Treatment of reflex sympathetic dystrophy using the stress-loading program

Effect of stress loading combined with fluido-therapy on CRPS-1 in stroke hemiplegics.

“…The result of this study is supported by the study of Carlson and Watson [21]. In 1987, Watson and Carlson described the first active stress-loading program for patients with CRPS-I.…”

“…There is a significant reduction of pain in experimental group than that of control group(p=0.001).Stress loading may work by normalizing afferent input in to the spinal cord, which resets altered central processes and normalizes pain response(i.e eliminates allodynia) and neurovascular tone. According to Carlson and Watson(1988),this theoretical rationale is similar to proprioceptive neuromuscular facilitation(PNF), which is described as" methods of promoting or hastening the response of the neuro muscular mechanism through stimulation of the proprioceptors [21]. A theoretical rationale for the use of stress loading in RSD is presented in light of current theories of RSD and exercise physiology.…”

“…Exercise, if of sufficient intensity, duration and frequency, places a demand on tissues that causes adaptive changes. Active loading of the involved tissues in RSD provides input to the central nervous system, which is hypothesized to alter the abnormal sympathetic output and break up the pain cycle [21].…”

“…In 1987, Watson and Carlson described the first active stress-loading program for patients with CRPS-I. With a progressive scrub and carry loading program, they reported an improvement in pain (65%), motion (65%) in 41 patients with CRPS of the hand [21]. The reduction of pain may be attributed to the use of stress loading that might have reduced allodynia and use of fluido therapy that provided analgesic effect on the affected area of hand and wrist.…”

“…For stress loading Carlson L K and Watson H K ,1987 protocol was used [21,22]. The Dystrophile@ Device that is used in the standard protocol was not used in the study rather a handled scrub was used against a wooden ply.…”