Article

Although controversial, an amputation for longstanding and
therapy-resistant Complex Regional Pain Syndrome Type I (CRPS-I) may improve
quality of life and pain intensity. Resilience, the way people deal with
adversity in a positive way may be related to these positive outcomes. This study
focused on the relationship between resilience and post-amputation outcomes, i.e.
quality of life, pain and recurrence of CRPS-I and psychological distress.
METHOD: Twenty-six patients with an amputation related to CRPS-I filled in the
Connor-Davidson Resilience Scale (CD-RISC), World Health Organisation -- Quality
of life Assessment (WHOQOL-Bref) and the Symptom Checklist-90 Revised (SCL-90-R).
An interview was conducted and a physical examination performed. Results were
compared with reference groups from literature and a control group from the
outpatient rehabilitation clinic at our medical center. RESULTS: Resilience
correlated significantly with all domains of the WHOQOL-Bref (rho ranged from
0.41 to 0.72) and negatively with all domains of the SCL-90-R (rho ranged from
-0.39 to -0.68). Patients with an amputation because of CRPS-I have higher scores
on resilience and quality of life than the control group. Resilience was lower in
patients who reported CRPS-I symptoms compared to those who did not. CONCLUSIONS:
The results confirmed our hypothesis that patients with an amputation because of
CRPS-I who have a higher resilience also have a higher quality of life and
experience lower psychological distress. The prognostic value of resilience in
this patient group requires further research. Implications for Rehabilitation
Until characteristics of patients with positive quality of life outcome have been
further unraveled, amputation for CRPS-I should only be performed in expertise
centers. Resilience, the process of adapting well in the face of adversity,
should be further explored in Rehabilitation Medicine research in general.
Measurement of resilience should be a standard procedure when patients with
CRPS-I request an amputation. Improving resilience of patients in in- and
outpatient rehabilitation clinics might be an additional treatment in
rehabilitation care.

Langue : ANGLAIS