Adults with Complex Regional Pain Syndrome Type 1 Involving the Upper Extremity: A Novel Biokinesio-Psychosocial Movement System Diagnostic Classification Approach

Abstract

Complex regional pain syndrome type 1 (CRPS Type 1) is a painful and often disabling condition that encompasses an array of complex pathophysiological mechanisms. Along with an assortment of various diagnostic symptoms, CRPS Type 1 generally encompasses pathological centrally and/or peripherally based motor symptoms, including dystonia, bradykinesia, tremor, perceptual and neglect-like symptoms, deconditioning, reduced range of motion, along with others. These motor symptoms can commonly lead their way to movement system dysfunctions. Although irretractable pain is the most frequent and intense symptom experienced in patients with CRPS Type 1, motor symptoms and the movement system are the primary content explored within this paper. Notably, the following review focuses its attention on CRPS Type 1 in the upper extremity of the adult population. The author of this paper has introduced the novel term of the biokinesio-psychosocial model, and is suggested to embrace the movement system in a richer and more inclusive light. The main distinguishing factor between the biopsychosocial model and the biokinesio-psychosocial framework is the introduction of a kinesiological approach towards examining and treating a dysfunctional movement system, specifically in patients with CRPS Type 1. In addition, the review pays attention to biological/ physiological, psychological and social variables that importantly contribute to the diagnosis and treatment of CRPS Type 1. A description of the movement system in relation to CRPS Type 1 is also provided along with an example and critique of a few current existing measures that may be used to assess various motor impairments in patients with CRPS Type 1. Whilst concentrating on the central nervous system as a key perpetrator towards various motor impairments, the review also focuses on psychosocial elements that contribute to the overall experience of a defective movement system in patients with CRPS Type 1. Finally, the review describes the notion of movement system diagnoses or classification systems in relation to CRPS Type 1. With an emphasis on the biokinesio-psychosocial paradigm, 3 newly established movement system diagnoses or classification schemes in relation to adult patients with CRPS Type 1 of the upper extremity, are produced and described in terms of how and when to use them.