Short- and Long-term Outcomes of Children with Complex Regional Pain Syndrome Type I Treated with Exercise Therapy

Abstract

Intense exercise therapy is effective in initially treating childhood CRPS and is associated with low rate of long-term symptoms or dysfunction.

Neuropathic pain: a practical guide for the clinician

“…Some reports suggest benefits of conservative interventions such as exercise, 76 transcutaneous electrical nerve stimulation, 77 percutaneous electrical nerve stimulation, 78 graded motor imagery 79 and cognitive behavioural therapy or supportive psychotherapy.…”

A Child Patient Followed-up with the Diagnosis of Recurrent Complex Regional Pain Syndrome

“…Which of these pathophysiological changes mediates the bone changes is still a matter of dispute (11). The increased absorption of the tracer in bone scan may point to neurogenic inflammation, decreased sympathetic activity or bone demineralization caused by active bone metabolism (8,12). Bone scan may be used in determining patients who would benefit from biphosphonate therapy.…”

“…Bone scan may be used in determining patients who would benefit from biphosphonate therapy. In contrast to adults, bone scans in children and adolescents display diffuse decreased tracer absorption in all three stages of the disorder, but bone scans with increased absorption have also been reported (10)(11)(12)(13)(14)(15). A study reported that among 103 children with CRPS, the bone scan of the affected area showed increased accumulation of the radiotracer in 31, decreased accumulation in 11, and normal absorption in the rest (14).…”

Distrofia simpático-reflexa

“…Reflex sympathetic dystrophy generally affects lower limbs and is rarely bilateral. 3,6,[8][9][10] Wilder et al 7 observed 70 children with RSD and found that 87% of episodes occurred in lower limbs and that 31% of the children exhibited events in more than one location.…”

“…[7][8][9]12 Two studies 7,15 evaluated children with RSD, employing physiotherapy, TENS (transcutaneous electrical nerve stimulation) and psychotherapy, almost always associated with NHAI. This treatment was effective for around 70% of the patients, with significant functional improvements.…”