Complex Regional Pain Syndrome type I (CRPS I) and self-rehabilitation: A health-related quality of life study

Abstract

A rehabilitation program, with successive types of exercises, including limb laterality recognition, imagined movements and mirror therapy, can be conducted in patients with CRPS I1. This graded motor imagery program, developed by Moseley, needs patients’ participation, is educative, and improves edema, pain, and functional capacities. We want to investigate whether this program would improve health-related quality of life of patients with CRPS I. All patients with upper or lower limb CRPS I are included. The program includes physical and occupational therapies twice a week, in association with daily exercises at home, for a period of 6 weeks. Pain (Visual Analog Scale pain and Saint-Antoine survey), health-related quality of life (MOS-SF-36) and for upper limb strength (Jamar dynamometer), function (box and block test) and disabilities (DASH survey) are assessed at the beginning and the end of the therapy. Six patients (5 females and 1 male) are included, whose 4 with upper limb and 2 with lower limb CRPS I. The mean length of CRPS I is about 289 days. Emotional and sensory scores of Saint-Antoine survey decrease in all patients. At the upper limb, strength, dexterity and disabilities are improved. Health-related quality of life (all MOS-SF-36 items) is improved. Graded motor imagery program is successful for patients with CRPS I, by reducing pain and improving function and health-related quality of life, even after a significant delay. It requires a high level of motivation, and provides some educational value. However, the impact on daily life remains important, due to physical limitations. More studies, with larger populations, must obviously be conducted to confirm this data.