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.

scholarly journals Effects of Five Daily Activities on Harmonic Analysis of the Radial Pulse

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Pan-Jen Chen ◽  
Han-Kuei Wu ◽  
Po-Chi Hsu ◽  
Lun-Chien Lo ◽  
Hen-Hong Chang ◽  
...  
Keyword(s):  
Radial Artery ◽  
Pulse Signal ◽  
The Body ◽  
Daily Activities ◽  
Radial Pulse ◽  
Pulse Diagnosis ◽  
Before And After ◽  
Pulse Waves ◽  
High Level ◽  
Fast Fourier Analysis

All daily physiological activities have some effects on the body, and traditional Chinese medicine believes that pulse diagnosis can reflect the circulation of qi and blood throughout the body. This study aimed to explore the effects of five physiological activities, namely, sleep, exercise, ingestion, defecation, and shower, on pulse waves of the radial artery. Thirty test subjects were recruited for the study, and a wearable pulse signal measurement device was used for self-measurement of radial artery pulses before and after various physiological activities. All collected data were subjected to fast Fourier analysis, which transformed each wave from its time domain to frequency domain of 10 harmonics to describe the changes in pulse waves. The results were as follows: exercise and sleep had larger but opposite effects on the pulse waves; defecation and sleep relaxed the body and had the same trend of effect on the pulse waves. Both exercise and ingestion require energy to proceed, and both exert a burden on the body, and the pulse waves showed the same trend of changes. In contrast, shower had a little effect on the pulse waves. Preliminary observation in this study showed that relaxation of the body could increase high-level harmonics, whereas stress could increase low-level harmonics. Further studies are warranted to unravel the physiological significance of this finding.

Fields of promoted actions for facilitating multitasking activity during a medical emergency

2017 ◽  
Vol 3 (2) ◽  
pp. 70-72 ◽  
Author(s):  
Thierry Morineau ◽  
Pascal Chapelain ◽  
Marion Le Courtois ◽  
Jean-Marc Le Gac
Keyword(s):  
Spatial Arrangement ◽  
Medical Emergency ◽  
Clinical Event ◽  
Team Members ◽  
Emergency Team ◽  
Advantages And Disadvantages ◽  
Level Of Satisfaction ◽  
Adverse Clinical Event ◽  
Before And After ◽  
High Level

BackgroundAn adverse clinical event requires emergency team coordination and multitasking activity. Based on studies in ecological psychology, we propose that a structured ambient environment can implicitly facilitate these requirements.MethodWe designed a new configuration of work in which spatial zones were specified as fields of promoted actions for doctors, nurses and nursing auxiliaries. 6 emergency teams were confronted with scenarios in a simulation setting, either with a traditional configuration of work or with the new configuration.ResultsSignificantly, each kind of caregiver respected the delimited spatial zones: 91.5% of occupation time for doctors, 97.1% for nurses and 95.3% for nursing auxiliaries. The mean durations of occupation of a same zone by the nursing auxiliaries and another caregiver decreased significantly, thus reducing the likelihood of mutual disturbance. Readiness for multitasking activity measured before and after experiencing the work configuration increased significantly among caregivers. An ergonomic evaluation scale showed a high level of satisfaction among caregivers (68.5 points out of 100). Participants also indicated the advantages and disadvantages of this new work configuration.ConclusionsThis study is a first step towards recommendations to standardise the positioning of emergency team members and for a new spatial arrangement of equipment.

scholarly journals Altered updating of bodily and spatial representations following tool-use in Complex Regional Pain Syndrome

2019 ◽  
Author(s):  
Axel D. Vittersø ◽  
Gavin Buckingham ◽  
Monika Halicka ◽  
Michael J. Proulx ◽  
Janet H. Bultitude
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Upper Limb ◽  
Tool Use ◽  
Pain Syndrome ◽  
Peripersonal Space ◽  
The Body ◽  
Lower Limbs ◽  
Spatial Representations ◽  
Hand Temperature ◽  
Free People

AbstractDistorted representations of the body and peripersonal space are common in Complex Regional Pain Syndrome (CRPS), and might modulate its symptoms (e.g. asymmetric limb temperature). In pain-free people, such representations are malleable, and update when we interact with objects in our environment (e.g. during tool-use). Distortions are also common after immobilisation, but quickly normalise once movement is regained. We tested the hypothesis that people with CRPS have problems updating bodily and spatial representations, which contributes to the maintenance of their distorted representations by preventing normalization. We also explored spatially defined modulations of hand temperature asymmetries, and any influence of updating bodily and spatial representations on this effect. Thirty-six people with unilateral CRPS (18 upper limb, 18 lower limb) and 36 pain-free controls completed tool-use tasks considered to alter body and peripersonal space representations (measured using tactile distance judgements and a visuotactile crossmodal congruency task, respectively). We also tested how the arrangement (crossed, uncrossed) of the hands and tools affected hand temperature. In upper limb CRPS the non-affected arm representation updated normally, but the affected arm representation updated in the opposite to normal direction. A similar pattern was seen in lower limbs CRPS, although not significant. Furthermore, people with CRPS showed more pronounced updating of peripersonal space than the controls. We did not observe any modulation of hand temperature asymmetries by the arrangement of hands or tools. Our findings suggest enhanced malleability of bodily and spatial representations in CRPS, potentially implicating central mechanisms in the aetiology of this condition.

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.

Co-morbidity between trigeminal autonomic cephalalgias and complex regional pain syndrome: Two case reports

Cephalalgia ◽  
2021 ◽  
pp. 033310242110582
Author(s):  
Peter D Drummond ◽  
Philip M Finch
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Upper Limb ◽  
Case Reports ◽  
Stellate Ganglion ◽  
Pain Syndrome ◽  
Pain Modulation ◽  
The Body ◽  
Trigeminal Autonomic Cephalalgias ◽  
Mechanical Stimuli ◽  
Co Morbidity

Background Trigeminal autonomic cephalalgias and complex regional pain syndrome are rare conditions, and their co-occurrence has not been reported previously. Clinical findings: In two patients, ipsilateral trigeminal autonomic cephalalgias developed after the onset of upper limb complex regional pain syndrome. Hyperalgesia to thermal and mechanical stimuli extended beyond the affected limb to encompass the ipsilateral forehead, and was accompanied by ipsilateral hyperacusis and photophobia. In addition, examination of the painful limb and bright light appeared to aggravate symptoms of trigeminal autonomic cephalalgias. Detailed examination of the association between facial and upper limb pain indicated that both sources of pain cycled together. Furthermore, in one case, stellate ganglion blockade inhibited pain for an extended period not only in the affected limb but also the face. Conclusions These findings suggest some overlap in the pathophysiology of complex regional pain syndrome and trigeminal autonomic cephalalgias. Specifically, central sensitization and/or disruption of inhibitory pain modulation on the affected side of the body in complex regional pain syndrome might trigger ipsilateral cranial symptoms and increase vulnerability to trigeminal autonomic cephalalgias.

Complex Regional Pain Syndrome of the Upper and Lower Extremity

2018 ◽  
Author(s):  
Agnes Stogicza ◽  
Bartha Peter Tohotom ◽  
Edit Racz ◽  
Andrea Trescot ◽  
Alan Berkman
Keyword(s):  
Nervous System ◽  
Sympathetic Nervous System ◽  
Complex Regional Pain Syndrome ◽  
Medication Management ◽  
Pain Syndrome ◽  
The Body ◽  
Loss Of Function ◽  
Early Presentation ◽  
Temperature Changes ◽  
Sympathetic Nervous

Complex regional pain syndrome (CRPS) is a chronic debilitating pain condition of the extremities; it can affect, less commonly, other areas of the body (face, pelvis, abdomen). Its early presentation—pain disproportionate to the injury, skin temperature changes, hyperalgesia, allodynia—is often not recognized, delaying treatment. In later phases, with sympathetic nervous system involvement, it presents with skin and muscle atrophy, hair loss, allodynia, loss of function, and decreased range of motion. In severe cases, it can spread from one area to the other. Imaging findings (X-ray, MRI, bone scintigraphy) are nonspecific. They are used to support the diagnosis, and to exclude conditions that can present similarly. Treatment is challenging and includes physical therapy, psychologic support, medication management, and minimally invasive interventions to decrease pain, to positively influence the sympathetic nervous system, and to preserve function. A multidisciplinary approach is likely to be the most beneficial.

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