Physical therapy and cognitive-behavioral treatment for complex regional pain syndromes
Physical therapy and cognitive-behavioral treatment for complex regional pain syndromes
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DOI：
10.1067/mpd.2002.124380
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发表时间：
2002-07-01
影响因子：
5.1
通讯作者：
Berde, CB
中科院分区：
文献类型：
--
作者：
Lee, BH;Scharff, L;Berde, CB
复杂性局部疼痛综合征（CRPS; 1型，反射性交感神经营养不良，2型，头痛）涉及持续性疼痛、异常性疼痛和血管扩张体征。我们对CRPS儿童和青少年进行了一项前瞻性、随机、单盲的物理治疗（PT）和认知行为治疗试验。将8至17岁的儿童（n = 28）随机分配至A组（PT每周1次，持续6周）或B组（PT每周3次，持续6周）。两组均接受6次认知行为治疗。在两个随访时间段重复评估疼痛和功能。通过使用参数或非参数方差分析和事后检验比较三个时间点的结局。治疗后，两组患者的疼痛和功能的所有五项指标均显著改善，大多数患者在长期随访中持续获益。50%的患者报告复发，10例患者最终接受了交感神经阻滞。大多数患有CRPS的儿童通过非侵入性康复治疗方法表现出疼痛减轻和功能改善。长期功能结果也非常好。（J Pediatr 2002;141：135-40）。
Complex regional pain syndromes (CRPS; type 1, reflex sympathetic dystrophy, and type 2, causalgia) involve persistent pain, allodynia, and vasomotor signs. We conducted a prospective, randomized, single-blind trial of physical therapy (PT) and cognitive-behavioral treatment for children and adolescents with CRPS. Children 8 to 17 years of age (n = 28) were randomly assigned to either group A (PT once per week for 6 weeks) or group B (PT 3 times per week for 6 weeks). Both groups received 6 sessions of cognitive-behavioral treatment. Assessments of pain and function were repeated at two follow-up time periods. Outcomes were compared at the three time points through the use of parametric or nonparametric analysis of variance and post hoc tests. All five measures of pain and function improved significantly in both groups after treatment, with sustained benefit evident in the majority of patients at long-term follow-up. Recurrent episodes were reported in 50% of patients, and 10 patients eventually received sympathetic blockade. Most children with CRPS showed reduced pain and improved function with a noninvasive rehabilitative treatment approach. Long-term functional outcomes were also very good. (J Pediatr 2002;141:135-40).