Pain reduction due to novel sensory-motor training in Complex Regional Pain Syndrome I – A pilot study

2017 ◽  
Vol 15 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Anne-Christine Schmid ◽  
Anja Schwarz ◽  
Sylvia M. Gustin ◽  
Joel D. Greenspan ◽  
Friedhelm C. Hummel ◽  
...  
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Pain Reduction ◽  
Memory Training ◽  
Motor Training ◽  
Cortical Representation ◽  
Motor Representation ◽  
Home Based ◽  
Sensory Motor ◽  
Before And After

AbstractBackground and aimsPatients suffering from Complex Regional Pain Syndrome (CRPS) of the upper limb show a changed cortical representation of the affected hand. The lip area invades the former hand area contralateral to the affected hand. This change in cortical representation is correlated to the intensity of ongoing pain in patients with CRPS. Further studies revealed that restoration of the original representation coincides with a decrease of pain. Sensory-motor training protocols can increase and/or relocate cortical somatosensory and motor representation areas of the fingers, as shown, for example, in Braille reading individuals and professional violin players. Further, there is evidence that sensory-motor discrimination training has a beneficial effect on both the intensity of pain and the mislocalization of sensory-motor cortical areas in CRPS patients. Based on these propositions, we developed a novel sensory-motor self-training paradigm for CRPS patients to use in a home-based manner.MethodsTen CRPS patients performed the sensory-motor training for 2 weeks. The training consists of a braille-like haptic task with different training modes (bi-manual, speed and memory training). During the training, as well as 1 week before and after, patients were asked to fill out pain diaries. Furthermore, measures of impairment were acquired at baseline and post training.ResultsPatients showed significant pain reduction after the 2 week training period. The overall disability as well as the depression scores showed a trend to improve after the 2 week training. The reduction in pain was correlated with the total amount of training performed.ConclusionsThis is a first proof of principle study of a novel sensory-motor self-training protocol to reduce pain in CRPS patients. The more consistent the patients trained the larger the pain reduction. Sensory-motor training, which can be performed on a regular basis at home might provide a novel interventional strategy to improve symptoms of CRPS.ImplicationsAlthough a larger study needs to be conducted to confirm our findings, including long-term follow-up, the results show, that a sensory-motor home-based training is a strategy worth exploring further for the reduction of pain as well as high frequency training for patients with CRPS.

scholarly journals Effects of early home-based strength and sensory-motor training after total hip arthroplasty: study protocol for a randomized controlled trial

2021 ◽  
Author(s):  
Pika Krištof Mirt ◽  
Vojko Strojnik ◽  
Gregor Kavčič ◽  
Rihard Trebše
Keyword(s):  
Total Hip Arthroplasty ◽  
Strength Training ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Control Group ◽  
Motor Training ◽  
Postoperative Phase ◽  
Total Hip ◽  
Home Based ◽  
Sensory Motor

Abstract BackgroundTotal hip arthroplasty (THA) is very effective in alleviating pain, but functional deficits persist up to a year following surgery. Regardless of standard physiotherapy programs, significant additional muscular atrophy and weakness occurs. Deficits in strength have serious adverse consequences for these patients with respect to physical function, the maintenance of independence and the requirement for revision surgery. Progressive resistance training in rehabilitation following THA has been shown to significantly enhance muscle strength and function. The fundamental principle is to progressively overload the exercised muscle as it becomes stronger. Different strength training protocols have been used at different times in the postoperative phase, in group or individual practices, with major differences being in center-based and home-based programs with or without supervision. The primary objectives of our study are to evaluate whether an early postoperative home-based strength training protocol is feasible for all elective THA patients, does not cause major adverse effects and can improve patient functional outcomes at 3 months and 1 year following surgery.Methods/DesignThis study is a prospective multicenter randomized clinical trial to be conducted in the orthopedic departments of two Slovenian hospitals. In each hospital, 124 patients aged 60 or older with unilateral osteoarthritis, an ASA score between 1 and 3, signed informed consent form, and no terminal illness disabling rehabilitation participation will be randomly assigned to the intervention or control group. THA with an anterior approach will be performed. All patients will receive current standard physiotherapy during hospitalization. Patients in the intervention group will also learn strength and sensory-motor training exercises. Upon discharge all will receive USB drives with exercise videos, written exercise instructions and a training diary. Physiotherapists will perform the assessments (physical tests and the maximal voluntary isometric contraction assessment), and patients will fill out outcome assessment questionnaires (the Harris Hip Score and 36-Item Short Form Health Survey) at baseline and 1, 3 and 12 months after surgery.DiscussionThe main purpose of our study is to design a new standardized rehabilitation protocol with videos that will be effective, safe and accessible to all Slovenian THA patients.Trial registrationClinicalTrials.gov ID: NCT04061993. Protocol ID: PRT_PhD. Record Verification April 2021. https://clinicaltrials.gov/ct2/show/NCT04061993

‘Now you see it, now you do not’: sensory–motor re-education in complex regional pain syndrome

Hand Therapy ◽  
2011 ◽  
Vol 16 (2) ◽  
pp. 29-38 ◽  
Author(s):  
Jennifer S Lewis ◽  
Karen Coales ◽  
Jane Hall ◽  
Candida S McCabe
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Sensory Motor

scholarly journals Outcomes of Sympathetic Blocks in the Management of Complex Regional Pain Syndrome

2019 ◽  
Vol 131 (4) ◽  
pp. 883-893 ◽  
Author(s):  
Jianguo Cheng ◽  
Vafi Salmasi ◽  
Jing You ◽  
Michael Grille ◽  
Dongsheng Yang ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Pain Relief ◽  
Success Rate ◽  
Complex Regional Pain Syndrome ◽  
Spinal Cord Stimulation ◽  
Pain Syndrome ◽  
Pain Reduction ◽  
Secondary Outcome ◽  
Predictive Values ◽  
Sympathetic Blocks

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Sympathetic dysfunction may be present in complex regional pain syndrome, and sympathetic blocks are routinely performed in practice. To investigate the therapeutic and predictive values of sympathetic blocks, the authors test the hypotheses that sympathetic blocks provide analgesic effects that may be associated with the temperature differences between the two extremities before and after the blocks and that the effects of sympathetic blocks may predict the success (defined as achieving more than 50% pain reduction) of spinal cord stimulation trials. Methods The authors performed a retrospective study of 318 patients who underwent sympathetic blocks in a major academic center (2009 to 2016) to assess the association between pain reduction and preprocedure temperature difference between the involved and contralateral limbs. The primary outcome was pain improvement by more than 50%, and the secondary outcome was duration of more than 50% pain reduction per patient report. The authors assessed the association between pain reduction and the success rate of spinal cord stimulation trials. Results Among the 318 patients, 255 were diagnosed with complex regional pain syndrome and others with various sympathetically related disorders. Successful pain reduction (more than 50%) was observed in 155 patients with complex regional pain syndrome (155 of 255, 61%). The majority of patients (132 of 155, 85%) experienced more than 50% pain relief for 1 to 4 weeks or longer. The degree and duration of pain relief were not associated with preprocedure temperature parameters with estimated odds ratio of 1.03 (97.5% CI, 0.95–1.11) or 1.01 (97.5% CI, 0.96–1.06) for one degree decrease (P = 0.459 or 0.809). There was no difference in the success rate of spinal cord stimulation trials between patients with or without more than 50% pain relief after sympathetic blocks (35 of 40, 88% vs. 26 of 29, 90%, P > 0.990). Conclusions The authors conclude that sympathetic blocks may be therapeutic in patients with complex regional pain syndrome regardless of preprocedure limb temperatures. The effects of sympathetic blocks do not predict the success of spinal cord stimulation.

Sensorimotor returning in complex regional pain syndrome parallels pain reduction

2005 ◽  
Vol 57 (3) ◽  
pp. 425-429 ◽  
Author(s):  
Burkhard Pleger ◽  
Martin Tegenthoff ◽  
Patrick Ragert ◽  
Ann-Freya Förster ◽  
Hubert R. Dinse ◽  
...  
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Pain Reduction

What Is a Meaningful Pain Reduction in Patients With Complex Regional Pain Syndrome Type 1?

2003 ◽  
Vol 19 (5) ◽  
pp. 281-285 ◽  
Author(s):  
Tymour Forouzanfar ◽  
Wilhelm E. J. Weber ◽  
Marius Kemler ◽  
Maarten van Kleef
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Pain Reduction ◽  
Syndrome Type

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

2008 ◽  
Vol 16 (1) ◽  
pp. 27-35 ◽  
Author(s):  
Nirmeen Zagzoog ◽  
Shrikant J Chinchalkar ◽  
Thelma Sumsion
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Client Satisfaction ◽  
Pain Syndrome ◽  
The Body ◽  
Unique Contribution ◽  
Therapy Regimen ◽  
Therapy Program ◽  
Level Of Satisfaction ◽  
Before And After ◽  
High Level

Complex regional pain syndrome (CRPS) is a neuropathic pain condition that may develop following trauma to an extremity. Clients treated for CRPS at St Joseph's Health Care London – Hand and Upper Limb Centre, London, Ontario, were asked to evaluate their level of satisfaction with the treatment they had received by comparing their pain, functional status and emotional status before and after receiving therapy. The results indicated a high level of satisfaction among clients, attributable to the unique nature of the therapy program in use at this facility, where the occupational therapist works in close collaboration with the surgeon and pain specialists, and the therapy regimen is designed for each client individually according to his or her needs. The unique contribution of the present study to the body of clinical literature on CRPS is that it introduces a focus on client functionality and on client satisfaction with therapy received.

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