic sensory interfaces so that these can be applied to clinical care. 

The AANEM is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The AANEM designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits TM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. Credit expires 10/10/2025.

None of the authors has any conflict of interest to disclose.

Widya Adidharma ,MD; Alexander N. Khouri, MD; Jennifer C. Lee, MSE; Kathryn Vanderboll, MLIS; Theodore A. Kung, MD; Paul S. Cederna, MD; Stephen W. P. Kemp, PhD.
Availability: On-Demand
Expires on Oct 10, 2025
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Non-Member: $25.00
Credit Offered:
1 CME Credit
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