Article

OBJECTIVE: To determine if treatment of longstanding complex regional pain
syndrome type 1, focusing on functional improvement only while neglecting pain,
results in clinical improvement of this syndrome. DESIGN: Prospective description
of a case series of 106 patients. Outpatient clinic for rehabilitation.
INTERVENTIONS: Physical therapy of the affected limb directed at a functional
improvement only while neglecting the pain, was performed following an extensive
explanation. Normal use of the limb between the treatments was encouraged despite
pain. A maximum of five of these sessions were performed in three months.
MEASURES: Radboud Skills Test was used to monitor functional improvement of the
arms. Speed and walking distance was used as the measure of outcome for the legs.
RESULTS: The function of the affected arm or leg improved in 95 patients. Full
functional recovery was experienced in 49 (46%) of them. A reduction in pain
presented in 75 patients. In 23 patients functional recovery was reached despite
an increase in pain. Four patients stopped early due to pain increase.
CONCLUSIONS: Our results suggest that 'pain exposure physical therapy' is
effective and safe for patients who are unresponsive to accepted standard
therapies. Avoiding the use of a limb due to pain will result in loss of
function. Forced usage of limbs restores the function, reverses these adaptive
processes and leads to regain of control by practice with a reduction of pain in
most cases.

Langue : ANGLAIS