Safety of “pain exposure” physical therapy in patients with complex regional pain syndrome type 1

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• 作者：Hendrik van de Meent^a ; ^{h.vandemeent@reval.umcn.nl"" rel=""nofollow} ; Margreet Oerlemans^c ; Almar Bruggeman^d ; Frank Klomp^b ; Robert van Dongen^e ; Rob Oostendorp^c ; Jan Paul Frö ; lke^d
• 关键词：Complex regional pain syndrome ; Reflex sympathetic dystrophy ; Pain ; Physical therapy (specialty) ; Safety ; Quality of life
• 刊名：Pain
• 出版年：2011
• 出版时间：June 2011
• 年：2011
• 卷：152
• 期：6
• 页码：1431-1438
• 全文大小：202 K

文摘

“Pain exposure” physical therapy (PEPT) is a new treatment for patients with complex regional pain syndrome type 1 (CRPS-1) that consists of a progressive-loading exercise program and management of pain-avoidance behavior without the use of specific CRPS-1 medication or analgesics. The aim of this study was to investigate primarily whether PEPT could be applied safely in patients with CRPS-1. Twenty patients with CRPS-1 were consecutively enrolled in the study after giving informed consent. The diagnosis of CRPS-1 was defined using the Bruehl and Harden/IASP diagnostic criteria. CRPS-1 was diagnosed between 3 and 18 months after the inciting event (trauma). According to a multiple single-case design (baseline [A1], treatment [B], follow-up [A2]), multiple baseline and follow-up measurements were performed to evaluate changes in CRPS signs and symptoms and to assess functional parameters. When comparing the baseline with the follow-up phase, patients improved significantly with respect to pain on the visual analogue scale (57 % ), pain intensity (48 % ), muscle strength (52 % ), arm/shoulder/hand disability (36 % ), 10-meter walking speed (29 % ), pain disability index (60 % ), kinesiophobia (18 % ), and the domains of perceived health change in the SF-36 survey (269 % ). Three patients initially showed increased vegetative signs but improved in all other CRPS parameters and showed good functional recovery at follow-up. We conclude that PEPT is a safe and effective treatment for patients with CRPS-1.

A progressive-loading exercise program and management of pain-avoidance behavior without the use of specific medication (“pain exposure” physical therapy) is safe and effective for patients with complex regional pain syndrome.