Abstract
Study design
Case report.
Introduction
Conventional rehabilitation alone may not be effective in reducing symptoms in some
patients with complex regional pain syndrome.
Purpose of the study
This case report portrays the benefits of a new tailored rehabilitation program for
a 39-year-old patient suffering from upper limb complex regional pain syndrome with
severe touch-evoked pain (static mechanical allodynia).
Methods
This patient had previously received conventional rehabilitation for a year and a
half including physical and nonsurgical medical interventions that did not improve
symptoms or function. In the search for an alternative, this patient was referred
to occupational therapy to try a tailored rehabilitation program, drawing on multiple
strategies used sequentially according to the patient's tolerance and symptom evolution.
During this 22-month program, the following methods were added (listed chronologically):
somatosensory rehabilitation of pain method, graded motor imagery, pain management
modalities, active mobilizations, strengthening exercises, and task simulation. The
patient successively showed resolution of mechanical allodynia, decreased pain, reduction
of tactile hypesthesia and improvement in active range of motion, strength, and function.
These improvements allowed him to return to work.
Discussion
This suggests that a tailored rehabilitation program combining somatosensory rehabilitation
of pain method, graded motor imagery and more conventional approaches could improve
symptoms and functional status in patients with upper limb complex regional pain syndrome,
even with persistent refractory symptoms.
Conclusion
The addition of the somatosensory rehabilitation of pain method and the graded motor
imagery approach to conventional therapy could be considered in cases of complex regional
pain syndrome that do not respond to conventional rehabilitation alone.
Keywords
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JHT Read for Credit
Quiz: #539
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- #1.The rehab program consisted of
- a.resistive exercise
- b.graded motor imagery
- c.somatosensory rehab
- d.all of the above
- a.
- #2.The study design was a
- a.systematic review
- b.single RCT
- c.case study
- d.qualitative report
- a.
- #3.The primary feature of the patient’s CRPS was
- a.mechanical allodynia
- b.thermal allodynia
- c.sensory disturbance
- d.coordination disturbance
- a.
- #4.Clinic visits were
- a.daily for 22 weeks
- b.BIW for the first 15 weeks; once per week thereafter
- c.TIW for one year
- d.on an as needed basis
- a.
- #5.The authors were able to isolate the single most effective intervention that contributed to the resolution of the CRPS
- a.true
- b.false
- a.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Article info
Publication history
Accepted:
January 22,
2018
Received in revised form:
January 16,
2018
Received:
November 28,
2017
Footnotes
Conflict of interest: All named authors hereby declare that they have no conflicts of interest to disclose.
Identification
Copyright
© 2018 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved.
