Somatosensory rehabilitation for allodynia in complex regional pain syndrome of the upper limb: A retrospective cohort study
| Autor: | D. Norman Buckley, Susan L. Michlovitz, Tara L. Packham, C J Spicher, Joy C. MacDermid |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Somatosensory rehabilitation Physical Therapy Sports Therapy and Rehabilitation Allodynia Upper Extremity Monofilaments 03 medical and health sciences Young Adult 0302 clinical medicine 030202 anesthesiology Medicine and Health Sciences Medicine Humans Physical Therapy Modalities Burning Pain Aged Pain Measurement Retrospective Studies Rehabilitation business.industry Retrospective cohort study Middle Aged medicine.disease Complex regional pain syndrome medicine.anatomical_structure Treatment Outcome McGill Pain Questionnaire Hyperalgesia Cohort Physical therapy Upper limb Female medicine.symptom business 030217 neurology & neurosurgery Complex Regional Pain Syndromes |
| Zdroj: | Bone and Joint Institute |
| Popis: | Study Design Retrospective cohort study. Introduction Somatosensory rehabilitation is a standardized method of evaluation and conservative treatment of painful disorders of vibrotactile sensation, including the mechanical allodynia and burning pain of complex regional pain syndrome (CRPS). Purpose of the Study The purpose of this study was to examine the effectiveness of somatosensory rehabilitation for reducing allodynia in persons with CRPS of 1 upper limb in a retrospective consecutive cohort of patients. Methods An independent chart review of all client records (May 2004-August 2015) in the Somatosensory Rehabilitation Centre (Fribourg, Switzerland) identified 48 persons meeting the Budapest criteria for CRPS of 1 limb who had undergone assessment and treatment. Outcomes of interest were the French version of the McGill Pain Questionnaire (Questionnaire de la Douleur St-Antoine [QDSA]), total area of allodynia as recorded by mapping the area of skin where a 15-g monofilament was perceived as painful, and the allodynia threshold (minimum pressure required to elicit pain within the allodynic territory). Results This cohort was primarily women (70%), with a mean age of 45 years (range: 18-74). Mean duration of burning pain was 31 months (range: 1 week-27.5 years), and baseline QDSA core was 48. The average primary area of allodynia was 66 cm 2 (range: 2.6-320), and the most common allodynia threshold was 4.0 g. The average duration of treatment was 81 days. At cessation of treatment, the average QDSA score was 20 (effect size Cohen's d = 1.64). Allodynia completely resolved in 27 persons (56% of the total sample where only 58% completed treatment). Discussion This uncontrolled retrospective study suggests that somatosensory rehabilitation may be an effective treatment with a large effect size for reducing the allodynia and painful sensations associated with CRPS of the upper limb. More work is in progress to provide estimates of reliability and validity for the measurement tools for allodynia employed by this method. Level of Evidence 2c. |
| Databáze: | OpenAIRE |
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