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Department| Volume 19, ISSUE 4, P438-439, October 2006

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Client Satisfaction of Hand Therapy Intervention: An Evaluation of the Effectiveness of Therapy for Clients Recovered from Complex Regional Pain Syndrome

      Complex regional pain syndrome (CRPS) is a neuropathic pain condition that may develop following trauma to an extremity. The purpose of our investigation was to conduct a mail survey to evaluate their level of satisfaction with the hand therapy treatment. Out of 60 participants, 28 respondents sent completed questionnaires. Using Dillman's method, a response rate of 53.84% was achieved. The study was designed to include a self-evaluation of the client's status before and after receiving therapy. The survey questions were formulated based on a review of CRPS literature and were drawn from several standardized previously validated instruments. Using Statistical Package for the Social Sciences, the data were analyzed. A majority of the participants (78.60%) were females, and only 21.40% were males. Participants were between the ages of 40 and 80 years (mean=59.03, SD=12.49). While 89.30% were right handed, 10.70% were left handed, and 64.30% of the respondents reported CRPS in their dominant hand. In addition, almost all participants (93%) indicated that they experienced CRPS as a result of an injury to the affected hand, with 75% of these injuries being fractures and 25% being soft tissue trauma and nerve injury. A majority (64.30%) indicated that they were diagnosed with CRPS early. Pain medications were administered to 96.4% of participants. Splints (82.10%) and nerve block injections (71.40%) were the next most prescribed treatment modalities. The continuous passive motion machine (CPM) was used in 53.60% of the cases, while 14.30% of participants reported the use of other treatment modalities. On average, the scores for the effectiveness of the different combinations of treatment modalities (mean=6.24, SD=2.50) suggest a clinically effective outcome. The clients' satisfaction level ranged between 2 and 5 on a scale ranging from 1 (not at all) to 5 (extremely). The mean score (mean=4.59, SD=0.79, N=27) suggests that satisfaction with the therapy/treatment received was remarkably high. Table 1 shows the results indicating a significant decrease in the amount and frequency of pain and improvement in their functional status. Clients' overall level of satisfaction with the treatment they received is based on its positive effect on their functional status, pain severity and frequency, and emotional status. The clients' satisfaction level ranged between 2 and 5 on a scale ranging from 1 (not at all) to 5 (extremely). The mean score (mean=4.59, SD=0.79, N=27) suggests that satisfaction with the therapy/treatment received was remarkably high.
      Table 1Functional Status, Pain Severity and Frequency, and Emotional Status Ratings from Pre- and Posttherapy
      Pretherapy Scores Posttherapy Scores Change Scores
      Mean SD Mean SD Mean SD t df N
      Combined specific activities 28 9.46 0.91 5.14 3.20 4.31 3.48 6.54* 27
      Combined regular activities 27 9.06 1.30 4.85 3.22 4.21 3.24 6.75* 26
      Combined pain severity 27 9.19 1.03 5.09 3.27 4.09 3.00 7.09* 26
      Pain frequency 26 4.23 1.14 3.07 1.32 1.15 1.73 3.38* 25
      Emotional problems with social activities 27 3.85 1.32 2.92 1.38 0.92 1.17 4.09* 26
      Note: The values represent significant decreases in all means posttherapy, which, in turn, reflect a decrease in the level of difficulty in functional status, in pain severity and frequency, and in the limitation of participation in social activities experienced by clients. *p<0.05.
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