Article

Complex regional pain syndrome (CRPS) is a pathologic condition in which the
painful experience is disproportionate in time and intensity in comparison with
the inciting event. At present,
the pathophysiology of CRPS is not well
understood. Several studies have indicated that cortical reorganization plays a
role in the persistence of the symptoms. A new promising approach, graded motor
imagery (GMI), seems to be effective, but there are limited data for the CRPS-1
upper extremity population.
The aim of this study was to demonstrate the
effectiveness of a modified GMI (mGMI) protocol based on the work of Moseley to
reduce pain and enhance functional capacities for a population with nonchronic
CRPS-1 of the upper extremity. The following outcome measures were used to assess
the clinical effectiveness: pain (short form of the McGill Pain Questionnaire),
grip force (Martin vigorimeter), perception of upper extremity function
(Disabilities of the Arm, Shoulder and Hand Questionnaire), and patient's global
impression of change. All outcomes at T4 were compared with the baseline data
(T0) using the Mann-Whitney test and the chi test (nonparametric tests). Seven
patients were recruited for the study. At the end of the mGMI (T4), we obtained
significant results for the decrease in the pain experienced in the last 7 days
(visual analog scale; P=0.046), improvement in the affected extremity grip force
(P=0.042), and the patient's global impression of change (P=0.015). However, the
data of the perception of upper extremity function (Disabilities of the Arm,
Shoulder and Hand Questionnaire) were not clinically or statistically
significant. Our results indicate that this mGMI protocol seems to be a promising
therapeutic modality to reduce pain. However, more investigations are needed to
determine whether mGMI has a significant impact on upper extremity function.

Langue : ANGLAIS