Article

Retrospective cohort study. 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). 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.
CI - Copyright (c) 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS