The effects of whirlpool bath and neuromuscular electrical stimulation on complex regional pain syndrome

Abstract

[Purpose] The aim of the present study was to investigate and compare the effects of whirlpool bath and neuromuscular electrical stimulation on complex regional pain syndrome. [Subjects and Methods] Sixty outpatients (30 per group) with complex regional pain syndrome participated. They received 15 treatment 5 days per week for 3 weeks. The outcome measures were the visual analogue scale for pain, edema, range of motion of the wrist (flexion and extension), fingertip-to-distal palmar crease distance, hand grip strength, and pinch strength. All parameters were measured at baseline (week 0) and at the trial end (week 3). [Results] There were significant improvements in all parameters after therapy in both groups. The whirlpool bath group showed significantly better improvements in the visual analogue score, hand edema, hand grip strength, wrist range of motion (both flexion and extension), fingertip-to-distal palmar crease distance, and the three-point and fingertip pinch strengths than the neuromuscular electrical stimulation group; however, the lateral pinch strengths were similar. [Conclusion] Both whirlpool bath and neuromuscular electrical stimulation are effective in the treatment of complex regional pain syndrome, but the efficacy of the whirlpool bath treatment was better.

Effectiveness of neuromuscular electrical stimulation for reducing oedema: A systematic review

“…Upper limb oedema. Similar to the results of studies assessing NMES for reducing lower limb oedema, there are 2 studies that support the feasibility and effectiveness of NMES for reducing upper limb oedema (16)(17). Other benefits found were improvements in pain, function, range of motion and strength.…”

“…1 and a summary of the studies sourced is shown in Table III. Seven studies assessed the role of NMES for reducing oedema (11)(12)(13)(14)(15)(16)(17). Oedema size, or swelling, was a primary outcome measure in all the included studies.…”

“…Within the studies sourced, there is a wide variation in the parameters utilized, but, in general, NMES was applied for periods of 20-30 min. Stimulation occurred once a day in 5 studies (12)(13)(14)(15)17), 5 times per week in one study (16), and reduced from 3 times, to 2 times, to once per month, in 1 study (11). The majority of studies support the use of a higher dose for a short period of time, as opposed to a low dose for a long period of time.…”

“…Reporting within the studies was generally consistent. Six studies scored the maximum attainable score for clearly describing the study aims and objectives (12)(13)(14)(15)(16)(17). External validity was low scoring, generally due to study participants being selected patients, small study size and a lack of description of the facility in which the study was undertaken.…”

“…Internal validity was generally high scoring, with 5 studies scoring maximum marks (12,(14)(15)(16)(17). Marks were lost from 2 studies (11,13) due to the absence of reported patient compliance (item 19).…”